Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers
By L. Trevena, B. Zikmund‐Fisher, A. Edwards, Wolfgang Gaissmaier, Mirta Galesic, Paul K. J. Han, John King, M. Lawson, Suzanne K. Linder, Isaac Lipkus and 4 more. BMC Medical Informatics and Decision Making, 2013
514 citations recorded by the source corpus.
BackgroundMaking evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools.MethodAn expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results.ResultsThe eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience.ConclusionA substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice.
Subfields: Family Practice, General Health Professions, Public Health, Environmental and Occupational Health
View Paper: https://www.semanticscholar.org/paper/dd36a97344ce3aec6f4a3be106bff40098e9fb69
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Citations in the corpus
- A three-talk model for shared decision making: multistage consultation process (2017, unknown): “34 These would fit naturally in the “option talk” step.”
- Risk and Uncertainty Communication (2017, background): “Words may also be used as an adjunct to numerical risks as evaluative labels to provide context to a number, although Trevena et al. (2013) recommended caution, as they can have a substantial effect through arousal of affect.”
- Measuring trust in vaccination: A systematic review (2018, background): “trust in the information itself(13,18,19) as well as trust in those who produce and propagate the information.(20,21) In this review, we consider trust in information as nested within the trust held in the source of that information.”
- Returning Individual Research Results to Participants: Guidance for a New Research Paradigm (2018, background): “…meaning, it is generally preferable to provide absolute reference information (just as absolute risk communication is generally preferred over relative risk communications), though the committee acknowledges that this will not always be possible (Dunagan et al., 2013; Trevena et al., 2013).”