Article type
Year
Abstract
Introduction/Objective: Informed consent to treatment requires that both physicians' and patients' comprehensions of the probability of risks and benefits of therapy be congruent. A common approach by physicians is to use qualitative descriptors of likelihood of each outcome to aid the patient's decision making. Our goal is to enhance doctor-patient communication particularly with respect to decision making. This study may show that this may best be accomplished by eliminating qualitative descriptors as a means of presenting risks/benefits.
Methods: This study is primarily descriptive in nature and is not hypothesis testing. The study population included non-physician patients from a family practice centre, menopausal clinic and general medicine clinics. A sample size of 180 women was required in order to determine statistical significance. Each respondent was presented 6 scenarios describing a patient experience, which expresses the likelihood of disease. The study subject was asked to estimate the likelihood of disease represented. They were then asked to select their preferred means of presenting the risk/benefit of HRT for the described scenario in preventing the sequelae. The four means of presenting the data were: an analogy to represent the estimated risk/benefit, percentage, graphic scale or one word descriptor.
Results: There was a correlation between the level of education and the presentation format of preference. Only 55.3%, 51.4% and 60.4% of individuals with a maximum of a high school diploma faced with an average risk scenario for osteoporosis, CHD and breast cancer preferred being presented a percentage versus 77.3%, 77.8% and 77.3% of those having attended university. As the respondent aged, there was an increasing tendency toward using a single word to express risk or benefit.
Discussion: Medicine is a complicated subject, with its own language. Therefore, the ability to render it comprehensible for the layman is part of the Art of its practice. The importance of being able to discuss treatment options, implicating the patient in the decision-making process, cannot be overestimated. The first aspect to consider is the audience, the patient. Here lies the ultimate tool, being able to assess the patient's understanding and adjust our explications to meet that level. This implies having various means of interpreting the latest evidence to support practice guidelines to our patients. The study also demonstrated a significant need for patient education with respect to HRT. The lack of necessary information may unfortunately be a reproach of our medical system, such that very little time, money and effort are allocated to patient education and primary and secondary prevention of quite common disease entities.
Methods: This study is primarily descriptive in nature and is not hypothesis testing. The study population included non-physician patients from a family practice centre, menopausal clinic and general medicine clinics. A sample size of 180 women was required in order to determine statistical significance. Each respondent was presented 6 scenarios describing a patient experience, which expresses the likelihood of disease. The study subject was asked to estimate the likelihood of disease represented. They were then asked to select their preferred means of presenting the risk/benefit of HRT for the described scenario in preventing the sequelae. The four means of presenting the data were: an analogy to represent the estimated risk/benefit, percentage, graphic scale or one word descriptor.
Results: There was a correlation between the level of education and the presentation format of preference. Only 55.3%, 51.4% and 60.4% of individuals with a maximum of a high school diploma faced with an average risk scenario for osteoporosis, CHD and breast cancer preferred being presented a percentage versus 77.3%, 77.8% and 77.3% of those having attended university. As the respondent aged, there was an increasing tendency toward using a single word to express risk or benefit.
Discussion: Medicine is a complicated subject, with its own language. Therefore, the ability to render it comprehensible for the layman is part of the Art of its practice. The importance of being able to discuss treatment options, implicating the patient in the decision-making process, cannot be overestimated. The first aspect to consider is the audience, the patient. Here lies the ultimate tool, being able to assess the patient's understanding and adjust our explications to meet that level. This implies having various means of interpreting the latest evidence to support practice guidelines to our patients. The study also demonstrated a significant need for patient education with respect to HRT. The lack of necessary information may unfortunately be a reproach of our medical system, such that very little time, money and effort are allocated to patient education and primary and secondary prevention of quite common disease entities.