Department of Anaesthesia, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
University of Sheffield Medical School, Sheffield, UK.
Anaesthesia. 2020 Jan;75 Suppl 1:e39-e45. doi: 10.1111/anae.14871.
Shared decision-making is central to the pre-operative consent process and accurate communication of risk is dependent on a clear understanding of numerical information by both the patient and clinician. The risk of an adverse event or complication is often described using verbal probability expressions but how these are interpreted by clinicians and patients in the pre-operative setting has not been studied. We asked patients and clinicians to assign a numerical translation (as a percentage) for seven verbal probability expressions in relation to the probability of a major peri-operative complication occurring. In total, data from 290 patients and 57 clinicians were analysed. There was a wide range in percentages assigned by patients to all verbal probability expressions. Patients assigned a wider range of percentage values to each of the verbal probability expressions and these were all significantly higher than those assigned by clinicians: median (IQR [range]) negligible risk 5% (1-15 [0-100]) vs. 0% (0-0 [0-5]); minimal risk 5% (2-10) [0-100]) vs. 1% (0-1 [0-10]); low risk 10% (3-10 [0-100]) vs. 1% (0-2) [0-10]); standard risk 20% (10-40) [0-100]) vs. 1% (1-5) [0-30]); moderate risk 33% (20-50) [0-100]) vs. 5% (3-10) [0-80]); high risk 70% (30-90 [0-100]) vs. 15% (10-40) [1-75]); and very high risk 90% (50-95 [0-100]) vs. 40% (20-50 [5-100]), respectively (p < 0.005 for all comparisons). There is considerable variation in the numerical translation of verbal probability expressions by both patients and clinicians. This suggests that verbal probability expressions should not be used in isolation as part of doctor-patient discussions regarding peri-operative risk.
译文：
标题：术前风险沟通中的语言概率表达与数字理解
作者：Stacey M. O'Connor,MBBS, PhD, et al.
摘要：
目的：术前知情同意过程的核心是医患共同决策，而准确传达风险则依赖于医患双方对数值信息的清晰理解。通常使用口头概率术语来描述不良事件或并发症的风险，但这些术语在术前环境中是如何被医患双方理解的，尚未得到研究。我们要求患者和临床医生为 7 种口头概率术语指定数值翻译（以百分比表示），以反映主要围手术期并发症发生的概率。共分析了 290 名患者和 57 名临床医生的数据。患者对所有口头概率术语的赋值百分比范围很广。患者对每种口头概率术语的赋值范围都较宽，且均显著高于临床医生的赋值：极小风险（5%，1-15[0-100]）vs. 0%（0-0[0-5]）；微小风险（5%，2-10）[0-100]）vs. 1%（0-1[0-10]）；低风险（10%，3-10[0-100]）vs. 1%（0-2[0-10]）；标准风险（20%，10-40[0-100]）vs. 1%（1-5[0-30]）；中度风险（33%，20-50[0-100]）vs. 5%（3-10[0-80]）；高风险（70%，30-90[0-100]）vs. 15%（10-40[1-75]）；极高风险（90%，50-95[0-100]）vs. 40%（20-50[5-100]），差异均有统计学意义（所有比较 P<0.005）。患者和临床医生对口头概率术语的数值翻译存在较大差异。这表明，在围手术期风险的医患讨论中，不应单独使用口头概率术语。
