Patients' ability to recall risk associated with treatment options

Abstract

Many practitioners have expressed concern about patients' ability to understand and recall information about the risk associated with treatment options. A search of medical articles however has revealed very little systematic research in this area. 1 Redelmeier DA Rozin P Kahneman D Understanding patients' decisions: cognitive and emotional perspectives. JAMA. 1993; 270: 72-76 Crossref PubMed Scopus (394) Google Scholar We report a systematic study that analysed patients' recall of the risks related to carotid endarterectomy (CEA). CEA is a prophylactic surgical procedure that is done to reduce the chance of embolic stroke. 2 European Carotid Surgery Trialists' Collaborative Group.MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70%–99%) or with mild (0%–29%) carotid stenosis. Lancet. 1991; 337: 1235-1243 Summary PubMed Scopus (3101) Google Scholar The risks associated with surgery and best medical treatment are well understood for this patient group. 3 North American Symptomatic Carotid Endarterectomy Trial Collaborators.Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade stenosis. N Engl J Med. 1991; 325: 445-453 Crossref PubMed Scopus (7755) Google Scholar The operation will reduce but not abolish the risk of stroke, and in a small proportion of patients it will cause a stroke. The operation has an associated stroke risk of 5–7%. 2 European Carotid Surgery Trialists' Collaborative Group.MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70%–99%) or with mild (0%–29%) carotid stenosis. Lancet. 1991; 337: 1235-1243 Summary PubMed Scopus (3101) Google Scholar , 3 North American Symptomatic Carotid Endarterectomy Trial Collaborators.Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade stenosis. N Engl J Med. 1991; 325: 445-453 Crossref PubMed Scopus (7755) Google Scholar Department of ErrorPatients' ability to recall risk associated with treatment options—In this research letter by A J Lloyd and colleagues (Feb 20, 1999, p 645), the third sentence of the final paragraph should have read: “In the Bristol scenario many months or years after the consultation, parents testified that they were able to recall accurately the risks associated with paediatric cardiac surgery”. Full-Text PDF