Literature DB >> 18300064

Alternate methods of framing information about medication side effects: incremental risk versus total risk of occurrence.

Brian J Zikmund-Fisher1, Angela Fagerlin, Todd R Roberts, Holly A Derry, Peter A Ubel.   

Abstract

Communications of treatment risk, such as medication package inserts, commonly report total rates of adverse reactions (e.g., 4% get heartburn with placebo, 9% with medication). This approach, however, requires mental arithmetic to distinguish the incremental risk caused by medication (here, 5%) from the total post-treatment risk. In two Internet-administered survey experiments (N = 2,012 and 1,393), we tested whether explicitly reporting the incremental risk and framing it as the "additional risk" of complications influenced people's impressions of adverse event risks. Study 1 compared side-by-side displays of total risks against sequential presentations that highlighted the incremental risk, using both text and graphical formats. Results showed that incremental risk formats significantly lowered participants' worry about complications and reduced biases caused by varying the risk denominator. Study 2 unpacked this factor and showed that its effect on both perceived likelihood and worry derives primarily from the incremental risk framing rather than from sequential presentation. Explicitly reporting incremental risk statistics appears to facilitate recognition of how much risk already exists at baseline. Presenting adverse reaction risks in this manner may improve patient comprehension of the effects of treatment decisions and support effective risk communication.

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Year:  2008        PMID: 18300064     DOI: 10.1080/10810730701854011

Source DB:  PubMed          Journal:  J Health Commun        ISSN: 1081-0730


  20 in total

1.  Effect of various risk/benefit trade-offs on parents' understanding of a pediatric research study.

Authors:  Alan R Tait; Brian J Zikmund-Fisher; Angela Fagerlin; Terri Voepel-Lewis
Journal:  Pediatrics       Date:  2010-05-10       Impact factor: 7.124

2.  Patient decision making about organ quality in liver transplantation.

Authors:  Michael L Volk; Rachel S Tocco; Shawn J Pelletier; Brian J Zikmund-Fisher; Anna S F Lok
Journal:  Liver Transpl       Date:  2011-12       Impact factor: 5.799

3.  Helping patients decide: ten steps to better risk communication.

Authors:  Angela Fagerlin; Brian J Zikmund-Fisher; Peter A Ubel
Journal:  J Natl Cancer Inst       Date:  2011-09-19       Impact factor: 13.506

4.  The effect of format on parents' understanding of the risks and benefits of clinical research: a comparison between text, tables, and graphics.

Authors:  Alan R Tait; Terri Voepel-Lewis; Brian J Zikmund-Fisher; Angela Fagerlin
Journal:  J Health Commun       Date:  2010-07

5.  Prevalence of tamoxifen use for breast cancer chemoprevention among U.S. women.

Authors:  Erika A Waters; Kathleen A Cronin; Barry I Graubard; Paul K Han; Andrew N Freedman
Journal:  Cancer Epidemiol Biomarkers Prev       Date:  2010-02       Impact factor: 4.254

Review 6.  Risky feelings: why a 6% risk of cancer does not always feel like 6%.

Authors:  Brian J Zikmund-Fisher; Angela Fagerlin; Peter A Ubel
Journal:  Patient Educ Couns       Date:  2010-08-23

7.  Belief in numbers: When and why women disbelieve tailored breast cancer risk statistics.

Authors:  Laura D Scherer; Peter A Ubel; Jennifer McClure; Sarah M Greene; Sharon Hensley Alford; Lisa Holtzman; Nicole Exe; Angela Fagerlin
Journal:  Patient Educ Couns       Date:  2013-04-24

8.  A demonstration of ''less can be more'' in risk graphics.

Authors:  Brian J Zikmund-Fisher; Angela Fagerlin; Peter A Ubel
Journal:  Med Decis Making       Date:  2010-04-07       Impact factor: 2.583

9.  Testing whether decision aids introduce cognitive biases: results of a randomized trial.

Authors:  Peter A Ubel; Dylan M Smith; Brian J Zikmund-Fisher; Holly A Derry; Jennifer McClure; Azadeh Stark; Cheryl Wiese; Sarah Greene; Aleksandra Jankovic; Angela Fagerlin
Journal:  Patient Educ Couns       Date:  2009-12-09

Review 10.  Written information about individual medicines for consumers.

Authors:  Donald Nicolson; Peter Knapp; D K Theo Raynor; Pat Spoor
Journal:  Cochrane Database Syst Rev       Date:  2009-04-15
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