Intended for healthcare professionals


Effect of providing information about normal test results on patients' reassurance: randomised controlled trial

BMJ 2007; 334 doi: (Published 15 February 2007) Cite this as: BMJ 2007;334:352
  1. Keith J Petrie, professor1,
  2. Jan Tobias Müller, diplom psychologist3,
  3. Frederike Schirmbeck, diplom psychologist3,
  4. Liesje Donkin, student1,
  5. Elizabeth Broadbent, lecturer1,
  6. Christopher J Ellis, cardiologist2,
  7. Greg Gamble, statistician2,
  8. Winfried Rief, professor3
  1. 1Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, New Zealand
  2. 2Department of Cardiology, Auckland City Hospital
  3. 3Philipps-University, Faculty of Psychology, Marburg, Germany
  1. Correspondence to: K J Petrie kj.petrie{at}
  • Accepted 12 December 2006


Objective To investigate whether providing information about normal findings before a diagnostic test improves patients' reassurance and reduces anxiety about symptoms.

Design Randomised controlled trial.

Setting Outpatient cardiology clinic.

Participants 92 patients with chest pain referred for a diagnostic exercise stress test.

Intervention Before undergoing testing patients were randomised to receive standard information (n=28; control group), a pamphlet explaining the function of the test and the meaning of normal test results (n=30; pamphlet group), or the pamphlet and a brief discussion about the meaning of normal test results (n=34; discussion group).

Main outcome measures The primary outcome was patients' reported reassurance on a 5 item scale immediately after the test and at one month. Secondary outcomes were the proportion of patients still with chest pain and still taking cardiac drugs at one month.

Results The mean levels of reassurance after testing and feedback from the doctor were significantly higher in the discussion group (42.0, 95% confidence interval 39.7 to 44.2) than in the pamphlet (39.2, 36.1 to 42.3) and control groups (35.8, 31.6 to 39.9). This difference was maintained at one month. The proportion of patients still reporting chest pain at one month decreased significantly in the discussion group (to 17%) and pamphlet group (to 28%) but not in the control group (to 36%). A trend was for fewer patients in the discussion group to be taking cardiac drugs at one month.

Conclusion Providing patients with information about normal test results before testing can improve rates of reassurance and reduce the likelihood of future reports of chest pain.

Trial registration Current Controlled Trials ISRCTN87589121.


  • Contributors: KJP conceived and designed the study, drafted the manuscript, and is guarantor. JTM, FS, and LD helped develop the study materials and run the trial. GG, EB, CJE, and WR helped with data interpretation. CJE, WR, EB, and GG helped draft the paper. All authors contributed to and approved the final version.

  • Funding: University of Auckland.

  • Competing interests: None declared.

  • Ethical approval: This study was approved by the New Zealand Ministry of Health Ethics Committee (AKY/04/05/121).

  • Accepted 12 December 2006
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