Nebraska TeratogenInformation Service, 985440 Nebraska Medical Center, Omaha, NE 68198-544, USA.
Am J Med Genet C Semin Med Genet. 2011 Aug 15;157C(3):227-33. doi: 10.1002/ajmg.c.30308. Epub 2011 Jul 15.
Despite scientific advances in clinical teratology, exposures during pregnancy still cause great anxiety and misunderstanding. Patients and health care providers are frequently called upon to determine the health implications of scientific studies, which may involve limited and contradictory data. These findings are often conveyed numerically, which is a particularly difficult form of information for both patients and their health providers to understand and interpret. Almost half of the general population (and a substantial minority of physicians) have difficulty with numeracy. Patients with low numeracy tend to interpret information in an absolute manner and ignore uncertainty, have more difficulty using numeric information to inform their choices, and are more easily influenced by emotion and the format used in presenting information. Formats involved in conveying probability include positive or negative framing, use of relative versus absolute risk, and ratios and percentages. Health providers should communicate risk analysis in a fashion that facilitates comprehension and results in informed behavior. This is more likely to be achieved when risks are conceptualized as more than just numbers, and are considered in the context of individuals' life circumstances and values. Most teratogen risk communication is done over the telephone; this presents both advantages and challenges. Strategies are suggested to improve risk communication. These include avoiding the use of relative risk, using a consistent denominator, framing the information in a variety of ways (positive vs. negative), using verbal qualifiers judiciously, and employing visual aids.
尽管临床畸形学在科学上取得了进步，但孕期暴露仍会引起极大的焦虑和误解。患者和医疗保健提供者经常被要求确定科学研究的健康影响，这些研究可能涉及有限和相互矛盾的数据。这些发现通常以数字形式呈现，这对于患者及其医疗保健提供者来说都是一种特别难以理解和解释的信息形式。几乎一半的普通民众（以及相当一部分医生）都难以理解数字。计算能力低的患者往往以绝对的方式解释信息，忽略不确定性，更难以使用数字信息来指导他们的选择，并且更容易受到情绪和呈现信息的格式的影响。传达概率的格式包括正面或负面的框架、使用相对风险与绝对风险以及比值和百分比。医疗保健提供者应该以促进理解和产生知情行为的方式传达风险分析。当风险被视为不仅仅是数字，并且考虑到个人的生活环境和价值观时，更有可能实现这一目标。大多数致畸物风险沟通都是通过电话进行的；这既带来了优势，也带来了挑战。本文提出了一些策略来改善风险沟通。这些策略包括避免使用相对风险、使用一致的分母、以各种方式（正面与负面）构建信息、谨慎使用口头限定词以及使用视觉辅助工具。
