Department of Anesthesiology, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
Pediatrics. 2010 Jun;125(6):e1475-82. doi: 10.1542/peds.2009-1796. Epub 2010 May 10.
Informed decision-making requires that parents and research subjects understand the risks and benefits of a study, yet research suggests that comprehension of these elements is often poor. This study was designed to examine the effect of factors including manipulation of risk/benefit trade-offs, numeracy, and sociodemographics on parents' understanding of risks and benefits.
A total of 4685 parents completed an Internet survey in which they were randomly assigned to receive information about the risks and benefits of a hypothetical pain treatment study presented in 1 of 4 scenarios. Parents' gist (essential) and verbatim (exact) understanding and their perceptions of the risks and benefits were compared across scenarios. The effects of parental sociodemographics and numeracy were also examined.
Participants who were randomly assigned to consider a research study that offered the possibility of improved outcomes had higher gist and verbatim understanding of the information than participants who were considering studies that offered only reductions in the risk for adverse effects. Furthermore, these parents perceived the risks of the study to be significantly lower compared with the scenarios that offered the same risks but less benefit. White race, college education, and higher numeracy all were associated significantly with improved gist and verbatim understanding.
Research studies that offer only improved outcomes to participants may be evaluated more thoroughly than those that offer only reduced risks, and individual characteristics significantly moderate parents' ability to comprehend risk/benefit information. These results are important toward developing strategies to improve the ways in which risks and benefits are communicated to parents and research subjects.
知情决策要求家长和研究对象理解研究的风险和获益,但研究表明,他们对这些内容的理解往往较差。本研究旨在考察包括风险/获益权衡的操作、计算能力和社会人口统计学等因素对家长理解风险和获益的影响。
共有 4685 名家长完成了一项在线调查,他们被随机分配到 4 种情景中的 1 种,以了解假设的疼痛治疗研究的风险和获益信息。比较了家长对情景的要点(要点)和逐字(确切)理解,以及他们对风险和获益的看法。还考察了父母的社会人口统计学和计算能力的影响。
与考虑只降低不良反应风险的研究相比,被随机分配考虑提供改善结果可能性的研究的参与者对信息的要点和逐字理解更高。此外,与提供相同风险但获益较少的情景相比,这些家长认为研究的风险显著降低。白种人、大学教育和较高的计算能力都与要点和逐字理解的改善显著相关。
为参与者提供仅改善结果的研究可能会比仅降低风险的研究更全面地评估,而个体特征则显著调节家长理解风险/获益信息的能力。这些结果对于制定策略以改善向家长和研究对象传达风险和获益的方式非常重要。