Woloshin K K, Ruffin M T, Gorenflo D W
Department of Family Practice, MidMichigan Regional Medical Center, Midland.
Arch Fam Med. 1994 Nov;3(11):961-6. doi: 10.1001/archfami.3.11.961.
Physicians often use qualitative probability statements to compare treatment options or describe risks of treatment, especially if exact numerical information is not readily available.
To determine (1) the effect of context, experience, age, gender, race, occupation, and education on patients' numerical interpretation of probability terms and (2) patient preferences for information about side effects (qualitative or numerical).
Cross-sectional survey.
A university-based family practice in Ann Arbor, Mich.
Patients 18 years of age and older and parents of patients younger than 18 years of age seen during January and February 1993 for any reason except complete physical examination.
A questionnaire presented scenarios of minor and major complications related to four different medical conditions. Participants were asked to estimate how many people of 100 would have a complication if their physician described the risk for the complication in each scenario as unlikely. Participants were then asked whether they preferred receiving information from their physician about the risk for complications in words or numbers.
Of 345 questionnaires distributed, 307 patients (89%) completed them. The rates assigned to the minor complications were significantly higher than the rates assigned to the major complications (P = .0001). Participants who had experienced the described complication reported significantly higher rates for the minor complications of vaccination and surgery (P = .0001 and P = .0235, respectively). Education had a significant effect only on the rates assigned to vaccination complications (P = .0069). Occupation had a significant effect only on the rates assigned to antibiotic side effects (P = .0090).
When a physician uses qualitative probability statements, he or she must be sensitive to the patient's previous experience with that procedure or medication. Also, if one wants to convey the same potential rate of occurrence for major and minor side effects, then one needs to use different words for each.
医生经常使用定性概率陈述来比较治疗方案或描述治疗风险，尤其是在无法轻易获得确切数字信息的情况下。
确定（1）背景、经验、年龄、性别、种族、职业和教育对患者对概率术语的数字解释的影响，以及（2）患者对副作用信息（定性或数字）的偏好。
横断面调查。
密歇根州安阿伯市一家大学附属的家庭医疗诊所。
1993年1月和2月期间因任何原因前来就诊的18岁及以上患者以及18岁以下患者的父母，但不包括全面体检者。
一份问卷呈现了与四种不同医疗状况相关的轻微和严重并发症的情景。参与者被要求估计，如果他们的医生将每种情景中并发症的风险描述为不太可能，那么100人中有多少人会发生并发症。然后，参与者被问及他们更喜欢从医生那里获得关于并发症风险的文字信息还是数字信息。
在分发的345份问卷中，307名患者（89%）完成了问卷。分配给轻微并发症的发生率显著高于分配给严重并发症的发生率（P = .0001）。经历过所述并发症的参与者报告的疫苗接种和手术轻微并发症发生率显著更高（分别为P = .0001和P = .0235）。教育仅对分配给疫苗接种并发症的发生率有显著影响（P = .0069）。职业仅对分配给抗生素副作用的发生率有显著影响（P = .0090）。
当医生使用定性概率陈述时，他或她必须对患者先前对该程序或药物的经验敏感。此外，如果想要传达相同的严重和轻微副作用潜在发生率，那么对于每种情况需要使用不同的措辞。
