Communicating Proteomic Science to Lay Audiences, Part II

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Communicating Proteomic Science to Lay Audiences,
Part II

• Katherine E. Rowan, Ph.D.
• Carl Botan, Ph.D.
• George Mason University
• Krowan_at_gmu.edu
• Presentation for the
• BIO IT Coalition
• at George Mason University
• May 5, 2006

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Explaining Complexities

• Intuition says long, unfamiliar words and long
  sentences are obstacles to comprehension.
• But research identifies three other frequent
  sources of confusion.
• These confusion sources hamper both communication
  among experts in differing disciplines as well as
  expert-to-lay communication.

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Deepening Understanding

• When explaining to lay audiences, anticipate
  these three sources of confusion
• Familiar words not well understood (protein,
  biotech, the human genome, translation)
• Ideas hard-to-understand because hard to
  visualize (reactions, periodic table, clinical
  trial, R and D)
• Ideas hard-to-understand because hard to believe
  (those with no family history of cancer are at
  risk women not currently sexually active at risk
  for cervical cancer)

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Three Types of Explanation

• Elucidating explanations elucidate or
  distinguish essential from associated meanings of
  key concepts.
• Quasi-scientific explanations help audiences
  envision complex structures or processes.
• Transformative explanations address and overcome
  lay theories (Rowan, 1999, 2003).

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Clarifying Meaning of Key Terms

• People need help distinguishing associated from
  essential meanings.
• To help, use elucidating explanations
• 1. Begin with familiar example.
• 2. Define by ESSENTIAL meaning.
• 3. Give a RANGE of examples, not just one.
• 4. Give non-examples or say what something
  may seem to be but is NOT.

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Example Elucidating Explanation

• 1. Begin with the familiar.
• a. Cancer drugs work for some people and not
  others. I do research to understand why.
• b. We hear a lot about dietary fiber.
• 2. Define by essential, not associated,
  meaning.
• a. Proteomics involves the systematic
  evaluation of changes in the protein
  constituencies of the cell.
• b. Translation is the final step on the way
  from DNA to protein (Nobelprize.org).

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Example Elucidating Explanation (cont.)

• 3. Give a range of varied examples, not a
  single example.
• a. Petricoin and Liotta have identified more
  than 140 proteins in cancer cells . . . of the
  breast, ovary, prostate, and esophagus that
  change in amount as the cells in these tissue
  grow abnormally. . . .
• b. Proteins perform many functions. Some are
  structural some store chemicals some act as
  signals (How genes work)

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Example Elucidating Explanation (cont.)

• 4. Discuss a nonexample, an entity that seems
  an example but is not. Say what something IS and
  what it is NOT.
• a. Proteomics, the systematic evaluation of
  changes in the protein constituencies of the
  cell, is more than just lists of proteins The
  ultimate goal is to characterize the information
  flow within the cell and the organism.
• b. Stringy meat is not dietary fiber fiber
  comes from plants.

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Example Elucidating Explanation (cont.)

• c. Genomics provides information on what MAY
  happen, while proteomics provides information on
  what IS happening. Almost all therapies are
  directed at modulating protein activity, NOT gene
  activity. All biomarkers measured in clinic are
  proteins, not genes. (Petricoin)

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Transition to Quasi-scientific

• Some times the obstacle thwarting comprehension
  is not key terms but complex structures,
  processes.
• Research in educational psychology shows people
  comprehend complexities more fully and are better
  able to use information when explanations begin
  with a gist view, an analogy, a simple diagram.
• Therefore, people need quasi-scientific
  explanations to help them picture structures,
  processes that are complex.

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Hard-to-Envision Structures, Processes

• Examples
• Gene DNA Which is inside which?
• The probability .01
• Why study proteomicsthe big picture
• How genes encode proteins
• The periodic table

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Promoting VisualizationQuasi-scientific
Explanation

• Quasi-scientific explanations use headings,
  diagrams, and analogies to picture the complex
  (Rowan, 1999 Lipkus Holland, 1999 Schwartz et
  al., 1999).
• Good quasi-scientific explanations present
  difficult-to-picture cancer risk information in
  several formats e.g., narratives of several
  patients outcomes, graphics depicting
  frequencies, graphics depicting biological
  processes.

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Example Quasi-Scientific Explanation of Cancer
Risk

• Research says lay audiences may prefer risk
  presented as frequencies rather than as
  probabilities (See Danziger, 2000 also Schwartz
  et al., 1999).

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Example Promoting Visualization

• People may struggle to understand your business
  because they cannot visualize research and
  development.
• What steps are research? Whats development?
  What steps are you taking?

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Example

• For some, graphics may promote visualization
  better than numbers.
• Your body works like a chemical wash each cell
  uses enzymes like detergents to clean up most
  chemicals. Some people HAVE the enzyme to
  clean up chemicals from cigarette smoke. Others
  do NOT. Your results show you do NOT have this
  enzyme (Lipkus, I.M., PI, Duke University,
  funded study)

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Example Analogy Promoting Visualization

• Research shows analogies promote both mastery and
  use of information.
• Sample analogy from Petricoin
• Genomics is like having a parts list for a 747
  but no information on how parts fit together
  Proteomics is BOTH the schematic drawing of how
  they fit AND the parts themselves.

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Transition to Transformative

• Some ideas contain no difficult concepts or terms
  and they are not difficult to envision.
• Nevertheless, they are difficult because they are
  hard to believe.
• Transformative explanations identify and overcome
  lay theories to explain science that seems
  counter-intuitive.

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Explaining the Counter-intuitive

• People have lay theories about familiar
  aspects of life e.g., disease, sex, heredity,
  etc.
• Research on lay theories began in physics
  education (e.g., Hewson Hewson, 1983)
• Examples of erroneous lay theories
• Since Im not currently sexually active, Im not
  at risk for cervical cancer.
• No history of cancer in my family, so I wont get
  it.
• Genes are used when a baby develops from an
  embryo, and then never again.

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Example Transformative Explanation

• State the lay theory and acknowledge its apparent
  reasonableness
• It may seem reasonable to assume that if there
  are no people in your family who have cancer,
  your chances of getting cancer are low.
• Create dissatisfaction with the lay theory
• Family history is one source of cancer risk, but
  there are other sources. Lifestyle factors like
  obesity and smoking are connected to cancer.
• Explain the orthodox science
• The best tool we have for fighting cancer is to
  detect it early, maybe even before it begins.
  Since early cancers may not cause symptoms, and
  since even people with no family history of
  cancer are at risk, you deserve access to cancer
  screenings.

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Example Transformative Explanation

• State lay theory acknowledge apparent
  reasonableness
• Many people think that genes are used when a
  baby develops from an embryo and then never used
  again.
• Create dissatisfaction with lay theory, then
  explain orthodox science
• Genes are not like an instruction manual which
  the cell looks at once and then forgets. Genes
  are like an instruction manual used in the
  second-to-second running of the cell.
• Cells constantly encounter new environments.
  Blood sugar levels drop, germs try to invade, and
  cells respond quickly. . . When the cell needs
  certain chemicals, it switches the right genes on
  and they are expressedwhat they encode is made.
  As you can see, genes have an active role in the
  second-to-second life of the cell. (excerpt from
  How genes work)

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When Do You NOT explain?

• Lectures are usually given when people are
  sitting down.
• Explanations for lay audiences are often best
  presented in print, in brochures, in the Sunday
  supplement, on PBS.
• When people just want a sentence or so, you need
  an elevator talk.

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What IS an Elevator Talk?

• Simple, non-technical explanation expressed on
  short elevator ride
• Requires non-geeky, language
• No notes or illustrations

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Great Elevator Talks, 1

• Great elevator talks are short
• So whats personalized medicine?
• Its about matching the right patient with the
  right drug, says Bryan Drucker of Oregon Health
  and Science.
• We study why cancer drugs work for some people
  and not others. We are trying to understand how
  to tailor or personalize cancer drugs to
  individual patients. (Lance Liotta, George
  Mason)

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Great Elevator Talks, 2

• To increase comprehension, begin with the big
  picture
• NOT We deal with pharma (could be mis-heard)
• BUT rather Were a software company that helps
  scientists understand disease and ways to combat
  it.
• Avoid acronyms and jargon (CROs, pharma)

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Great Elevator Talks, 3

• Connect to everyday experiences
• Were a clinical research organization. Most
  people remember when they were in college and
  they read ads in the local paper looking for
  participants in some study. The ads said youd
  get 10 for participating, maybe beer money.
  Well, now clinical research organizations or CROs
  are a 40 billion industry (Pat Donnelly,
  President CEO PRA International, on Tommorows
  Business Radio)

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Research to Be Done

• Research needed on great explainers, how they
  develop, how to foster these skills.
• Brochures, web sites, videos can all be content
  analyzed for the effectiveness of their
  explanatory text and visuals (Rowan, 2000).

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Now Its YOUR Turn

• Consider your pledge
• (no tech talk to lay audience)
• When you explain, focus on problems that
  matterin everyday life.
• Avoid jargon.
• Explain key terms.
• Promote visualizing.
• Address lay theories.

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References

• Danziger, K. (2000). How are breast and ovarian
  cancer inherited? From Genetic Health,
  www.genetichealth.com
• Davis, T.C., et al., (2002). Health literacy and
  cancer communications. CA A cancer journal for
  clinicians, 52, 134-149.
• Duncan, G. How to make your elevator talk a
  floor above the rest. Denver Business Journal,
  Feb. 11, 2005.
• How genes work. From beingmrkenny.co.uk/archive/ev
  olution/genes
• Hewson,P. W., Hewson, M. G. (1983). Effect of
  instruction using students prior knowledge and
  conceptual change strategies on science learning.
  Journal of Research in Science Teaching, 20.

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References

• Liotta, L., Kohn, E. C., Petricoin, E. F.
  (2001). Clinical proteomics, JAMA, 286.
• Lipkus, I. M., Hollands, J. G. (1999). The
  visual communication of risk. Journal of the
  National Cancer Institute Monographs, 25.
• Petricoin, E. Liotta, L. (2003). Clinical
  applications of proteomics. Journal of
  Nutrition, 133, 2476S-2484S.
• Rang, H. P. The drug discovery process
  Elsevierhealth.com (visual in slide 14).
• Rowan, K. E. (1999). Effective communication of
  uncertain science. In S. Friedman, et al.,
  Communicating uncertainty Media coverage of new
  and controversial science. Mahwah, NJ Erlbaum.

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References

• Rowan, K. E. (2000). Mass media explanations of
  illness. Whaley (Ed.), Explaining illness.
  Mahwah, NJ Erlbaum.
• Rowan, K. E. (2003). Informing and explaining
  skills. In Greene Burleson, eds. Handbook of
  Communication and Social Interaction Skills.
  Mahwah, NJ Erlbaum.
• Schwartz, L. M., Woloshin, S., Welch, H. G.
  (1999). Risk communication in clinical practice.
  Journal of the National Cancer Institute
  Monographs, No. 25, 124-133.
• Witte, K. et al. (2001). Effective health risk
  messages A step-by-step guide. Thousand Oaks,
  CA Sage.