Clinical Review

Explaining risks: turning numerical data into meaningful pictures

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7341.827 (Published 06 April 2002) Cite this as: BMJ 2002;324:827
  1. Adrian Edwards, senior lecturer (Edwardsag@cf.ac.uk)a,
  2. Glyn Elwyn, senior lecturera,
  3. Al Mulley, chief of general medical divisionb
  1. a Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Llanedeyrn, Cardiff CF3 7PN
  2. b Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston MA 02114, USA
  1. Correspondence to: A Edwards

    The way in which information is presented affects both how health professionals introduce it and how patients use it

    The “information age” has profound implications for the way we work. The volume of information derives from biomedical and clinical evaluative sciences and is increasingly available to clinicians and patients through the world wide web.1 We need to process information, derive knowledge, and disseminate the knowledge into clinical practice. This is particularly challenging for doctors in the context of the consultation. Information often highlights uncertainties, including collective professional uncertainty, which we address with more and better research; individual professional uncertainty, which we address with professional education and support for decisions; and stochastic uncertainty (the irreducible element of chance), which we address with effective risk communication about the harms and benefits of different options for treatment or care.

    In this article we discuss whether the shift towards a greater use of information in consultations is helpful and summarise the current literature on risk communication. We also explore how information can be used without losing the benefits that are traditionally associated with the art, rather than the science, of medicine.

    Summary points

    Patients often desire more information than is currently provided

    Communicating about risks should be a two way process in which professionals and patients exchange information and opinions about those risks

    Professionals need to support patients in making choices by turning raw data into information that is more helpful to the discussions than the data

    “Framing” manipulations of information, such as using information about relative risk in isolation of base rates, to achieve professionally determined goals should be avoided

    “Decision aids” can be useful as they often include visual presentations of risk information and relate the information to more familiar risks

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    Methods

    This paper draws on systematic reviews and other key literature in the …

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