Science of Effective Risk Communication
Much of medicine is about risk – or the chance that something will happen.
To make wise decisions, doctors and patients need to understand the chance of disease and the chance of benefit – and harms – from tests and treatments. Effectively communicating about chance is very challenging. There are major gaps in the science of risk communication – what are the best ways to talk about chance events, convey uncertainty or even represent data. Our programhas done research on basic risk communication topics including defining and measuring numeracy (i.e., quantitative literacy) and testing a variety of interventions: a book – Know your chances - to improve numeracy, various numerical formats to communicate absolute risks and charts to put disease risks into context.
Screening Fact Sheets
Patient and Physician Guide: National Lung Screen Trial
This guide explains the benefits and harms of low-dose computed tomography (CT) screen for lung cancer in people at high riisk.
If you're a 55 year-old male who has never smoked, how likely is it you will die from heart disease over the next 10 years? From prostate cancer? Pneumonia? We have created charts to provide patients with information - based on actual records - of their risk of death. We used Census data and records from the National Center for Health Statistics to calculate age- and sex-specific death rates. In addition, we broke out the rates for smokers vs. non-smokers.
The Risk of Death by Age, Sex, and Smoking Status in the United States: Putting Health Risks in Context. Authored by Steven Woloshin , Lisa M. Schwartz, H . Gilbert Welch
To make sense of the disease risks they face, people need basic facts about the magnitude of a particular risk and how one risk compares with other risks. Unfortunately, this fundamental information is not readily available to patients or physicians. We created simple one-page charts that present the 10-year chance of dying from various causes according to age, sex, and smoking status.
We used the National Center for Health Statistics Multiple Cause of Death Public Use File for 2004 and data from the 2004 US Census to calculate age- and sex-specific death rates for various causes of death. We then combined data on smoking prevalence (from the National Health Interview Survey) and the relative risks of death from various causes for smokers vs never smokers (from the American Cancer Society’s Cancer Prevention Study-II) to determine age-, sex-, and smoking-specific death rates. Finally, we accumulated these risks for various starting ages in a series of 10-year life tables. The charts present the 10-year risks of dying from heart disease; stroke; lung, colon, breast, cervical, ovarian, and prostate cancer; pneumonia; influenza; AIDS; chronic obstructive pulmonary disease; accidents; and all causes.
Ann Intern Med, 1997;127: 966-72 Risk communication in clinical practice: Putting cancer in context
Monogr Natl Cancer Inst, 1999;25: 124-33 A new scale for assessing perceptions of chance: A validation study
Med Decis Making, 2000;20: 298-307 Can patients interpret health information? An assessment of the medical data interpretation test.
Med Dec Making, 2005;25: 290-300 The effectiveness of a primer to help people understand risk: Two randomized trials in distinct populations.
Ann Intern Med , 2007;146: 256-65 The risk of death by age, sex, and smoking status in the United States: Putting health risks in context
J Natl Cancer Inst. , 2008;100: 845-53 Quantitative literacy assessments: An introduction to testing tests.
Numeracy, 2009;Iss. 2, Article 3: