BMJ  2003;327:736-740 (27 September), doi:10.1136/bmj.327.7417.736

Education and debate

Risk communication in practice: the contribution of decision aids

¹ Ottawa Health Research Institute, Ottawa Hospital, Civic Campus, C4-1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9, ² Department of Family Medicine, Laval University, Quebec, QC, Canada G1K 7P4

As patients want to participate more in decision making, and as the range of medical options expands, clinicians are challenged to improve their communication of risk and supportive skills. Are practitioners' counselling skills up to the job?

The first 150 words of the full text of this article appear below.

Different decisions require different strategies to communicate risk and support decisions, and we consider that two broad classes of decisions exist for patients. The first class lies in the area of "effective" health services, in which the benefits are large compared with harms—the participation of patients improves control of chronic conditions¹ and the widespread underuse of these beneficial options.² The second is in "preference sensitive" health services, in which the ratios of benefit to harm are either uncertain or dependent on patient values²—participation of patients improves quality of decisions and prevents overuse in the subset of informed patients who don't value the options.³

View this table: [in this window] [in a new window]   Differences in decision support for effective versus preference sensitive medical options

 

We investigated practical and effective approaches that doctors and practitioners can use when counselling patients about these two classes of decisions. Box 1 shows the sources we used. These approaches should help patients to understand . . . [Full text of this article]

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