Perception of treatment risk depends on how the surgeon communicates risk information to the patient

Awareness of treatment risk depends on how risk information is communicated. Credit: American College of Surgeons

A study presented at the Virtual American College of Surgeons (ACS) Clinical Conference 2021 found that using quantitative rather than qualitative terms to describe the risks of different treatment options improved communication between surgeons and patients. Will be done.

Based on a survey of adults in the United States, researchers find that using qualitative explanations of various risks (for example, using terms such as “sometimes” and “rare”) leads to broader interpretations. discovered. In contrast, according to the authors, the diversification of interpretations was low when the subjects were given a risk rate (eg, 1% risk) or a range of risk rates (eg, 1-5%).

Joshua E. Rosen, MD, MHS, a researcher and first research author at the Center for Surgical Outcomes Research at the University of Washington in Seattle, tells patients to understand the potential complications of various alternative therapies. It is important to help you make based decisions.Patient is needed Accurate information Dr. Rosen said about the types and extents of risk they face, allowing them to make decisions in the context of what is happening in their lives.

When comparing surgery to a course of antibiotics, the results and quality of life may be very similar, but there are differences in other results that may be important to the patient. For example, the recovery time associated with surgery can lead to work or school breaks, but antibiotics risk unresolved problems and require surgery later. Students taking future exams may prefer to choose an antibiotic course over surgery first. Recovery time Dr. Rosen explained that it could prevent him from taking the exam in connection with surgery.

“The way surgeons communicate with patients is really important,” said Dr. Rosen. “We need to communicate accurately so that patients can interpret that information in their lives.”

Unfortunately, the use of qualitative explanations of risk tends to lead to different interpretations. For example, the subjects were given one of three explanations for the risk of deep space infection after appendicitis surgery.

  • 3 percent
  • 1-5 percent
  • rare

Respondents were then asked to characterize the risk of deep space infection after surgery for appendicitis (appendectomy). People who are said to be at risk “rare” use the term to mean that they are on average 26% more likely to get infected, much higher than the 3% or 1-5% range of point estimates. He said he interpreted it. ..

“Surgeons need to be careful in communicating such information as it can affect how patients perceive risk. Our findings emphasize how surgeons do it. Advances what every surgeon knows what to do, “says senior research authors Joshua M. Liao, MD, and MSc. .. “Surgeons can use our findings to consider when and how to communicate risk using numerical estimates and ranges.”

Joshua E. Rosen, MD, MHS, General Surgery at the University of Washington School of Medicine in Seattle, and the first research author will explain the findings. Credit: American College of Surgeons

Survey results are communication tools

According to Dr. Rosen, the results of this study are intended to be used as a tool to help surgeons advise patients. Based on these findings, the surgeon should:

  • Be aware that the way information is communicated affects how patients receive or interpret it.
  • Since there is little room for interpretation variation, we communicate numerically.
  • Use the qualitative description of risk only if it is numbered.
  • Check with the patient to assess how well the patient understands their condition and potential treatment options.

The survey was conducted on 296 American adults (54% male) recruited through Amazon Mechanical Turk (MTurk). Respondents were asked to estimate the risk of complications (0-100 percent) of “typical patients with appendicitis”. In this study, we used the Fligner-Killeen test for variance uniformity to compare the spread of respondent estimates based on the risk communication language.

Of the 296 respondents, the variance of risk estimates was highest for all complications tested when risk was communicated using qualitative descriptors. In addition, the variance was generally lower when the risk was communicated as a point estimate rather than a range.

A broader effort is underway

This study is part of a broad portfolio through the Decision Science Group ( that seeks to improve health by improving the way doctors, clinical teams, patients, and their loved ones make medical decisions. Dr. Liao says it is a department. One of the main goals of the group’s work is to put the insights into practice by using the results of this study to design decision-making tools and protocols that will help patients make decisions about appendicitis treatment. Core members of this group include faculty members from the Faculty of Medicine, the Faculty of Public Health, and the Foster Business School at the University of Washington.

Pregnant women get better results after immediate surgery for complex appendicitis

For more information:
Rosen JE et al. Perception of treatment risk depends on how risk information is communicated. American College of Surgeons Clinical Conference 2021.

Quote: Treatment risk awareness was obtained by the surgeon from on October 24, 2021 (October 24, 2021). ) Depends on the method of communicating risk information. html

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Perception of treatment risk depends on how the surgeon communicates risk information to the patient

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