Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Too Much Information? Risk-benefit data does not always lead to informed decision-making

15.04.2011
Quantitative data should not be disclosed to all patients, article argues, and a commentary calls for research into how best to present information about risk

Giving patients data about the risks and benefits of a medical intervention is not always helpful and may even lead them to irrational decisions, according to an article in the Hastings Center Report. That finding calls into question whether it is essential to disclose quantitative data to patients to help them make informed decisions. An accompanying commentary calls for experimental evidence to determine the best way to provide information to patients.

The analyses come at a time when many patient advocates and others are embracing the "quantitative imperative" – the obligation to disclose risk-related data to patients to ensure informed consent and promote shared decision-making. Because patients often do not get information about all of their options by talking to their health care providers, decision aids – pamphlets, videos, and computer programs – increasingly are being used to convey such data more comprehensively. There are more than 500 decision aids and more than 55 randomized controlled trials studying their impact. A recent review concluded that decision aids increase patient knowledge and the feeling of being informed while decreasing indecision and passivity.

However, disclosure of quantitative data can backfire. "There are important problems with it stemming from the way people understand and respond to numerical and graphical information," writes Peter H. Schwartz, a faculty investigator at the Indiana University Center for Bioethics. An accompanying commentary by Peter Ubel, professor of marketing and public policy at Duke University, agrees with Schwartz's analysis of the numeracy problem, and argues that there ways to present risk that overcome some of the problems.

One problem is that more than half of adults have significant difficulty understanding or applying probabilistic and mathematical concepts. National surveys suggest that at least 22 percent of adults have only the most basic quantitative skills, such as counting, while another 33 percent fare only slightly better and are able to do simple arithmetic.

But even people who have a good grasp of probability and math are prone to biases in how they interpret data on risks, Schwartz says, citing 30 years of psychology literature. They may give exaggerated importance to small risks or, conversely, exhibit "optimism bias" and exaggerate the chance that they will be in the "lucky" group. "Which of these biases come into play in a given situation…. depends on the individual's psychology and the way the information is presented," he writes. Either way, the bias can lead patients to make decisions about medical interventions that are not based on reason or facts.

Schwartz cites as an example the interpretation of the new mammography guidelines announced by the United States Preventive Services Task Force in 2009, which proposed that screening start at age 50 instead of 40 and be done every two years instead of annually. While mammograms for women ages 40 to 49 slightly reduce mortality from breast cancer, they also result in significantly more false positives and overtreatment. Thus a woman's decision to get mammograms while she is in this age range involves important trade-offs, and the choice depends on the individual's beliefs and values.

Schwartz argues that clinicians should not always disclose all available quantitative data to all patients. "While the data should always be available to patients who want it, the question is, how to offer it and in what form," he writes. "These issues suggest that much more empirical research and ethical analysis are required about the use of quantitative information in decision-making."

"Questions about how and when to disclose quantitative information will become ever more pressing as advances in epidemiology and genetics provide increasingly precise ways to characterize the risks that patients face and the possible impacts of preventive treatments."

In his commentary, Peter Ubel reports that his studies show that whether decision aids improve patient decisions depends on how it is constructed. For example, pictographs proved better at conveying risks than narrative or other kinds of graphic information. He argues for research into how best to present information about risk to patients so as to aid decision making. "Those of us who care about patient autonomy and informed consent should work to find out what kind and manner of information will be most useful and least biasing to the largest number of people," he concludes.

Michael Turton | EurekAlert!
Further information:
http://www.thehastingscenter.org

More articles from Studies and Analyses:

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Terahertz spectroscopy goes nano

20.10.2017 | Information Technology

Strange but true: Turning a material upside down can sometimes make it softer

20.10.2017 | Materials Sciences

NRL clarifies valley polarization for electronic and optoelectronic technologies

20.10.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>