How Do Physicians Provide Statistical Information about Antidepressants to Hypothetical Patients?

被引:11
作者
Gaissmaier, Wolfgang [1 ]
Anderson, Britta L. [2 ]
Schulkin, Jay [2 ]
机构
[1] Max Planck Inst Human Dev, Harding Ctr Risk Literacy, D-14195 Berlin, Germany
[2] Amer Coll Obstetricians & Gynecologists, Washington, DC 20024 USA
关键词
informed consent; risk communication; patient-physician communication; statistical literacy; DRUG FACTS BOX; PREFERENCE REVERSALS; LOW NUMERACY; RISK; DOCTORS; GYNECOLOGISTS; COMPREHENSION; EVALUABILITY; VALIDATION; LITERACY;
D O I
10.1177/0272989X13501720
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background. Little is known about how physicians provide statistical information to patients, which is important for informed consent. Methods. In a survey, obstetricians and gynecologists (N = 142) received statistical information about the benefit and side effects of an antidepressant. They received information in various formats, including event rates (antidepressant v. placebo), absolute risks, and relative risks. Participants had to imagine 2 hypothetical patients, 1 for whom they believed the drug to be safe and effective and 1 for whom they did not, and select the information they would give those patients. We assessed whether the information they selected for each patient was complete, transparent, interpretable, or persuasive (i.e., to nudge patients toward a particular option) and compared physicians who gave both patients the same information with those who gave both patients different information. Results. A similar proportion of physicians (roughly 25% each) selected information that was 1) complete and transparent, 2) complete but not transparent, 3) not interpretable for the patient because necessary comparative information was missing, or 4) suited for nudging. Physicians who gave both patients the same information (61% of physicians) more often selected at least complete information, even if it was often not transparent. Physicians who gave both patients different information (39% of physicians), in contrast, more often selected information that was suited for nudging in line with the belief they were asked to imagine. A limitation is that scenarios were hypothetical. Conclusions. Most physicians did not provide complete and transparent information. Clinicians who presented consistent information to different patients tended to present complete information, whereas those who varied what information they chose to present appeared more prone to nudging.
引用
收藏
页码:206 / 215
页数:10
相关论文
共 45 条
[1]   IMPROVING DOCTORS UNDERSTANDING OF STATISTICS [J].
ALTMAN, DG ;
BLAND, JM .
JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES A-STATISTICS IN SOCIETY, 1991, 154 :223-267
[2]   Statistical Literacy in Obstetricians and Gynecologists [J].
Anderson, Britta L. ;
Gigerenzer, Gerd ;
Parker, Scott ;
Schulkin, Jay .
JOURNAL FOR HEALTHCARE QUALITY, 2014, 36 (01) :5-17
[3]   Physicians' communication of Down syndrome screening test results: The influence of physician numeracy [J].
Anderson, Britta L. ;
Obrecht, Natalie A. ;
Chapman, Gretchen B. ;
Driscoll, Deborah A. ;
Schulkin, Jay .
GENETICS IN MEDICINE, 2011, 13 (08) :744-749
[4]  
[Anonymous], 2007, Psychological science in the public interest, DOI DOI 10.1111/J.1539-6053.2008.00033.X
[5]   WHAT STATISTICS SHOULD WE TEACH MEDICAL UNDERGRADUATES AND GRADUATES [J].
APPLETON, DR .
STATISTICS IN MEDICINE, 1990, 9 (09) :1013-1021
[6]   Psychological Research and the Prostate-Cancer Screening Controversy [J].
Arkes, Hal R. ;
Gaissmaier, Wolfgang .
PSYCHOLOGICAL SCIENCE, 2012, 23 (06) :547-553
[7]   ESTIMATES OF CONTINGENCY BETWEEN 2 DICHOTOMOUS-VARIABLES [J].
ARKES, HR ;
HARKNESS, AR .
JOURNAL OF EXPERIMENTAL PSYCHOLOGY-GENERAL, 1983, 112 (01) :117-135
[8]   Residents' ability to identify patients with poor literacy skills [J].
Bass, PF ;
Wilson, JF ;
Griffith, CH ;
Barnett, DR .
ACADEMIC MEDICINE, 2002, 77 (10) :1039-1041
[9]   Over the counter medicines and the need for immediate action: a further evaluation of European Commission recommended wordings for communicating risk [J].
Berry, D ;
Raynor, T ;
Knapp, P ;
Bersellini, E .
PATIENT EDUCATION AND COUNSELING, 2004, 53 (02) :129-134
[10]   WHEN DOCTORS MEET NUMBERS [J].
BERWICK, DM ;
FINEBERG, HV ;
WEINSTEIN, MC .
AMERICAN JOURNAL OF MEDICINE, 1981, 71 (06) :991-998