Center for Bioethics and Social Sciences in Medicine, 300 North Ingalls St, Rm 7C27, Ann Arbor, MI 48109-5429, USA.
J Natl Cancer Inst. 2011 Oct 5;103(19):1436-43. doi: 10.1093/jnci/djr318. Epub 2011 Sep 19.
With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. Many Americans have low numeracy skills making the cognitive demands even greater whenever, as is often the case, patients are presented with risk statistics and asked to make comparisons between the risks and benefits of multiple options and to make informed medical decisions. In this commentary, we highlight 10 methods that have been empirically shown to improve patients' understanding of risk and benefit information and/or their decision making. The methods range from presenting absolute risks using frequencies (rather than presenting relative risks) to using a risk format that clarifies how treatment changes risks from preexisting baseline levels to using plain language. We then provide recommendations for how health-care providers and health educators can best to communicate this complex medical information to patients, including using plain language, pictographs, and absolute risks instead of relative risks.
越来越多的患者被要求在癌症筛查、预防和治疗方面做出复杂的决策。这些决策同时充满了情感和认知上的困难。许多美国人的计算能力较低，这使得认知要求更加艰巨，尤其是当患者经常被提供风险统计数据，并被要求在多种选择的风险和益处之间进行比较，并做出明智的医疗决策时。在这篇评论中，我们强调了 10 种经过实证证明可以提高患者对风险和收益信息的理解和/或决策能力的方法。这些方法范围从使用频率（而不是呈现相对风险）呈现绝对风险，到使用一种风险格式，阐明治疗如何将风险从预先存在的基线水平改变，再到使用通俗易懂的语言。然后，我们为医疗保健提供者和健康教育者提供了如何最好地向患者传达这种复杂的医疗信息的建议，包括使用通俗易懂的语言、图表和绝对风险而不是相对风险。
