BMC Med Inform Decis Mak - Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers.

Tópicos

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Resumo

CKGROUND: Making 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.METHOD: An 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.RESULTS: The 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.CONCLUSION: A 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.

Resumo Limpo

ckground make evidencebas decis often requir comparison two option researchbas evid may exist quantifi like outcom option understand numer estim improv patient risk percept lead better inform decis make paper summaris current best practic communic evidencebas numer outcom develop patient decis aid ptdas health communic toolsmethod expert consensus group fourteen research north america europ australasia identifi eleven main issu risk communic two expert issu wrote state art summari best evid draw ptda health psycholog broader scientif literatur addit common use term defin set guid principl key messag deriv resultsresult eleven key compon risk communic present chanc event will occur present chang numer outcom outcom estim test screen decis numer estim context evalu label convey uncertainti visual format tailor estim format understand outcom time narrat method convey chanc event import skill understand numer estim interact webbas format guid principl evid summari advis risk communic format reflect task requir user alway defin relev refer class ie denomin time aim use consist format throughout document avoid x format variabl denomin consid magnitud number use possibl format bias take account numeraci graph literaci audienceconclus substanti rapid expand evid base exist risk communic develop tool facilit evidencebas decis make appli principl improv qualiti risk communic practic

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