Communicating risk: Doctor's recommendation is decision making in uncertain conditions

doi:10.1136/bmj.327.7428.1404-a

BMJ 2003;327:1404 (13 December), doi:10.1136/bmj.327.7428.1404-a

Letter

Communicating risk

Doctor's recommendation is decision making in uncertain conditions

The first 100% of the full text of this article appears below.

EDITOR—In his editorial Edwards discussed the communicationof risk.¹ Many times in health care decisions must be made underconditions of uncertainty, such as choosing the type of breastcancer surgery when the staging of the disease has yet to beconfirmed.

Under such circumstances we have found that Chinese women facingchoice between mastectomy and lumpectomy lack sufficient informationon risks and outcomes and, as such, tend to use an intuitiverather than rational decision making approach.^2
3 In the absenceof clear outcome data, these women want their surgeon to makea clear recommendation about a preference for treatment. Sucha recommendation may be being used as an "experience" proxyfor lack of risk estimation.

Richard Fielding, deputy director

fielding@hkusua.hku.hk

Wendy W T Lam, director

Centre for Psycho-Oncology Research and Teaching, 5/F, Academic and Admin Block, Faculty of Medicine Building, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China

Competing interests: None declared.

Edwards A. Communicating risks. BMJ 2003;327: 691-2. (27 September.)[Free Full Text]
Lam WWT, Fielding R. The evolving experience of illness for Chinese women with breast cancer: A qualitative study. Psycho-Oncol 2003;12: 127-40.[CrossRef][Medline]
Lam WWT, Fielding R, Chan M, Chow L, Ho EYY. Patient participation and satisfaction with treatment decision making in Chinese women with breast cancer. Breast Cancer Res Treatment 2003;80: 171-80.[Medline]