Helping Patients Decide: Ten Steps to Better Risk Communication

TLDR

Patients increasingly face complex cancer decisions that are emotionally charged and cognitively demanding, especially given widespread low numeracy skills that make interpreting risk statistics difficult. This commentary identifies ten empirically supported methods to enhance patients’ understanding of risk and benefit information and offers recommendations for clinicians and educators on effective communication. The methods involve presenting absolute risks as frequencies, clarifying treatment effects relative to baseline, and employing plain language, pictographs, and absolute risk formats.

Abstract

With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. Many Americans have low numeracy skills making the cognitive demands even greater whenever, as is often the case, patients are presented with risk statistics and asked to make comparisons between the risks and benefits of multiple options and to make informed medical decisions. In this commentary, we highlight 10 methods that have been empirically shown to improve patients’ understanding of risk and benefit information and/or their decision making. The methods range from presenting absolute risks using frequencies (rather than presenting relative risks) to using a risk format that clarifies how treatment changes risks from preexisting baseline levels to using plain language. We then provide recommendations for how health-care providers and health educators can best to communicate this complex medical information to patients, including using plain language, pictographs, and absolute risks instead of relative risks.