Communicating benefit and risk

• Published in: British journal of haematology Vol. 146; no. 1; pp. 31 - 33
• Main Author: Baglin, Trevor
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2009; Blackwell
• Subjects: Biological and medical sciences; communication; Disclosure; Hematologic and hematopoietic diseases; Humans; Medical sciences; Patient Participation; Randomized Controlled Trials as Topic - methods; Randomized Controlled Trials as Topic - statistics & numerical data; Research Design; Risk; Risk Assessment - methods; risk reduction; Risk Reduction Behavior; Sample Size; shared decision‐making; Treatment Outcome; risk reduction; Benefit risk analysis; Hematology; Decision making; Risk factor; shared decision-making; risk; Communication
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/j.1365-2141.2009.07709.x

Summary Improved reporting of clinical trials and greater engagement by patients in treatment decisions requires that clinicians have a working knowledge of estimates of benefit and risk and how to communicate these measures. A basic understanding of study design and analysis is often neglected by clinicians in training, and recent analyses indicate that inadequate reporting and design are associated with biassed estimates of treatment effects. Communicating likely treatment results to patients requires presentation of information as absolute rather than relative risk, using common denominators or probabilities, and explaining risk with reference to a proposed treatment duration. Conveying uncertainty in relation to estimates of likelihood is particularly difficult when discussing outcomes with patients and often the clinician is still left with phrases such as ‘best guess’.