Communicating risk

Harmsen et al ’s interesting paper¹ on risk communication relates closely to work published 13 years ago in this journal. Misselbrook and Armstrong² used a hypothetical scenario to look at the effect of giving patients the same statistical information in different ways: 75% said they would accept medication if given the absolute risk reduction, whereas only 44% would if given a ‘personal probability of benefit model’. This is echoed by Harmsen et al ’s finding that giving information in a form chosen to be as comprehensible as possible reduced the subsequent uptake of preventative medication; what their study adds, as they say, is supporting evidence based on ‘real patients’.

Given the current controversy about statins, this paper is particularly timely in highlighting the tension between being patient-centred and promoting population benefit. Within the extensive literature about this tension, two particularly useful contributions are Summerskill’s account³ of a GP consultation about statins, and Gupta’s⁴ discussion of the ethical and cost-effectiveness issues involved. These issues are central to considering how evidence-based medicine and shared decision-making interact.