Volume 26, Issue 3
  • ISSN 0142-5471
  • E-ISSN: 1569-979X



Pension participants face complex decisions which require them to choose between multiple alternatives that have different consequences, that vary in likelihood, and that often relate to different values. In the medical domain, ample research has been conducted on how to support patients in making such decisions, yielding three important lessons. First, by emphasizing the gist of information, the information becomes more meaningful to participants. Second, value clarification methods should be used to help participants retrieve or form their own values and compare those with the decision alternatives. Third, simple static visual aids facilitate the comprehension of statistics and probabilities.

Available under the CC BY 4.0 license.

Article metrics loading...

Loading full text...

Full text loading...



  1. Autoriteit Financiële Markten
    Autoriteit Financiële Markten (2016) Leidraad Wet verbeterde premieregeling.
    [Google Scholar]
  2. Autoriteit Financiële Markten
    Autoriteit Financiële Markten (2020) Het belang van een uitlegbaar pensioenstelsel.
    [Google Scholar]
  3. Barratt, A., Edwards, A., Trevena, L., McCaffery, K., Woloshin, S., Bekker, H., … Charvet, A.
    (2005) Section C: Presenting probabilities. InA. O’Connor, H. Llewellyn-Thomas and D. Stacey (Eds.), IPDAS Collaboration Background Document (pp.11–16).
    [Google Scholar]
  4. Blalock, S. J. & Reyna, V. F.
    (2016) Using fuzzy-trace theory to understand and improve health judgments, decisions, and behaviors: A literature review. Health Psychology, 35(8), 781–792. 10.1037/hea0000384
    https://doi.org/10.1037/hea0000384 [Google Scholar]
  5. Cox, J. G.
    (2020) Verbal quantifiers and communicating painkiller side effect risk. Health Communication, 35(11), 1349–1358. 10.1080/10410236.2019.1632402
    https://doi.org/10.1080/10410236.2019.1632402 [Google Scholar]
  6. Cox, R. & de Goeij, P.
    (2020) Infographics and financial decisions. Netspar Design Paper, 148.
    [Google Scholar]
  7. Debets, S., Prast, H., Rossi, M., & Van Soest, A.
    (2020) Pension communication, knowledge, and behaviour. Journal of Pension Economics and Finance, 1–20. 10.1017/S1474747220000232
    https://doi.org/10.1017/S1474747220000232 [Google Scholar]
  8. EIOPA
    EIOPA (2013) Good practices on information provision for DC schemes: Enabling occupational DC scheme members to plan for retirement.
    [Google Scholar]
  9. EIOPA
    EIOPA (2021) Consultation paper: Technical advice on the development of pension tracking systems.
    [Google Scholar]
  10. Elwyn, G., Stiel, M., Durand, M., & Boivin, J.
    (2011) The design of patient decision support interventions: addressing the theory–practice gap. Journal of Evaluation in Clinical Practice, 17(4), 565–574. 10.1111/j.1365‑2753.2010.01517.x
    https://doi.org/10.1111/j.1365-2753.2010.01517.x [Google Scholar]
  11. Fagerlin, A., Pignone, M., Abhyankar, P., Col, N., Feldman-Stewart, D., Gavaruzzi, T., … Witteman, H. O.
    (2013) Clarifying values: an updated review. BMC Medical Informatics and Decision Making, 13(2), S8. 10.1186/1472‑6947‑13‑S2‑S8
    https://doi.org/10.1186/1472-6947-13-S2-S8 [Google Scholar]
  12. Fagerlin, A., Zikmund-Fisher, B. J., & Ubel, P. A.
    (2011) Helping patients decide: ten steps to better risk communication. Journal of the National Cancer Institute, 103(19), 1436–1443. 10.1093/jnci/djr318
    https://doi.org/10.1093/jnci/djr318 [Google Scholar]
  13. Feldman-Stewart, D., Tong, C., Siemens, R., Alibhai, S., Pickles, T., Robinson, J., & Brundage, M. D.
    (2012) The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: Evidence from a randomized controlled trial. Medical Decision Making, 32(4), 616–626. 10.1177/0272989X11434601
    https://doi.org/10.1177/0272989X11434601 [Google Scholar]
  14. Fraenkel, L., Peters, E., Charpentier, P., Olsen, B., Errante, L., Schoen, R. T., & Reyna, V.
    (2012) Decision tool to improve the quality of care in rheumatoid arthritis. Arthritis Care & Research, 64(7), 977–985. 10.1002/acr.21657
    https://doi.org/10.1002/acr.21657 [Google Scholar]
  15. Hawley, S. T., Zikmund-Fisher, B., Ubel, P., Jancovic, A., Lucas, T., & Fagerlin, A.
    (2008) The impact of the format of graphical presentation on health-related knowledge and treatment choices. Patient Education and Counseling, 73(3), 448–455. 10.1016/j.pec.2008.07.023
    https://doi.org/10.1016/j.pec.2008.07.023 [Google Scholar]
  16. Hoeken, H., van der Geest, T., van der Goot, M., Hornikx, J., Jongenelen, M., & Kruikemeier, S.
    (2011) De rol van begrijpelijke taal in een digitale context: Ontwikkelingen op de domeinen Leven Lang Leren, complexe financiële producten, bestuur en politiek, en gezondheid. Tijdschrift voor Taalbeheersing, 33(3), 266–286. 10.5117/TVT2011.3.DE_R410
    https://doi.org/10.5117/TVT2011.3.DE_R410 [Google Scholar]
  17. Kause, A., Bruine de Bruin, W., Fung, F., Taylor, A., & Lowe, J.
    (2020) Visualizations of projected rainfall change in the United Kingdom: An interview study about user perceptions. Sustainability, 12(7), 2955. 10.3390/su12072955
    https://doi.org/10.3390/su12072955 [Google Scholar]
  18. Klapper, L., Lusardi, A., & Van Oudheusden, P.
    (2015) Financial literacy around the world: Insights from the Standard & Poor’s Ratings Services Global Financial Literacy Survey. World Bank. https://responsiblefinanceforum.org/wp-content/uploads/2015/12/2015-Finlit_paper_17_F3_SINGLES.pdf
    [Google Scholar]
  19. Knoll, M. A. Z.
    (2011) Behavioral and psychological aspects of the retirement decision. Social Security Bulletin, 71(4).
    [Google Scholar]
  20. McCaffery, K. J., Holmes-Rovner, M., Smith, S. K., Rovner, D., Nutbeam, D., Clayman, M. L., … & Sheridan, S. L.
    (2013) Addressing health literacy in patient decision aids. BMC Medical Informatics and Decision Making, 13(2), S10. 10.1186/1472‑6947‑13‑S2‑S10
    https://doi.org/10.1186/1472-6947-13-S2-S10 [Google Scholar]
  21. Meppelink, C. S., Smit, E. G., Buurman, B. M., & van Weert, J. C.
    (2015) Should we be afraid of simple messages? The effects of text difficulty and illustrations in people with low or high health literacy. Health Communication, 30(12), 1181–1189. 10.1080/10410236.2015.1037425
    https://doi.org/10.1080/10410236.2015.1037425 [Google Scholar]
  22. Nell, M. L.
    (2017) Multichannel pension communication: An integrated perspective on policies, practices, and literacy demands (Doctoral dissertation, Utrecht University).
  23. Peters, E., Dieckmann, N., Dixon, A., Hibbard, J. H., & Mertz, C. K.
    (2007) Less is more in presenting quality information to consumers. Medical Care Research and Review, 64(2), 169–190. 10.1177/10775587070640020301
    https://doi.org/10.1177/10775587070640020301 [Google Scholar]
  24. Reyna, V. F.
    (2008) A theory of medical decision making and health: Fuzzy Trace Theory. Medical Decision Making, 28(6), 850–865. 10.1177/0272989X08327066
    https://doi.org/10.1177/0272989X08327066 [Google Scholar]
  25. Reyna, V.
    (2018) When irrational biases are smart: A fuzzy-trace theory of complex decision making. Journal of Intelligence, 6(2), 29. 10.3390/jintelligence6020029
    https://doi.org/10.3390/jintelligence6020029 [Google Scholar]
  26. Smith, S. G., Raine, R., Obichere, A., Wolf, M. S., Wardle, J., & von Wagner, C.
    (2015) The effect of a supplementary (‘gist-based’) information leaflet on colorectal cancer knowledge and screening intention: a randomized controlled trial. Journal of Behavioral Medicine, 38(2), 261–272. 10.1007/s10865‑014‑9596‑z
    https://doi.org/10.1007/s10865-014-9596-z [Google Scholar]
  27. Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., … Trevena, L.
    (2017) Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, (4). 10.1002/14651858.CD001431.pub5
    https://doi.org/10.1002/14651858.CD001431.pub5 [Google Scholar]
  28. Tait, A. R., Voepel-Lewis, T., Zikmund-Fisher, B. J., & Fagerlin, A.
    (2010) Presenting research risks and benefits to parents: Does format matter?. Anesthesia & Analgesia, 111(3), 718–723. 10.1213/ANE.0b013e3181e8570a
    https://doi.org/10.1213/ANE.0b013e3181e8570a [Google Scholar]
  29. Van Waveren, B., Kuin, M., & Duysak, S. [Google Scholar]
  30. Verbond van Verzekeraars
    Verbond van Verzekeraars (2018) Handleiding Standaardmodel ‘vast-variabel pensioen’ voor pensioenverzekeraars en PPI’s. https://www.verzekeraars.nl/media/5586/handleiding-standaardmodel-december-2018.pdf
    [Google Scholar]
  31. Witteman, H. O., Julien, A.-S., Ndjaboue, R., Exe, N. L., Kahn, V. C., Fagerlin, A., & Zikmund-Fisher, B. J.
    (2020) What Helps People Make Values-Congruent Medical Decisions? Eleven Strategies Tested across 6 Studies. Medical Decision Making, 40(3), 266–278. 10.1177/0272989X20904955
    https://doi.org/10.1177/0272989X20904955 [Google Scholar]
  32. Wolfe, C. R., Reyna, V. F., Widmer, C. L., Cedillos, E. M., Fisher, C. R., Brust-Renck, P. G., Weil, A. M.
    (2015) Efficacy of a web-based intelligent tutoring system for communicating genetic risk of breast cancer: A fuzzy-trace theory approach. Medical Decision Making, 35(1), 46–59. 10.1177/0272989X14535983
    https://doi.org/10.1177/0272989X14535983 [Google Scholar]
  33. Zikmund-Fisher, B. J., Dickson, M., & Witteman, H. O.
    (2011) Cool but counterproductive: Interactive, e60. 10.2196/jmir.1665
    https://doi.org/10.2196/jmir.1665 [Google Scholar]
  34. Zikmund-Fisher, B. J., Fagerlin, A., & Ubel, P. A.
    (2010) A demonstration of ‘‘less can be more’’ in risk graphics. Medical Decision Making, 30(6), 661–671. 10.1177/0272989X10364244
    https://doi.org/10.1177/0272989X10364244 [Google Scholar]
  35. Zikmund-Fisher, B. J., Witteman, H. O., Fuhrel-Forbis, A., Exe, N. L., Kahn, V. C., & Dickson, M.
    (2012) Animated graphics for comparing two risks: A cautionary tale. Journal of Medical Internet Research, 14(4), e106. 10.2196/jmir.2030
    https://doi.org/10.2196/jmir.2030 [Google Scholar]

Data & Media loading...

  • Article Type: Research Article
This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error