Literature DB >> 18421509

The ethics of information: absolute risk reduction and patient understanding of screening.

Peter H Schwartz1, Eric M Meslin.   

Abstract

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decision-making. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence.

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Year:  2008        PMID: 18421509      PMCID: PMC2517883          DOI: 10.1007/s11606-008-0616-y

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


  43 in total

Review 1.  Measuring patients' preferences for treatment and perceptions of risk.

Authors:  A Bowling; S Ebrahim
Journal:  Qual Health Care       Date:  2001-09

2.  Does informed consent alter elderly patients' preferences for colorectal cancer screening? Results of a randomized trial.

Authors:  A M Wolf; J B Schorling
Journal:  J Gen Intern Med       Date:  2000-01       Impact factor: 5.128

3.  General performance on a numeracy scale among highly educated samples.

Authors:  I M Lipkus; G Samsa; B K Rimer
Journal:  Med Decis Making       Date:  2001 Jan-Feb       Impact factor: 2.583

Review 4.  Presenting risk information--a review of the effects of "framing" and other manipulations on patient outcomes.

Authors:  A Edwards; G Elwyn; J Covey; E Matthews; R Pill
Journal:  J Health Commun       Date:  2001 Jan-Mar

5.  Patients' responses to risk information about the benefits of treating hypertension.

Authors:  D Misselbrook; D Armstrong
Journal:  Br J Gen Pract       Date:  2001-04       Impact factor: 5.386

Review 6.  The extent of patients' understanding of the risk of treatments.

Authors:  A J Lloyd
Journal:  Qual Health Care       Date:  2001-09

7.  Informed adherence: the need for shared medical decision making.

Authors:  W J Sieber; R M Kaplan
Journal:  Control Clin Trials       Date:  2000-10

Review 8.  Shared decision making in clinical medicine: past research and future directions.

Authors:  D L Frosch; R M Kaplan
Journal:  Am J Prev Med       Date:  1999-11       Impact factor: 5.043

9.  The effectiveness of a primer to help people understand risk: two randomized trials in distinct populations.

Authors:  Steven Woloshin; Lisa M Schwartz; H Gilbert Welch
Journal:  Ann Intern Med       Date:  2007-02-20       Impact factor: 25.391

10.  Misconceptions about efficacy of mammography screening: a public health dilemma.

Authors:  E Chamot; T V Perneger
Journal:  J Epidemiol Community Health       Date:  2001-11       Impact factor: 3.710

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  6 in total

1.  Disclosure and rationality: comparative risk information and decision-making about prevention.

Authors:  Peter H Schwartz
Journal:  Theor Med Bioeth       Date:  2009

2.  Better decision making in preventive health screening: Balancing benefits and harms.

Authors:  Neil R Bell; Roland Grad; James A Dickinson; Harminder Singh; Ainsley Elizabeth Moore; Danielle Kasperavicius; Kaylyn L Kretschmer
Journal:  Can Fam Physician       Date:  2017-07       Impact factor: 3.275

3.  Doctors and patients' susceptibility to framing bias: a randomized trial.

Authors:  Thomas V Perneger; Thomas Agoritsas
Journal:  J Gen Intern Med       Date:  2011-07-27       Impact factor: 5.128

4.  Risk communication in clinical trials: a cognitive experiment and a survey.

Authors:  Yin Bun Cheung; Hwee Lin Wee; Julian Thumboo; Cynthia Goh; Ricardo Pietrobon; Han Chong Toh; Yu Fen Yong; Say Beng Tan
Journal:  BMC Med Inform Decis Mak       Date:  2010-09-27       Impact factor: 2.796

5.  Layperson Views about the Design and Evaluation of Decision Aids: A Public Deliberation.

Authors:  Peter H Schwartz; Kieran C O'Doherty; Colene Bentley; Karen K Schmidt; Michael M Burgess
Journal:  Med Decis Making       Date:  2021-04-05       Impact factor: 2.583

Review 6.  Use of relative and absolute effect measures in reporting health inequalities: structured review.

Authors:  Nicholas B King; Sam Harper; Meredith E Young
Journal:  BMJ       Date:  2012-09-03
  6 in total

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