Perception of semiquantitative terms in surgery.

OBJECTIVE

To assess whether semiquantitative terms (eg, "often" or "rare"), which are often used for achieving informed consent, have the same meaning for laypersons and physicians.

BACKGROUND

To obtain informed consent, physicians have to make their patients aware of the risks of an operation. Thereby, semiquantitative terms are often used.

METHODS

Questionnaire interview among surgeons and randomly approached laypersons. A set of semiquantitative terms was presented to participants for quantification. Pertinent to 8 exemplary complications of common operations, these values were compared among the 2 interviewed groups and corresponding rates in scientific literature.

RESULTS

The questionnaire was completed by 48 surgeons and 582 laypersons in Switzerland. Confronted with corresponding complication rates in literature, laypersons underestimated the risk significantly in 6 of 8 cases. After a simulated informed consent conversation with a surgeon by using semiquantitative terms, laypersons overestimated the complication rate significantly in 7 of 8 cases. An interaction analysis did not show any significant difference between correct estimations of complication rates of respondents who graduated, who had a professional medical background or who had had prior contact with the health care system (eg, medical consultation, hospitalization, operation) compared with the others.

CONCLUSIONS

Laypersons overestimate probabilities of semiquantitative terms named by surgeons. We recommend using "percentages" or "odds ratios" to achieve a more reliable preoperative informed consent.