In Pursuit of credibility: Evaluating the divergence between member-checking and hermeneutic phenomenology

Credibility refers to the trustworthiness, genuineness, and plausibility of the research findings and has always been a contentious issue in qualitative research, particularly for those conducting studies on the hermeneutic phenomenology paradigm. The relationship between credibility and high qualitative research is noted by many qualitative scholars. Member checking, also known as participant or respondent validation, is a technique for exploring the credibility of results where data or results are returned to participants to check for accuracy and resonance with their experiences. Although member-checking has long been accepted as the gold standard in quantitative research, research shows that it is not the pinnacle for expressing rigor in Heideggerian hermeneutic phenomenology because it contradicts many of the underpinning philosophies. Within this article the author explores how member checking has been used in published research and presents a brief overview of the various discourses on member checking in qualitative research. The author discusses the importance of evaluating whether the method fits with the theoretical position of a study and the importance to consider how member checking was undertaken and for what purpose. It is essential that researchers are transparent about what they hope to achieve with the method and how their claims about credibility and validity fit with their epistemological stance.

Role of psychopathology on children credibility of sexual abuse testimony

When an alleged victim has a pre-existing psychopathological diagnosis, this can affect the rating of their version of the abuse in terms of credibility. The objective of this work is to analyze the relationship between the assessment of the credibility of the testimony of a CSA victim, the psychological problems that the child may have presented prior to sexual abuse and the possible psychological sequelae that she may present as a result of the abuse. 109 cases were selected in which the credibility of the testimony could be determined. Through forensic interviews and the study of the corresponding professional reports, the following were obtained: sociodemographic data, data on their previous psychological state and data on their psychological state after the reported events. The psychological state of the child after the reported events shows no relation to the forensic evaluation of the credibility of her testimony. The existence of a relationship between the absence of previous psychopathology and the fact that the victim's testimony is valued as a credible account is confirmed. This study reveals that children who presented psychological manifestations prior to their experience of abuse receive a lower credibility rating than those without previous psychopathological symptoms or diagnoses.

Does Foreign-Accented Speech Affect Credibility? Evidence from the Illusory-Truth Paradigm

In a pioneering study, Lev-Ari and Keysar (2010) observed that unknown statements are judged less credible when uttered with foreign accent compared to native accent. This finding was interpreted in terms of processing fluency; when intelligibility is reduced, the credibility of the message decreases. Here, we use the illusory truth paradigm to explore how accent affects credibility. In a between-participant design, participants were exposed to unknown statements uttered by native-accented or foreign-accented speakers. After a distractor task, the same statements were presented with new statements, and participants assessed their truthfulness. Truthfulness ratings were higher for repeated statements than for new statements, replicating the illusory truth effect. Contrary to the processing fluency hypothesis, the effect was similar in both the foreign-accented and native-accented speech groups. A new group of participants rated the speakers' voices on various social traits. A negative bias against foreign speakers was observed. However, this negative-bias did not affect truth ratings.The impact of foreign-accented speech on message credibility is discussed in the context of two factors, processing fluency and out-group stereotype activation.

Performative credibility: How opioid researchers sustain public trust during the opioid epidemic

Experts often face credibility challenges during times of crisis. However, opioid use disorder (OUD) researchers preserved their scientific credibility despite the increasing public scrutiny of medical knowledge during the opioid epidemic. Building on 30 in-depth interviews with OUD researchers, this article examines how researchers conduct scientific research, collaborate with non-expert stakeholders, and communicate research outcomes to the public. It distinguishes between performative credibility - a discourse enacted through languages, meanings, and symbols in constructing the reality of credibility, and descriptive credibility - the description, perception, and measurements of credibility under a given credibility discourse. It argues that the crisis of expertise is situational - it depends on whether and how performative credibility is sustained. This article finds that OUD researchers enact at least three credibility discourses: professional, data-driven, and community-centered. While researchers can have multiple discourses in mind, their choices of enacting a specific credibility discourse when interacting with non-experts and the public are contingent upon their rankings in the profession, medical training backgrounds, forms of patient interactions, and access to OUD medications. This case recenters sociological studies of expertise and trust on the enacting power of experts' statements and actions. It also reveals the relevance of social locations in understanding the formation of the credibility crisis. Finally, it provides a conceptual framework for understanding public (mis)trust in science and medicine.

A risk and credibility framework for in silico clinical trials of medical devices

BACKGROUND AND OBJECTIVE

The use of in silico clinical trials (ISCTs) to generate clinically-relevant data on new medical devices is an emerging area of regulatory research. Interest in ISCTs stems from recognized challenges in acquiring sufficient clinical data and the continued maturation of in silico technologies. There is currently no guidance in place for evaluating the credibility of ISCT applications. The objective of this work was to adapt an existing risk-based credibility framework specifically for ISCT applications, and demonstrate its utility on a contemporary case study.

METHODS

Expanding on guidance currently in place for assessing the risk of traditional modeling applications of medical devices and demonstrating model credibility through benchtop validation activities, a framework is proposed to (1) evaluate the model risk for ISCT applications based on the independent factors of scope, coverage, and severity, and (2) assess the credibility of clinical validation activities based on consideration of the clinical comparator, the validation model, the agreement between the two, and the applicability of the clinical validation activities to the ISCT application.

RESULTS

The resulting framework spans across the range of ISCT applications that may be envisioned, as well as the variety of clinical datasets that can be used to demonstrate model credibility. Credibility factors reflect the expected clinical variability in the validation comparator and validation model, the statistical power of the comparator, the rigor of agreement between the comparator and model in terms of both inputs and outputs, and the overall similarity of the device in the validation activities to the device within the intended ISCT. When applied to a high-risk case study, the framework reveals that planned clinical validation activities require additional rigor in order to achieve the credibility targets, enabling an assessment of the validation effort relative to the potential benefit prior to investing in the validation studies.

DISCUSSION

An objective and risk-based framework for establishing credibility requirements for ISCT applications is a critical step in advancing ISCT from theory to practice. The proposed framework enforces that appropriate validation of ISCT applications requires evidence that the intended clinical environment is accurately represented. The framework will contribute to reducing uncertainty amongst technical, clinical, and regulatory constituents on ISCT applications, and promote rational adoption.

Are popular books about diet and health written based on scientific evidence? A comparison of citations between the USA and Japan

OBJECTIVES

To describe and compare the references cited in popular books about diet and health between the USA and Japan.

DESIGN

Books were selected based on their best-seller rankings in the diet and health category of online bookstores. We identified references throughout all pages of the books and examined the number of references, reference format (identifiable or not) and presence of specific types of references, such as systematic reviews of human research. We compared the characteristics of references between the two countries and examined related factors to citation.

SETTING

Cross-sectional study.

PARTICIPANTS

Books (n 100 in each country).

RESULTS

Among 100 books from each country, sixty-five US and sixty-six Japanese books had references. Forty-five US books cited more than 100 references, against only five Japanese books. The number of books that cited systematic reviews of human research differed between the USA (n 49) and Japan (n 9). Additionally, the number of books that provided identifiable information for all references was significantly higher in the USA (n 63) than in Japan (n 42). Books whose first authors have licences of medical doctors were more likely to cite references than those without in both countries.

CONCLUSIONS

Two-thirds of books about diet and health cited references in both the USA and Japan, but Japanese books cited fewer references and were less likely to cite systematic reviews and provide identifiable references than US books. Further research into the scientific reliability of information in books about diet and health is warranted.

Whom to trust? Inferred source credibility and response borrowing in a memory task

We investigated whether people can discriminate between sources of information that are either credible or respond at random, based only on their own knowledge and the responses provided by these sources. In three experiments, participants were asked to judge the validity of trivia statements. Some statements were accompanied by true/false responses provided by either a credible source or a source whose responses were random. In Experiment 1, participants first saw a set of easy questions, which provided the basis for assessing the relative credibility of the sources, before responding to a set of difficult questions, where response borrowing was assessed. In Experiments 2 and 3, participants solved a test composed of difficult questions only, but only after studying the correct responses to all these questions. In Experiment 2, there was no delay between the study and test phases, whereas in Experiment 3, the delay was 24 hours. In all experiments, more participants explicitly identified the more credible source in the postexperimental questionnaire than misidentified the noninformative source as credible. However, differentiated response borrowing-borrowing more responses from the credible than the noninformative source-emerged only in Experiment 2. Therefore, people can often explicitly infer source credibility from the responses the sources provide. However, using these inferences to regulate response borrowing is relatively less likely and happens only under specific, favorable circumstances.

Online information on chronic pain in 3 countries: an assessment of readability, credibility, and accuracy

Objectives

To assess the readability, credibility, and accuracy of online information on chronic pain in Australia, Mexico, and Nepal.

Methods

We assessed Google-based websites and government health websites about chronic pain for readability (using the Flesch Kincaid Readability Ease tool), credibility (using the Journal of American Medical Association [JAMA] benchmark criteria and Health on the Net Code [HONcode]), and accuracy (using 3 core concepts of pain science education: (1) pain does not mean my body is damaged; (2) thoughts, emotions, and experiences affect pain; and (3) I can retrain my overactive pain system).

Results

We assessed 71 Google-based websites and 15 government websites. There were no significant between-country differences in chronic pain information retrieved through Google for readability, credibility, or accuracy. Based on readability scores, the websites were "fairly difficult to read," suitable for ages 15 to 17 years or grades 10 to 12 years. For credibility, less than 30% of all websites met the full JAMA criteria, and more than 60% were not HONcode certified. For accuracy, all 3 core concepts were present in less than 30% of websites. Moreover, we found that the Australian government websites have low readability but are credible, and the majority provided all 3 core concepts in pain science education. A single Mexican government website had low readability without any core concepts but was credible.

Conclusion

The readability, credibility, and accuracy of online information on chronic pain should be improved internationally to support facilitating better management of chronic pain.

Facial Trustworthiness Influences Age Differences in Visual Attention Toward Credible Versus Non-credible Messages

Background and Objectives

The literature on consumer decision-making and aging suggests that older adults make less optimal buying decisions than younger adults do, partly because older adults tend to perceive salespersons' faces as more trustworthy. This study aims to directly test the difference in the effect of perceived facial trustworthiness on buying intention between younger and older adults. It also aims to reveal the underlying mechanisms of this age-related difference by testing whether a more trustworthy face disrupts older adults' attention toward credible (vs. non-credible) information to a higher degree compared with younger adults.

Research Design and Methods

A sample of 92 younger (aged 18-37 years) and 83 older (aged 60-82 years) adults viewed advertisements for 32 products while their eye movements were captured by an eye tracker to measure their fixation duration (as an indicator of attention). The advertisements varied in terms of the credibility of the content and the trustworthiness of the salesperson's face.

Results

Both age groups showed higher buying intentions for products featured in advertisements with higher credibility and facial trustworthiness. When facial trustworthiness was lower, both age groups showed greater attentional preferences for credible over non-credible content. However, this distinction in attention disappeared in older but not younger adults with an increase in facial trustworthiness.

Discussion and Implications

Our findings suggest that although facial trustworthiness generally increases buying intention of both younger and older adults, it only reduces older (but not younger) adults' attentional discrimination between credible and non-credible content. This paper offers a novel and promising mechanism for the increase in fraud vulnerability in late adulthood.

The Credibility of Physician Rating Websites: A Systematic Literature Review

OBJECTIVES

Increasingly, the credibility of online reviews is drawing critical attention due to the lack of control mechanisms, the constant debate about fake reviews and, last but not least, current developments in the field of artificial intelligence. For this reason, the aim of this study was to examine the extent to which assessments recorded on physician rating websites (PRWs) are credible, based on a comparison to other evaluation criteria.

METHODS

Referring to the PRISMA guidelines, a comprehensive literature search was conducted across different scientific databases. Data were synthesized by comparing individual statistical outcomes, objectives and conclusions.

RESULTS

The chosen search strategy led to a database of 36,755 studies of which 28 were ultimately included in the systematic review. The literature review yielded mixed results regarding the credibility of PRWs. While seven publications supported the credibility of PRWs, six publications found no correlation between PRWs and alternative datasets. 15 studies reported mixed results.

CONCLUSIONS

This study has shown that ratings on PRWs seem to be credible when relying primarily on patients' perception. However, these portals seem inadequate to represent alternative comparative values such as the medical quality of physicians. For health policy makers our results show that decisions based on patients' perceptions may be well supported by data from PRWs. For all other decisions, however, PRWs do not seem to contain sufficiently useful data.

Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts

BACKGROUND

Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects.

METHODS

This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages.

RESULTS

Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κ_q) was high (Stage 1: 92% agreement [95% CI 87, 97], κ_q 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κ_q 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%).

CONCLUSION

While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

Anxiety sensitivity as a predictor, and non-specific therapeutic factors as predictors and mediators of CBT outcome for obsessive-compulsive disorder in a naturalistic mental health setting

OBJECTIVE

We examined the unique predictive strength of anxiety sensitivity (AS) and the role of expectancy, credibility, and therapeutic alliance (TA) as predictors and mediators of cognitive-behavioral treatment (CBT) outcomes in obsessive-compulsive disorder (OCD).

METHOD

The current study is a prospective cohort study. Participants (N = 116) were treatment-seeking individuals with a primary diagnosis of OCD. Independent raters assessed patients on Yale-Brown Obsessive-Compulsive Scale (YBOCS) and Anxiety Sensitivity Index-3 at baseline, post-intervention, and three-month follow-up. Participants responded to the Credibility and Expectancy questionnaire and Working Alliance Inventory-Short revised at baseline, first-session, and mid-session.

RESULTS

The individual addition of AS, end-of-first-session credibility and expectancy, mid-session credibility and expectancy, and therapeutic alliance predicted significant CBT outcomes. There was a moderate positive correlation between baseline OCD severity and the global score of AS, but a weak one with AS dimensions. Both expectancy and credibility significantly improved from baseline to end-of-first-session treatment. End-of-first and third-session outcome expectancies, not credibility, have significant, indirect effects on OCD CBT outcomes.

CONCLUSIONS

AS, within-session credibility and expectancies and TA independently predict CBT outcomes. Within-sessions outcome expectancies mediate CBT outcomes in OCD, not credibility. Expectancy and credibility both include state-like elements that can be influenced to enhance the outcomes of CBT. Proposals for reducing treatment barriers in CBT for OCD are offered.

'We don't live in a harm reduction world, we live in a prohibition world': tensions arising in the design of drug alerts

BACKGROUND

Drug alerts designed for health and community workforces have potential to avert acute harms associated with unpredictable illicit drug markets, by preparing workers to respond to unusual drug-related events, and distribute information to service users. However, the design of such alerts is complicated by diverse needs of individuals, and broader socio-political contexts. Here, we discuss the tensions that arose in the process of co-designing drug alert templates with health and community workers.

METHODS

We conducted five in-depth digital co-design workshops with 31 workers employed in alcohol and other drug and urgent care settings. Our approach to analysis was informed by Iterative Categorisation and reflexive thematic analysis methods.

RESULTS

We identified five key tensions. First, there is a need to provide comprehensive information to meet the information needs of a diverse group of workers with varying knowledge levels, while also designing alerts to be clear, concise, and relevant to the work of individuals. Second, it is important that alerts do not create 'information overload'; however, it is also important that information should be available to those who want it. Third, alert design and dissemination must be perceived to be credible, to avoid 'alert scepticism'; however, credibility is challenging to develop in a broader context of criminalisation, stigmatisation, and sensationalism. Fourth, alerts must be carefully designed to achieve 'intended effects' and avoid unintended effects, while acknowledging that it is impossible to control all potential effects. Finally, while alerts may be intended for an audience of health and community workers, people who use drugs are the end-users and must be kept front of mind in the design process.

CONCLUSIONS

The co-design process revealed complexities in designing drug alerts, particularly in the context of stigmatised illicit drug use, workforce diversity, and dissemination strategies. This study has highlighted the value of developing these important risk communication tools with their target audiences to ensure that they are relevant, useful, and impactful. The findings have informed the development of our drug alert prototypes and provide local context to complement existing best-practice risk-communications literature.

Applicability assessment for in-silico patient-specific TEVAR procedures

Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive technique to treat thoracic aorta pathologies and consists of placing a self-expandable stent-graft into the pathological region to restore the vessel lumen and recreate a more physiological condition. Exhaustive computational models, namely the finite element analysis, can be implemented to reproduce the clinical procedure. In this context, numerical models, if used for clinical applications, must be reliable and the simulation credibility should be proved to predict clinical procedure outcomes or to build in-silico clinical trials. This work aims first at applying a previously validated TEVAR methodology to a patient-specific case. Then, defining the TEVAR procedure performed on a patient population as the context of use, the overall applicability of the TEVAR modeling is assessed to demonstrate the reliability of the model itself following a step-by-step method based on the ASME V&V40 protocol. Validation evidence sources are identified for the specific context of use and adopted to demonstrate the applicability of the numerical procedure, thereby answering a question of interest that evaluates the deployed stent-graft configuration in the vessel.

When the influencer says jump! How influencer signaling affects engagement with COVID-19 misinformation

With signaling theory, credibility, and social media engagement (SME) as guiding frameworks, this study used an experiment to examine how social media influencers (SMIs) affect how people engage with COVID-19 misinformation. SMI-promoted information elicited more SME, credibility, and purchase likelihood than non-SMI promoted information. The most effective message was a post promoted by an SMI that contained detailed information about an authentic product. However, data indicated nuance regarding the effect of SMIs. The authenticity of the information as well as the amount of detail in the post played a role. Additionally, mediated effects analysis showed that the impact of SME on purchase likelihood was higher among non-SMI followers. Data suggests that using a multi-signal messaging approach is suitable regardless of promotion by an SMI. This has important implications to public health messaging and the author discusses how health agencies may effectively signal information to the public.

WHO approves? Relative trust, the WHO, and China's COVID-19 vaccines

This paper aims to answer a general question: whether an international organization (IO) is able to shape public opinion in the context of the COVID-19 pandemic. Since the pandemic took hold in early 2020, countries across the globe have switched gear from prevention to vaccination. Most had to not only secure a sufficient supply of vaccines, but also to curb vaccine hesitancy among their populations. Can endorsement by an international organization like the World Health Organization (WHO) enhance a vaccine's acceptability? Based on a survey experiment conducted in Taiwan, our study leverages the special relationship between China and Taiwan to show that WHO endorsement can induce acceptance of Chinese vaccines among Taiwanese people. However, the effect is found to be contextual in the sense that it only works when people's trust in the WHO is higher than their trust in the vaccine's country of origin. Our study not only contributes to the literature of IO legitimacy by empirically showing IOs' causal effects on public opinion, but also sheds light on how a vaccine's credibility can be enhanced to promote vaccination uptake.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11558-022-09481-1.

Dimensions of uncertainty communication: What is conveyed by verbal terms and numeric ranges

The paper reviews two strands of research on communication of uncertainty that usually have been investigated separately: (1) Probabilities attached to specific outcomes, and (2) Range judgments. Probabilities are sometimes expressed by verbal phrases ("rain is likely") and at other times in a numeric format ("70% chance of rain"), whereas range judgments describe the potential amounts expected ("1-4 mm of rain"). Examination of previous research shows that both descriptions convey, in addition to the strength of expectations, pragmatic information about the communicative situation. For instance, so-called verbal probability expressions (VPE), as likely, unlikely, a chance, or not certain give some, albeit vague, probabilistic information, but carry in addition an implicit message about the sources of uncertainty, the outcome's valence and severity, along with information about the speakers' attitudes and their communicative intentions. VPEs are directional by drawing attention either to an outcome's occurrence ("it is possible") or to its non-occurrence ("it is doubtful"). In this sense they may be more informative than numbers. Uncertainties about outcomes in a distribution (continuous quantities) are alternatively expressed as interval estimates. The width of such intervals can function as a cue to credibility and expertise. Incomplete, one-sided intervals, where only one boundary is stated, imply directionality. "More than 100 people" suggests a crowd, while "less than 200" implies a shortfall. As with VPEs, directionally positive intervals are more frequent, and perhaps more neutral than negative ones. To convey expectancies and uncertainty in a balanced way, communicators may have to alternate between complementary frames.

Putting your best face forward: How instructor emoji use influences students' impressions of credibility, immediacy, and liking

This project explores the impacts of emojis on students' impressions when used in a course welcome email. We adopt a 4 × 3 factorial design to determine how different emojis (i.e., , , ) impact students' impressions of credibility, immediacy, and liking. Data from students (N = 368) indicates emoji choice does impact impressions. Consistently, instructors' emoji use resulted in decreased perceived competence and trustworthiness but increased perceived caring, immediacy, and liking. Findings have implications for instructors who engage in technologically-mediated out-of-class communication and want to strengthen early student-instructor relationships. Limitations and future directions are also discussed.

Macroeconomic expectations, central bank communication, and background uncertainty: A COVID-19 laboratory experiment

This paper explores the robustness of laboratory expectation formation and public signal credibility to external uncertainty shocks and online experimentation. We exploit the recent pandemic as a source of exogenous background uncertainty in a New Keynesian learning-to-forecast experiment (LtFE) where participants receive projections of varying precision about future inflation. We compare results from identical LtFE completed immediately before the onset of the pandemic, soon after (online), and well after (online and in-person). Baseline LtFEs with no communication are robust to both factors. However, both background uncertainty and online experimentation impact how subjects use public signals. The pandemic led to a decreased appetite for and tolerance of overly precise communication while increasing the efficacy of projections that also convey uncertainty. Subjects became more averse to central bank forecast errors after the onset of the pandemic if the central bank conveyed a precise outlook but not if it conveyed forecast uncertainty.

Characterising trusted spokespeople in noncommunicable disease prevention: A systematic scoping review

Noncommunicable diseases (NCD) are an increasing global threat. Utilising public policy to address NCDs can reduce incidence and prevalence. However, NCD-relevant public policy action is minimal in many countries as changing public policy is difficult and multifactorial. Two factors that may influence this process is the message people receive and the messenger delivering it. To date, much health communication research has focused on message content, with limited research on messengers that are trusted by policymakers and the public to communicate NCD matters. We aimed to review the literature to characterise who the public and policymakers consider to be trustworthy and/or credible for NCD messaging, and why this might be the case. Arksey and O'Malley's scoping review methodology guided the review. A systematic search of three databases up to June 2021 combined with hand searching of review reference lists was undertaken. Nineteen articles were included. Data extraction focused on study design, issue being influenced, spokesperson studied, and measures of trust. Results showed health professionals were the most-frequently trusted sources of information. Other spokespeople, such as government sources or religious leaders, were only trustworthy in some contexts, and even distrusted in others. Reasons why spokespeople were trusted included technical expertise, strategic engagement with stakeholders, and reputation. However, we also found the nature of trust and credibility of spokespeople is dependent on the studied population and context. Overall, characteristics of influential messengers were nonspecific. Thus, trusted messengers and their characteristics in NCD-messaging must be better understood to develop and maintain the trust of the public and policymakers.

What is the believability of evidence that is read or heard by physical therapists?

BACKGROUND

Physical therapists obtain information from a variety of sources. The sources may influence their believability and use in clinical practice.

OBJECTIVES

In this hypothesis-based study, we queried physical therapists (PTs) on the believability of evidence across six musculoskeletal treatment domains and analyzed variables that predicted the strength of beliefs.

METHODS

This international survey included six different language portals and used a snowball dispensation strategy. PTs who were credentialed, licensed, or who practiced in the field, were queried on the believability of six treatment domains (i.e., exercise, manual therapy, psychologically-informed practice, sports/occupational performance, thermal/electrical agents, and pain science/patient education) and potential predictors of believability (i.e., social media use, years of practice, time and access to literature, specialization, confidence in reviewing literature and attributions of the researcher).

RESULTS

In total, 1098 PTs from 36 countries completed the survey. PTs had strong beliefs in what they read or hear about exercise, sports/occupational performance, pain science/patient education, and psychologically-informed interventions. There was only moderate believability regarding manual therapy treatment and weak believability associated with thermal/electrical agents. Multiple linear regression analyses revealed that the most robust predictor to outcome relationships included time and access to literature and believability of pain science/patient education, years of clinical practice and believability of psychologically informed practice, and believability of thermal/electrical agents.

CONCLUSION

An important takeaway from this study is that believability was influenced by several factors (primarily by years of practice, attributions of the researcher, and time and access to literature) and appeared to vary across treatment domains.

Estimates of major non-communicable disease risk factors for India, 2010 & 2015: A summary of evidence

Background & objectives

The National Monitoring Framework for the prevention and control of NCDs in India has set targets for reduction of risk factors relative to the measure recorded in 2010. Estimates for 2010 and 2015 were established using meta-analyses in the absence of a national risk factor survey till 2017.

Methods

We searched national survey reports and also articles published in English from India between 2008 and 2017 in PubMed, Google Scholar and Cochrane review databases for specific risk factors among 18-69 yr Indians. Quality of studies was evaluated using Joanna-Briggs tool, but all studies were included in analyses. Estimates for each of the eight strata by age, gender and place of residence, respectively, were generated. MetaXL was used to calculate the pooled estimate for 2010 and 2015 using a random effects model. Strata-specific estimates were combined to arrive at national estimate using population weight of each stratum. The credibility of the estimates was determined using four parameters - average Briggs score; representativeness of the contributing studies and precision and stability of the estimates.

Results

The estimates [95% confidence interval (CI)] for 2010 for different risk factors were as follows: current alcohol use, 15.7 per cent (13.2-18.2); current tobacco use, 27 per cent (21.4-32.6); household solid fuel use, 61.5 per cent (50.2-72.5); physical inactivity, 44.2 per cent (37.8-50.6); obesity, seven per cent (3.8-10.2) and raised blood pressure, 20.2 per cent (18.4-22.1). In 2015, compared to 2010, tobacco use showed a relative decline of 18 per cent, household solid fuel use of nine per cent and physical inactivity of 15 per cent. The estimates were stable for alcohol use, raised blood pressure and obesity between 2010 and 2015. All estimates varied between moderate and high degrees of credibility.

Interpretation & conclusions

The estimates are consistent with other available estimates and with current national-level initiatives focused on tobacco control and improving access to clean fuel. These estimates can be used to monitor progress on non-communicable disease risk factor targets for India.

The vaccine equity crisis is a stress test for all future major environmental challenges

The vaccine equity crisis has an extra element that makes it crucial for our capacity to tackle future major societal challenges. Unlike most of these, including the climate one, the current pandemic causes major damage that is directly observable in the very short term, that is, within the political cycle of the incumbent policymakers. If not even this kind of crisis with directly observable damage is able to influence the incentive structure of policymakers and lead to the adoption of timely and effective measures, there is no reason to expect that this would ever happen for crises whose effects largely materialize in future political cycles. As a consequence, if we fail to tackle this particular crisis effectively now, we are creating an enormous credibility problem for future crises that could seriously undermine our capacity to reach binding agreements in the future.

Combating Misinformation by Sharing the Truth: a Study on the Spread of Fact-Checks on Social Media

Misinformation on social media has become a horrendous problem in our society. Fact-checks on information often fall behind the diffusion of misinformation, which can lead to negative impacts on society. This research studies how different factors may affect the spread of fact-checks over the internet. We collected a dataset of fact-checks in a six-month period and analyzed how they spread on Twitter. The spread of fact-checks is measured by the total retweet count. The factors/variables include the truthfulness rating, topic of information, source credibility, etc. The research identifies truthfulness rating as a significant factor: conclusive fact-checks (either true or false) tend to be shared more than others. In addition, the source credibility, political leaning, and the sharing count also affect the spread of fact-checks. The findings of this research provide practical insights into accelerating the spread of the truth in the battle against misinformation online.

Pragmatic and knowledge range lenience towards foreigners

Foreign-accented speech categorizes the speaker as an outgroup individual with a lower linguistic competence and a different knowledge heritage from a native speaker. Here we explore whether the identification of an individual as a native or a foreign speaker has an impact on trivia statement judgments, regardless of her foreign-accented speech. Italian native participants first read a bio description of a native and of a foreign speaker and then rate to what degree a series of statements associated with each of the speakers makes sense (Studies 1 and 2) or are true (Study 3). Importantly, the fluency processing between native and foreign speakers was kept constant by using a written presentation of the materials. Under-informative statements such as 'Some frogs are amphibians' were tested in Study 1. The results of Study 1 show more acceptable judgments when the sentences were associated with the foreign speaker. Unknown facts about world knowledge such as 'Butterflies do not see gray' were tested in Studies 2 and 3. The results show more acceptable (Study 2) and more true (Study 3) judgments when the sentences were associated with the foreign speaker. In addition, in Study 3 the foreign speaker was considered more trustworthy than the native speaker in a rating test at the end of the main judgment-sentence task. Our findings show that linguistic identity per se has an impact on evaluation judgments, suggesting that message interpretation cannot be dissociated from who is communicating the message.

[The role and significance of trust for successful institutional risk communication]

The success of institutional crisis and risk communication is based on an open and dialogue-oriented communication policy as well as on a congruence between the expectations of all parties involved and their fulfillment. Central to communication with other actors and with the population is a mutual relationship of trust. This paper describes factors that are instrumental in determining whether and to what extent institutions can establish a basis of trust and credibility. It discusses how trustworthy risk communication can succeed even in times of crisis.Successful risk communication is tied to a process that conveys credibility and competence through openness of results, convincing communication of scientific evidence, the inclusion of plural values and criteria, and the synthesis of system and orientation knowledge. Given the uncertainty of knowledge and the confusion of communication processes in society, this task is not easy to accomplish. Despite these difficulties, institutions of risk assessment and regulation can build trust and perpetuate it over time through skillful coalition-building with organizations and groups with high trust potential, transparent, open-ended forms of communication, and the involvement of stakeholders and affected individuals in risk management.

Factors affecting perceived credibility of assessment in medical education: A scoping review

Assessment is more educationally effective when learners engage with assessment processes and perceive the feedback received as credible. With the goal of optimizing the educational value of assessment in medical education, we mapped the primary literature to identify factors that may affect a learner's perceptions of the credibility of assessment and assessment-generated feedback (i.e., scores or narrative comments). For this scoping review, search strategies were developed and executed in five databases. Eligible articles were primary research studies with medical learners (i.e., medical students to post-graduate fellows) as the focal population, discussed assessment of individual learners, and reported on perceived credibility in the context of assessment or assessment-generated feedback. We identified 4705 articles published between 2000 and November 16, 2020. Abstracts were screened by two reviewers; disagreements were adjudicated by a third reviewer. Full-text review resulted in 80 articles included in this synthesis. We identified three sets of intertwined factors that affect learners' perceived credibility of assessment and assessment-generated feedback: (i) elements of an assessment process, (ii) learners' level of training, and (iii) context of medical education. Medical learners make judgments regarding the credibility of assessments and assessment-generated feedback, which are influenced by a variety of individual, process, and contextual factors. Judgments of credibility appear to influence what information will or will not be used to improve later performance. For assessment to be educationally valuable, design and use of assessment-generated feedback should consider how learners interpret, use, or discount assessment-generated feedback.

Judging the credibility of websites: an effectiveness trial of the spacing effect in the elementary classroom

Spaced learning—the spacing effect—is a cognitive phenomenon whereby memory for to-be-learned material is better when a fixed amount of study time is spread across multiple learning sessions instead of crammed into a more condensed time period. The spacing effect has been shown to be effective across a wide range of ages and learning materials, but few studies have been conducted that look at whether spacing can be effective in real-world classrooms, using real curriculum content, with real teachers leading the intervention. In the current study, lesson plans for teaching website credibility were distributed to homeroom elementary teachers with specific instructions on how to manipulate the timing of the lessons for either a one-per-day or one-per-week delivery. One month after the final lesson, students were asked to apply their knowledge on a final test, where they evaluated two new websites. Results were mixed, suggesting that classroom noise might lessen or impede researchers’ ability to find spacing effects in naturalistic settings.

Exposing Individuals to Foreign Accent Increases their Trust in What Nonnative Speakers Say

People are more likely to believe things that are easier to process. Foreign-accented speech is relatively difficult to process, and prior research shows that, correspondingly, people believe information less when it is delivered in a foreign accent rather than a native accent. Here we show that a short exposure to foreign accent can reduce this bias, and that the reduction in bias is due to improvement in the processing of the accent. These results demonstrate how cognitive aspects of language processing can influence attitudes. The results also suggest that ensuring exposure to foreign accent can reduce discrimination against nonnative speakers.

Whose Advice is Credible? Claiming Lay Expertise in a Covid-19 Online Community

During the initial months of the Covid-19 pandemic, credentialed experts-scientists, doctors, public health experts, and policymakers-as well as members of the public and patients faced radical uncertainty. Knowledge about how Covid-19 was spread, how best to diagnose the disease, and how to treat infected patients was scant and contested. Despite this radical uncertainty, however, certain users of Covid-19 Together, a large online community for those who have contracted Covid-19, were able to dispense advice to one another that was seen as credible and trustworthy. Relying on Goffman's dramaturgical theory of social interaction, we highlight the performative dimension of claims to lay expertise to show how credibility is accrued under conditions of radical uncertainty. Drawing on four months of data from the forum, we show how credible performances of lay expertise necessitated the entangling of expert discourse with illness experience, creating a hybrid interlanguage. A credible performance of lay expertise in this setting was characterized by users' ability to switch freely between personal and scientific registers, finding and creating resonances between the two. To become a credible lay expert on this online community, users had to learn to ask questions and demonstrate a willingness to engage with biomedical knowledge while carefully generalizing their personal experience.

Who Speaks for Science?

Ironically, flat-Earthers, anti-vaxxers, and climate change naysayers trust in science. Unfortunately, they trust the wrong science. That conundrum lies at the heart of scientific literacy in an age of well-funded commercial and ideological interests and overwhelming digital information. The core question for the citizen-consumer is not philosophically "why trust science?" (Oreskes 2019) but sociologically "who speaks for science?" Teachers can help students learn how to navigate the treacherous territory of inevitably mediated communication and the vulnerabilities of epistemic dependence. Students need to understand the role of science communication practices (media literacy) and the roles of credibility, expertise and honesty and the deceptive strategies used by imitators of science to seem like credible voices for science.

The downgrading of pain sufferers' credibility

BACKGROUND

The evaluation of pain remains one of the most difficult challenges that healthcare practitioners face. Chronic pain appears to affect more than 35% of the population in the West, and indeed, pain is the most common reason patients seek medical care. Despite its ubiquity, studies in the last decades reveal that many patients feel their pain is dismissed by healthcare practitioners and that, as a result, they are denied proper medical care. Buchman, Ho, and Goldberg (J Bioethic Inq 14:31-42, 2017) point to this phenomenon as a form of "epistemic injustice": an unfair and harmful downgrading of credibility affecting some individuals and groups, which prevents them from receiving appropriate and beneficial medical care.

METHODS

By exploring the existing literature on this downgrading of patients' credibility written by healthcare professionals and scholars in medical humanities, I identify and examine the reasons patients are often not believed about their pain and why healthcare is too-often unhelpful or hurtful to people presenting with chronic pain. I also explore to what extent it is possible to forge an alternative epistemological model.

RESULTS

I suggest that most of the causes of this downgrading of patient's credibility result from either the difficulty in communicating pain or the widespread belief that pathology is always the result of objective tissue damage. I examine whether pain has to be effectively communicated and have an objective cause in order for it to be deemed credible. In the end, I argue that in the case of pain, both communication and objectivity are highly problematic.

CONCLUSIONS

I conclude by suggesting that, although alternative epistemological models might be impossible to build, believing patients has both moral and clinical benefits, and this warrants further research.

Can we trust measures of trust? a comparison of results from open and closed questions

Many public opinion surveys compare trust in a number of different information and (mediated) knowledge sources, typically using closed questions with a set of answer categories that are imposed by researchers. We aim to validate these categories by quantitatively comparing survey responses about trustworthy sources using open and closed questions, and by qualitatively analyzing the open answers. The results show that answer options typically used for closed questions in academic research are generally valid and closely match categories that respondents come up with unprimed. In some cases, answers to open questions can be non-exhaustive, particularly when sources are considered trustworthy but are not salient for respondents. Open questions, however, may still be useful for exploratory research or more detailed investigations of media diets on the outlet-level. Qualitative approaches to open questions can also give more insight into motivations for distrust, e.g. perceptions of inconsistency or a fundamental rejection of the shared factual basis of an issue. In addition, our results indicate that respondents’ interpretation of answer categories may change reported levels of trust: those that think of more specific outlets tend to report higher general media trust. This study provides new insights into how question design, and particularly the choice of answer options, may influence reported levels and sources of trust, and how qualitative and quantitative approaches to trust measurement can be combined.

Infodemic in Germany and Brazil: How the AfD and Jair Bolsonaro are Sowing Distrust During the Corona Pandemic

Even though the topic of infodemic - a blending of the words information and pandemic - emerged just in 2020 it addresses a question that has been crucial ever since in communication: How to establish - or undermine - credibility? This article deals with rhetorical techniques applied by Brazilian President Jair Messias Bolsonaro (2019-) and high-ranking politicians of the German party AfD (Alternative für Deutschland) during the COVID-19-pandemic. The analysis is based on tweets published through their official accounts during the first year of the pandemic (@jairbolsonaro, @AfD). Meanwhile Bolsonaro, who was in charge during the crisis, attacks the media claiming they would spread panic and false information, AfD, an opposition party, concentrates its criticism on the federal and state governments. The key concept credibility‹ as discussed by Ortwin Renn (2019) and basic claims that appear in Aristotle's »Rhetoric«, dating from the 4th century BC, build the theoretical basis of this study. Methodologically, the analysis is based on the Discourse-Historical Approach (Reisigl/Wodak 2001), focusing on discursive strategies of negative other representation, and a framework for studies on the language of legitimation and delegitimation developed by Theo van Leeuwen (1996).

Breast cancer on social media: a quali-quantitative study on the credibility and content type of the most shared news stories

BACKGROUND

Female breast cancer was the most diagnosed cancer in 2020, with more than two million new cases worldwide. Access to scientifically correct information can assist patients in early detection or prevention of the disease. However, misinformation on social networking sites (SNSs) about breast cancer can be propagated rapidly, posing a threat to health communication efforts. The aim of this study is to analyse the characteristics of the most shared news stories referencing the disease that circulated on SNSs, including the credibility of this content.

METHODS

This is an exploratory quali-quantitative study. Data collection was conducted between June 2019 and June 2020. We performed statistical and content analysis of the stories that had at least 1,000 total shares. Each story was classified in accordance to the following aspects: credibility; type of rumour; source; content type; mentions prevention or early detection/screening exams.

RESULTS

The abundance of news stories in our sample (n = 1,594) were not classified according to their credibility, as they do not address science, risk factors, prevention, treatment, or other aspects which can be assessed for scientific accuracy. However, content classified as "rumours" are 3.29 times more shared than those considered scientifically correct. Regarding content type, most stories are classified as 'real-life story' or 'solidarity' (67.69%). In our sample, 5.08% of the total comment on prevention and 19.7% reference early detection.

CONCLUSION

We consider it can be a good strategy, in SNSs, to combine content of greater popularity, such as real-life stories, with subjects that can make a difference in a patient's life, such as early detection, breast cancer symptoms and disease prevention strategies. Doctors, scientists and health journalists can expand the dialogue with the lay public regarding breast cancer, helping to counteract online misinformation.

Does the ownership of health website matter? A cross-sectional study on Chinese consumer behavior

BACKGROUND

Ownership has significant impact on website motivation. Consumers may heavily rely on the health website ownership cue when assessing credibility and making behavioral response toward health information on it. Health websites were primarily divided into four different ownership types (i.e., governmental, organizational, commercial, and personal) in China's context. However, research on Chinese consumer behavior toward different ownership types of health websites is scarce.

OBJECTIVES

To investigate the most credible and most commonly used health website ownership type among Chinese consumers, and to identify the influencing factors on perceived credibility, and actual usage of health websites.

METHODS

A cross-sectional survey of 1653 participants was conducted in 3-tier hospitals in 3 cities with different income levels. Multinomial logistic regression analyses were used to identify factors influencing Chinese consumers' perceived credibility and actual use of health websites.

RESULTS

The most credible health website was the organizational, followed by the governmental, commercial, and personal. The most commonly used health website was the commercial, followed by the organizational, governmental, and personal. Individuals in medium-income and low-income cities were more likely than those in high-income cities to trust and use non-governmental health websites. Compared to the governmental health website, consumers of high-level hospitals were less likely than those of primary hospitals to trust and use personal health websites. Compared to the governmental health website, high-income individuals were more likely than low-income individuals to trust the personal health website, and use the organizational and commercial health website.

CONCLUSIONS

Both Chinese consumers' perceived credibility and actual use of health website varied by ownership, and there was a gap between perceived credibility and actual usage of health website. Most sociodemographic factors had no statistically significant correlations with perceived credibility and actual usage of health website. City income level, consumer type and consumer income level were significantly associated with perceived credibility, actual usage of health websites.

Portuguese validation of the credibility/expectancy questionnaire in routine practice

This study aimed to validate and explore the psychometric properties of the credibility/expectancy questionnaire (CEQ) for the Portuguese population in the context of routine practice. The sample includes 87 clients from a university psychotherapy clinic. All clients completed self-report measures to assess credibility and expectation (CEQ), as well as measures of general mental health, depressive symptoms and therapeutic alliance in session 1 and session 2. The exploratory analysis revealed the existence of two factors in CEQ for the Portuguese population, factor 1 credibility and factor 2 expectation. The measure demonstrated good internal consistency, test-retest reliability and good adjustment in the confirmatory analysis. In terms of convergent validity, no significant correlation was found between credibility and expectation and the therapeutic alliance. The results corroborate the CEQ psychometric qualities for the Portuguese population, also showing its applicability in a context of routine practice.

Autistic Adults May Be Erroneously Perceived as Deceptive and Lacking Credibility

We hypothesized that autistic adults may be erroneously judged as deceptive or lacking credibility due to demonstrating unexpected and atypical behaviors. Thirty autistic and 29 neurotypical individuals participated in video-recorded interviews, and we measured their demonstration of gaze aversion, repetitive body movements, literal interpretation of figurative language, poor reciprocity, and flat affect. Participants (N = 1410) viewed one of these videos and rated their perception of the individual's truthfulness or credibility. The hypothesis was partially supported, with autistic individuals perceived as more deceptive and less credible than neurotypical individuals when telling the truth. However, this relationship was not influenced by the presence of any of the target behaviors, but instead, by the individual's overall presentation.

The role of validation in establishing the scientific credibility of predictive toxicology approaches intended for regulatory application

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The role of validation in establishing the credibility of predictive methods is discussed.

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Various assessment frameworks for predictive methods have evolved independently, being developed by different communities.

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A set of seven credibility factors is proposed as a method-agnostic means of comparing the various assessment frameworks.

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It is hoped this will facilitate communication and cross-disciplinary collaboration between method developers and users.

New approaches in toxicology based on in vitro methods and computational modelling offer considerable potential to improve the efficiency and effectiveness of chemical hazard and risk assessment in a variety of regulatory contexts. However, this presents challenges both for developers and regulatory assessors because often these two communities do not share the same level of confidence in a new approach. To address this challenge, various assessment frameworks have been developed over the past 20 years with the aim of creating harmonised and systematic approaches for evaluating new methods. These frameworks typically focus on specific methodologies and technologies, which has proven useful for establishing the validity and credibility of individual methods. However, given the increasing need to compare methods and combine their use in integrated assessment strategies, the multiplicity of frameworks is arguably becoming a barrier to their acceptance. In this commentary, we explore the concepts of model validity and credibility, and we illustrate how a set of seven credibility factors provides a method-agnostic means of comparing different kinds of predictive toxicology approaches. It is hoped that this will facilitate communication and cross-disciplinarity among method developers and users, with the ultimate aim of increasing the acceptance and use of predictive approaches in toxicology.

Regular matters: credibility determination and the institutional habitus in a Swiss asylum office

This article seeks to understand a common and regular feature of asylum decision-making, namely, that the majority of asylum claims are rejected, mostly on the basis of non-credibility. It draws on a bottom-up, qualitative study of an administration in which asylum decision-making takes place: the Swiss Secretariat for Migration. By adopting a practice-theoretical approach to administrative work, it advocates paying attention to caseworkers' routinised, self-evident and largely unquestioned behaviours, not only in terms of what they do, but also of what they think, feel and know. Building on Bourdieu, it introduces the concept of institutional habitus, which refers to the dispositions caseworkers develop on the job. On the basis of a specific decision-making practice termed 'digging deep', the article shows how these dispositions are structured and how, through the practices institutional habitus generates, these 'structuring structures' are continuously reaffirmed, leading to the relatively stable outcomes of administrative decision-making that can be observed from the outside. The article argues against the assumption that regularities of administrative work should be understood as the outcome of strict rule-following, top-down orders and political instrumentalism. At the same time, it challenges the individualist quality sometimes ascribed to discretionary practices in street-level bureaucracy literature and in critiques of credibility assessment practices in asylum adjudication.

Subgroup analysis in haematologic malignancies phase III clinical trials: A systematic review

AIMS

To assess the appropriateness of the use and interpretation of subgroup analysis in haematology randomized clinical trials (RCTs).

METHOD

A systematic review of Medline, including haematology phase III RCTs published between January 2013 and October 2019, was carried out to identify reported subgroup analysis. Information related to trial characteristics, subgroup analysis and claims of subgroup difference were collected.

RESULTS

The initial search identified 1622 studies. A total of 98 studies reporting subgroup analyses were identified. Of those, 24 RCT reported 46 claims of subgroup difference. Among them, 44 were claims for the primary outcome, of which 25 were considered strong claims and 17 were considered suggestions of a possible effect. Authors included subgroup variables for the primary outcome measured at baseline for 38 claims (n = 86.36%), used a subgroup variable as a stratification factor at randomization for 15 (34.09%), clearly prespecified their hypothesis for 11 (25%), the subgroup effect was one of a small number of hypothesised effects tested (≤ 5) for 17 (38.64%), carried out a test of interaction that provide statistically significant for 18 (40.91%), documented replication of a subgroup effect with previously related studies for 11 (25%), identified the consistency of a subgroup effect across related outcome for 10 (22.72%) and provided a biological rationale for the effect for 8 (18.18%). Of the 44 claims for the primary outcome, 34 (77.27%) met four or fewer of the 10 credibility criteria.

CONCLUSION

The subgroup claims reported in haematology RCTs lack credibility, even when the claims are strong. Information about subgroup difference should be interpreted cautiously.

Reporting and interpretation of subgroup analyses in heart failure randomized controlled trials

Aims

This study aimed to investigate the reporting of subgroup analyses in heart failure (HF) randomized controlled trials (RCTs) and to determine the strength and credibility of subgroup claims.

Methods and results

All primary HF RCTs published in nine high‐impact journals from 1 January 2008 to 31 December 2017 were included. Multivariable regression analysis was used to identify factors that may favour the reporting of results in specific subgroups. Strength of the subgroup effect claimed was classified into (i) strong, (ii) likely, or (iii) suggestive. Credibility of subgroup claim was scored using a pre‐specified 10 pointer criteria. Of the 261 HF RCTs studied, 107 (41%) reported subgroup analyses. Twenty‐five (23%) RCTs claimed a subgroup effect for the primary outcome of which six (24%) made a strong claim, eight (32%) claimed a likely effect, and 11 (44%) suggested a possible subgroup effect. Seven of the 25 RCTs did not employ interaction testing for subgroup claims of the primary outcome. Three out of 10 pre‐specified credibility criteria were satisfied by half of the trials. Fourteen trials justified the choice of subgroups, and 10 explicitly stated they were underpowered to detect differences within subgroups. Source of funding did not influence the frequency of reporting subgroup analyses (OR 0.53, 95% CI 0.78–3.62, P = 0.52).

Conclusions

Appropriate credibility criteria were rarely met even by HF RCTs that held strong subgroup claims. Subgroup analyses should be pre‐specified, be adequately powered, present interaction terms, and be replicated in independent data before being integrated into clinical decision making.

Coordinating expectations through central bank projections

Central banks are increasingly communicating their economic outlook in an effort to manage the public and financial market participants' expectations. We provide original causal evidence that the information communicated and the assumptions underlying a central bank's projection can matter for expectation formation and aggregate stability. Using a between-subject design, we systematically vary the central bank's projected forecasts in an experimental macroeconomy where subjects are incentivized to forecast the output gap and inflation. Without projections, subjects exhibit a wide range of heuristics, with the modal heuristic involving a significant backward-looking component. Ex-Ante Rational dual projections of the output gap and inflation significantly reduce the number of subjects' using backward-looking heuristics and nudge expectations in the direction of the rational expectations equilibrium. Ex-Ante Rational interest rate projections are cognitively challenging to employ and have limited effects on the distribution of heuristics. Adaptive dual projections generate unintended inflation volatility by inducing boundedly-rational forecasters to employ the projection and model-consistent forecasters to utilize the projection as a proxy for aggregate expectations. All projections reduce output gap disagreement but increase inflation disagreement. Central bank credibility is significantly diminished when the central bank makes larger forecast errors when communicating a relatively more complex projection. Our findings suggest that inflation-targeting central banks should strategically ignore agents' irrationalities when constructing their projections and communicate easy-to-process information.

Credible practice of modeling and simulation in healthcare: ten rules from a multidisciplinary perspective

The complexities of modern biomedicine are rapidly increasing. Thus, modeling and simulation have become increasingly important as a strategy to understand and predict the trajectory of pathophysiology, disease genesis, and disease spread in support of clinical and policy decisions. In such cases, inappropriate or ill-placed trust in the model and simulation outcomes may result in negative outcomes, and hence illustrate the need to formalize the execution and communication of modeling and simulation practices. Although verification and validation have been generally accepted as significant components of a model’s credibility, they cannot be assumed to equate to a holistic credible practice, which includes activities that can impact comprehension and in-depth examination inherent in the development and reuse of the models. For the past several years, the Committee on Credible Practice of Modeling and Simulation in Healthcare, an interdisciplinary group seeded from a U.S. interagency initiative, has worked to codify best practices. Here, we provide Ten Rules for credible practice of modeling and simulation in healthcare developed from a comparative analysis by the Committee’s multidisciplinary membership, followed by a large stakeholder community survey. These rules establish a unified conceptual framework for modeling and simulation design, implementation, evaluation, dissemination and usage across the modeling and simulation life-cycle. While biomedical science and clinical care domains have somewhat different requirements and expectations for credible practice, our study converged on rules that would be useful across a broad swath of model types. In brief, the rules are: (1) Define context clearly. (2) Use contextually appropriate data. (3) Evaluate within context. (4) List limitations explicitly. (5) Use version control. (6) Document appropriately. (7) Disseminate broadly. (8) Get independent reviews. (9) Test competing implementations. (10) Conform to standards. Although some of these are common sense guidelines, we have found that many are often missed or misconstrued, even by seasoned practitioners. Computational models are already widely used in basic science to generate new biomedical knowledge. As they penetrate clinical care and healthcare policy, contributing to personalized and precision medicine, clinical safety will require established guidelines for the credible practice of modeling and simulation in healthcare.

Source credibility modulates the validation of implausible information

Validation of text information as a general mechanism for detecting inconsistent or false information is an integral part of text comprehension. This study examined how the credibility of the information source affects validation processes. Two experiments investigated combined effects of source credibility and plausibility of information during validation with explicit (ratings) and implicit (reading times) measurements. Participants read short stories with a high-credible versus low-credible person that stated a consistent or inconsistent assertion with general world knowledge. Ratings of plausibility and ratings of source credibility were lower when a credible source stated a world-knowledge inconsistent assertion compared with a low-credible source. Reading times on target sentences and on spillover sentences were slower when a credible source stated an assertion inconsistent with world knowledge compared with a low-credible source, suggesting that source information modulated the validation of implausible information. These results show that source credibility modulates validation and suggest a bidirectional relationship of perceived plausibility and source credibility in the reading process.

Credibility work and moral evaluation at the ED

This paper contributes to the understanding of triage decision making by analyzing the credibility work jointly performed by patients and staff and its contribution to the non-clinical evaluation of clientele. I argue that the assessment of credibility occurs at the intersection between staff-devised typifications and patients' interactional performance, and is mediated by staff's experiential knowledge. In ordinary circumstances, patients can achieve credibility through three interactional strategies: embodying distress, limiting the voice of the lifeworld, and conveying narrative frankness. Patients belonging to groups associate by triage workers with disreputable characteristics, such as dishonesty, have the additional task of establishing themselves as trustworthy interlocutors by mobilizing worth claims. Embodying distress and limiting the voice of the lifeworld are instrumental to asserting legitimacy, whereas narrative frankness is an interactional prerequisite for manufacturing reasonableness.

False prophets and Cassandra's curse: The role of credibility in belief updating

Information from other sources can be beneficial or detrimental, depending on the veracity of the report. Along with prior beliefs and context, recipients have two main routes to determine veracity; the perceived credibility of the source and direct-evaluation via first-hand evidence, i.e. testing the advice against observation. Using a probabilistic learning paradigm, we look at the interplay of these two factors in the uptake (or rejection) of communicated beliefs, and the subsequent evaluation of the credibility of the communicator in light of this process. Whether the communicated belief is false (Experiment 1), or true (Experiment 2), we show that beliefs are interpreted in light of the perceived credibility of the source, such that beliefs from high trust sources are taken up (hypothesis 1), whilst beliefs from low trust sources are treated with suspicion and potentially rejected - dependent on early evidence experiences (hypothesis 2). Finally, we show that these credibility-led biased interpretations of evidence (whether belief or suspicion confirming) lead to further polarization of the perceived credibility of communicators (hypothesis 3). Crucially, this occurs irrespective of the veracity of the communication, such that sources accompanied by a high trust cue not only get away with communicating falsehoods, but see their perceived credibility increase, whilst sources accompanied by low trust cues not only have truthful communications rejected, but have their low trust penalized even further. These findings carry important implications for the consequences of artificially inflating or deflating the credibility of communicators (e.g., politicians or scientists in public debate).

The effects of industry funding and positive outcomes in the interpretation of clinical trial results: a randomized trial among Dutch psychiatrists

BACKGROUND

Most studies are inclined to report positive rather than negative or inconclusive results. It is currently unknown how clinicians appraise the results of a randomized clinical trial. For example, how does the study funding source influence the appraisal of an RCT, and do positive findings influence perceived credibility and clinical relevance? This study investigates whether psychiatrists' appraisal of a scientific abstract is influenced by industry funding disclosures and a positive outcome.

METHODS

Dutch psychiatrists were randomized to evaluate a scientific abstract describing a fictitious RCT for a novel antipsychotic drug. Four different abstracts were created reporting either absence or presence of industry funding disclosure as well as a positive or a negative outcome. Primary outcomes were the perceived credibility and clinical relevance of the study results (10-point Likert scale). Secondary outcomes were the assessment of methodological quality and interest in reading the full article.

RESULTS

Three hundred ninety-five psychiatrists completed the survey (completion rate 45%). Industry funding disclosure was found not to influence perceived credibility (Mean Difference MD 0.12; 95% CI - 0.28 to 0.47, p?) nor interpretation of its clinical relevance (MD 0.14; 95% CI - 0.54 to 0.27, p?). A negative outcome was perceived as more credible than a positive outcome (MD 0.81 points; 95% Confidence Interval (CI) 0.43 to 1.18, p?), but did not affect clinical relevance scores (MD -0.14; 95% CI - 0.54 to 0.27).

CONCLUSIONS

In this study, industry funding disclosure was not associated with the perceived credibility nor judgement of clinical relevance of a fictional RCT by psychiatrists. Positive study outcomes were found to be less credible compared to negative outcomes, but industry funding had no significant effects. Psychiatrists may underestimate the influence of funding sources on research results. The fact that physicians indicated negative outcomes to be more credible may point to more awareness of existing publication bias in the scientific literature.