1. Decision Support as a Clinical Skill Module V: Communicating Risk Information Last update: September 2008

2. How big is the risk? 1   A person’s risk of getting colon cancer is: 1 in 2148 in 1000 0.0484.8% And the chance of dying of colon cancer is 17 out of 1000   The average person’s chance of getting colon cancer is…  Less than 1 out of 1000 in the next year  5 out of 1000 in the next 10 years  20 out of 1000 in the next 20 years  48 out of 1000 OVER A LIFETIME* *In this case, a lifetime is defined as 85 years…

3. Helping patients interpret risk information 1  How big is the change in risk?  “Lower than what?”  Explain your patient’s degree change in risk if she does something (e.g., take a drug, changes lifestyle) vs. if she does not  Does the change in risk information reasonably apply to your patient?  Are the people this change in risk information is based on similar to your patient? Sex, age, health status?  How does this risk compare to other risks?  Provide some context From: Schwartz LM, Woloshin, S and Welch HG, “Know Your Chances: Understanding Health Statistics.”

4. NUMBER TRANSLATOR 1 1 in ____ ____ out of 1000 Percent 1 in 1 1000100% 1 in 2 50050% 1 in 3 33333% 1 in 4 25025% 1 in 5 20020% 1 in 6 16717% 1 in 7 14314% 1 in 8 12513% 1 in 9 11111% 1 in 10 10010% 1 in 20 505.0% 1 in 25 404.0% 1 in 50 202.0% 1 in 100 101.0% 1 in 200 50.50% 1 in 250 40.40% 1 in 300 3.30.33% 1 in 400 2.50.25% 1 in 500 2.00.20% 1 in 600 1.70.17% 1 in 700 1.40.14% 1 in 800 1.30.13% 1 From: Schwartz LM, Woloshin, S and Welch HG, “Know Your Chances: Understanding Health Statistics.”

5. Presenting Risk Information Probability of outcome in people ‘like me’ who experience the problem Similar profile: Probability of outcome in people ‘like me’ who experience the problem : Use quantitative, qualitative and graphic formats (100 faces) to enhance understanding Format: Use quantitative, qualitative and graphic formats (100 faces) to enhance understanding : Risk message + ‘Positive’ message improves message framing Framing: Risk message + ‘Positive’ message improves message framing

6. From: Schwartz LM, Woloshin, S and Welch HG, “Know Your Chances: Understanding Health Statistics.”

7. Conclusion Clear risk communication techniques will assist patients in putting risks and benefits in context and help to ensure that they are making truly INFORMED choices Clear risk communication techniques will assist patients in putting risks and benefits in context and help to ensure that they are making truly INFORMED choices