Abstract
BackgroundPatients increasingly seek more active involvement in health care decisions, but little is known about how to communicate complex risk information to patients. The objective of this study was to elicit patient preferences for the presentation and framing of complex risk information.MethodTo accomplish this, eight focus group discussions and 15 one-on-one interviews were conducted, where women were presented with risk data in a variety of different graphical formats, metrics, and time horizons. Risk data were based on a hypothetical woman's risk for coronary heart disease, hip fracture, and breast cancer, with and without hormone replacement therapy. Participants' preferences were assessed using likert scales, ranking, and abstractions of focus group discussions.ResultsForty peri- and postmenopausal women were recruited through hospital fliers (n = 25) and a community health fair (n = 15). Mean age was 51 years, 50% were non-Caucasian, and all had completed high school. Bar graphs were preferred by 83% of participants over line graphs, thermometer graphs, 100 representative faces, and survival curves. Lifetime risk estimates were preferred over 10 or 20-year horizons, and absolute risks were preferred over relative risks and number needed to treat.ConclusionAlthough there are many different formats for presenting and framing risk information, simple bar charts depicting absolute lifetime risk were rated and ranked highest overall for patient preferences for format.
Highlights
Patients increasingly seek more active involvement in health care decisions, but little is known about how to communicate complex risk information to patients
Few studies have examined the effect on patients of framing risk data with different metrics, such as relative or absolute risk and the number needed to treat (NNT)
Comparing relative and absolute risk reduction and NNT as methods to inform patients about preventive therapies, Hux et al illustrated that the metric used to present data can affect a patient's perception of a therapy's effectiveness [11]
Summary
Patients increasingly seek more active involvement in health care decisions, but little is known about how to communicate complex risk information to patients. The objective of this study was to elicit patient preferences for the presentation and framing of complex risk information. In order for patients to be effective participants in the decision making process, they need information on the effects of treatment on their health risks that they can use to make health care decisions. Few studies have examined the effect on patients of framing risk data with different metrics, such as relative or absolute risk and the number needed to treat (NNT). Comparing relative and absolute risk reduction and NNT as methods to inform patients about preventive therapies, Hux et al illustrated that the metric used to present data can affect a patient's perception of a therapy's effectiveness [11]
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