Washington University School of Medicine, Saint Louis, MO, United States.
Kent State University, Kent, OH, United States.
J Med Internet Res. 2021 Jan 25;23(1):e23318.
Internet-based risk assessment tools offer a potential avenue for people to learn about their cancer risk and adopt risk-reducing behaviors. However, little is known about whether internet-based risk assessment tools adhere to scientific evidence for what constitutes good risk communication strategies. Furthermore, their quality may vary from a user experience perspective.
This study aims to understand the extent to which current best practices in risk communication have been applied to internet-based cancer risk assessment tools.
We conducted a search on August 6, 2019, to identify websites that provided personalized assessments of cancer risk or the likelihood of developing cancer. Each website (N=39) was coded according to standardized criteria and focused on 3 categories: general website characteristics, accessibility and credibility, and risk communication formats and strategies.
Some best practices in risk communication were more frequently adhered to by websites. First, we found that undefined medical terminology was widespread, impeding comprehension for those with limited health literacy. For example, 90% (35/39) of websites included technical language that the general public may find difficult to understand, yet only 23% (9/39) indicated that medical professionals were their intended audience. Second, websites lacked sufficient information for users to determine the credibility of the risk assessment, making it difficult to judge the scientific validity of their risk. For instance, only 59% (23/39) of websites referenced the scientific model used to calculate the user's cancer risk. Third, practices known to foster unbiased risk comprehension, such as adding qualitative labels to quantitative numbers, were used by only 15% (6/39) of websites.
Limitations in risk communication strategies used by internet-based cancer risk assessment tools were common. By observing best practices, these tools could limit confusion and cultivate understanding to help people make informed decisions and motivate people to engage in risk-reducing behaviors.
基于互联网的风险评估工具为人们了解自身癌症风险和采取降低风险的行为提供了一种潜在途径。然而，人们对于这些工具是否符合良好风险沟通策略的科学证据知之甚少。此外，从用户体验的角度来看，这些工具的质量可能存在差异。
本研究旨在了解当前互联网癌症风险评估工具在多大程度上应用了风险沟通的最佳实践。
我们于 2019 年 8 月 6 日进行了一次搜索，以确定提供个性化癌症风险评估或癌症发病可能性评估的网站。每个网站（N=39）都根据标准化标准进行了编码，并侧重于 3 个类别：一般网站特征、可及性和可信度，以及风险沟通格式和策略。
一些风险沟通的最佳实践更频繁地被网站所遵循。首先，我们发现未定义的医学术语普遍存在，这会阻碍那些健康素养有限的人的理解。例如，90%（35/39）的网站包含公众可能难以理解的专业术语，但只有 23%（9/39）的网站表示其目标受众是医学专业人员。其次，网站缺乏足够的信息让用户确定风险评估的可信度，这使得很难判断其风险的科学有效性。例如，只有 59%（23/39）的网站引用了用于计算用户癌症风险的科学模型。第三，只有 15%（6/39）的网站使用了已知可以促进公正风险理解的实践，例如为定量数据添加定性标签。
互联网癌症风险评估工具在风险沟通策略方面存在局限性。通过观察最佳实践，这些工具可以减少混淆，培养理解，帮助人们做出明智的决策，并激励人们采取降低风险的行为。
