Aversion to pragmatic randomised controlled trials: three survey experiments with clinicians and laypeople in the USA.

Objectives: Pragmatic randomised controlled trials (pRCTs) are essential for determining the real-world safety and effectiveness of healthcare interventions. However, both laypeople and clinicians often demonstrate experiment aversion: preferring to implement either of two interventions for everyone rather than comparing them to determine which is best. We studied whether clinician and layperson views of pRCTs for COVID-19, as well as non-COVID-19, interventions became more positive during the pandemic, which increased both the urgency and public discussion of pRCTs.

Whole-exome sequencing in UK Biobank reveals rare genetic architecture for depression.

Nearly two hundred common-variant depression risk loci have been identified by genome-wide association studies (GWAS). However, the impact of rare coding variants on depression remains poorly understood. Here, we present whole-exome sequencing analyses of depression with seven different definitions based on survey, questionnaire, and electronic health records in 320,356 UK Biobank participants.

Comparison of Clinical Decision Support Tools to Improve Pediatric Lipid Screening.

Objective: To test whether different clinical decision support tools increase clinician orders and patient completions relative to standard practice and each other.

Study Design: A pragmatic, patient-randomized clinical trial in the electronic health record was conducted between October 2019 and April 2020 at Geisinger Health System in Pennsylvania, with 4 arms: care gap-a passive listing recommending screening; alert-a panel promoting and enabling lipid screen orders; both; and a standard practice-no guideline-based notification-control arm. Data were analyzed for 13 346 9- to 11-year-old patients seen within Geisinger primary care, cardiology, urgent care, or nutrition clinics, or who had an endocrinology visit.

An illusion of predictability in scientific results: Even experts confuse inferential uncertainty and outcome variability.

Traditionally, scientists have placed more emphasis on communicating inferential uncertainty (i.e., the precision of statistical estimates) compared to outcome variability (i.

Experiment aversion among clinicians and the public - an obstacle to evidence-based medicine and public health.

Background: Randomized controlled trials (RCTs) are essential for determining the safety and efficacy of healthcare interventions. However, both laypeople and clinicians often demonstrate experiment aversion: preferring to implement either of two interventions for everyone rather than comparing them to determine which is best. We studied whether clinician and layperson views of pragmatic RCTs for Covid-19 or other interventions became more positive early in the pandemic, which increased both the urgency and public discussion of RCTs.

The Social Shapes Test as a Self-Administered, Online Measure of Social Intelligence: Two Studies with Typically Developing Adults and Adults with Autism Spectrum Disorder.

The Social Shapes Test (SST) is a measure of social intelligence which does not use human faces or rely on extensive verbal ability. The SST has shown promising validity among adults without autism spectrum disorder (ASD), but it is uncertain whether it is suitable for adults with ASD. We find measurement invariance between adults with (n = 229) or without ASD (n = 1,049) on the 23-item SST.

Association of Developmental Language Disorder With Comorbid Developmental Conditions Using Algorithmic Phenotyping.

Importance: Developmental language disorder (DLD) is a common (with up to 7% prevalence) yet underdiagnosed childhood disorder whose underlying biological profile and comorbidities are not fully understood, especially at the population level.

Objective: To identify clinically relevant conditions that co-occur with DLD at the population level.

Design, Setting, And Participants: This case-control study used an electronic health record (EHR)-based population-level approach to compare the prevalence of comorbid health phenotypes between DLD cases and matched controls.

Using game-like animations of geometric shapes to simulate social interactions: An evaluation of group score differences.

This study introduces a novel, game-like method for measuring social intelligence: the Social Shapes Test. Unlike other existing video or game-based tests, the Shapes Test uses animations of abstract shapes to represent social interactions. We explore demographic differences in Shapes Test scores compared to a written situational judgment test.

Prediction of Influenza Complications: Development and Validation of a Machine Learning Prediction Model to Improve and Expand the Identification of Vaccine-Hesitant Patients at Risk of Severe Influenza Complications.

Influenza vaccinations are recommended for high-risk individuals, but few population-based strategies exist to identify individual risks. Patient-level data from unvaccinated individuals, stratified into retrospective cases (n = 111,022) and controls (n = 2,207,714), informed a machine learning model designed to create an influenza risk score; the model was called the Geisinger Flu-Complications Flag (GFlu-CxFlag). The flag was created and validated on a cohort of 604,389 unique individuals.

A 680,000-person megastudy of nudges to encourage vaccination in pharmacies.

Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principles to nudge flu vaccination or to a business-as-usual control condition that received no messages.

Effect of Targeted Behavioral Science Messages on COVID-19 Vaccination Registration Among Employees of a Large Health System: A Randomized Trial.

This randomized trial evaluates whether individually addressed emails designed with behaviorally informed features increase COVID-19 vaccination rates.

A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor's appointment.

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment ( = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%.

Can You Ever Be Too Smart for Your Own Good? Comparing Linear and Nonlinear Effects of Cognitive Ability on Life Outcomes.

Despite a long-standing expert consensus about the importance of cognitive ability for life outcomes, contrary views continue to proliferate in scholarly and popular literature. This divergence of beliefs presents an obstacle for evidence-based policymaking and decision-making in a variety of settings. One commonly held idea is that greater cognitive ability does not matter or is actually harmful beyond a certain point (sometimes stated as > 100 or 120 IQ points).

Attributing social meaning to animated shapes: A new experimental study of apparent behavior.

In 1944, Heider and Simmel reported that observers could perceive simple animated geometric shapes as characters with emotions, intentions, and other social attributes. This work has been cited over 3000 times and has had wide and ongoing influence on the study of social cognition and social intelligence. However, many researchers in this area have continued to use the original Heider and Simmel black-and-white video.

Informing patients that they are at high risk for serious complications of viral infection increases vaccination rates.

For many vaccine-preventable diseases like influenza, vaccination rates are lower than optimal to achieve community protection. Those at high risk for infection and serious complications are especially advised to be vaccinated to protect themselves. Using influenza as a model, we studied one method of increasing vaccine uptake: informing high-risk patients, identified by a machine learning model, about their risk status.

Putting the Self in Self-Correction: Findings From the Loss-of-Confidence Project.

Science is often perceived to be a self-correcting enterprise. In principle, the assessment of scientific claims is supposed to proceed in a cumulative fashion, with the reigning theories of the day progressively approximating truth more accurately over time. In practice, however, cumulative self-correction tends to proceed less efficiently than one might naively suppose.

Measuring and Controlling for the Compromise Effect When Estimating Risk Preference Parameters.

The compromise effect arises when being close to the "middle" of a choice set makes an option more appealing. The compromise effect poses conceptual and practical problems for economic research: by influencing choices, it can bias researchers' inferences about preference parameters. To study this bias, we conduct an experiment with 550 participants who made choices over lotteries from multiple price lists (MPLs).

The causal influence of brain size on human intelligence: Evidence from within-family phenotypic associations and GWAS modeling.

There exists a moderate correlation between MRI-measured brain size and the general factor of IQ performance (), but the question of whether the association reflects a theoretically important causal relationship or spurious confounding remains somewhat open. Previous small studies ( < 100) looking for the persistence of this correlation within families failed to find a tendency for the sibling with the larger brain to obtain a higher test score. We studied the within-family relationship between brain volume and intelligence in the much larger sample provided by the Human Connectome Project ( = 1,022) and found a highly significant correlation (disattenuated = 0.

Objecting to experiments even while approving of the policies or treatments they compare.

We resolve a controversy over two competing hypotheses about why people object to randomized experiments: 1) People unsurprisingly object to experiments only when they object to a policy or treatment the experiment contains, or 2) people can paradoxically object to experiments even when they approve of implementing either condition for everyone. Using multiple measures of preference and test criteria in five preregistered within-subjects studies with 1,955 participants, we find that people often disapprove of experiments involving randomization despite approving of the policies or treatments to be tested.

Penetrance and Pleiotropy of Polygenic Risk Scores for Schizophrenia in 106,160 Patients Across Four Health Care Systems.

Objective: Individuals at high risk for schizophrenia may benefit from early intervention, but few validated risk predictors are available. Genetic profiling is one approach to risk stratification that has been extensively validated in research cohorts. The authors sought to test the utility of this approach in clinical settings and to evaluate the broader health consequences of high genetic risk for schizophrenia.