Current Best Practice for Presenting Probabilities in Patient Decision Aids : Fundamental Principles

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2021
Authors
Bonner, Carissa
Trevena, Lyndal J.
Han, Paul K. J.
Okan, Yasmina
Ozanne, Elissa
Peters, Ellen
Timmermans, Danielle
Zikmund-Fisher, Brian J.
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Medical Decision Making (MDM) ; 41 (2021), 7. - pp. 821-833. - Sage. - ISSN 0272-989X. - eISSN 1552-681X
Abstract
Background
Shared decision making requires evidence to be conveyed to the patient in a way they can easily understand and compare. Patient decision aids facilitate this process. This article reviews the current evidence for how to present numerical probabilities within patient decision aids.

Methods
Following the 2013 review method, we assembled a group of 9 international experts on risk communication across Australia, Germany, the Netherlands, the United Kingdom, and the United States. We expanded the topics covered in the first review to reflect emerging areas of research. Groups of 2 to 3 authors reviewed the relevant literature based on their expertise and wrote each section before review by the full authorship team.

Results
Of 10 topics identified, we present 5 fundamental issues in this article. Although some topics resulted in clear guidance (presenting the chance an event will occur, addressing numerical skills), other topics (context/evaluative labels, conveying uncertainty, risk over time) continue to have evolving knowledge bases. We recommend presenting numbers over a set time period with a clear denominator, using consistent formats between outcomes and interventions to enable unbiased comparisons, and interpreting the numbers for the reader to meet the needs of varying numeracy.

Discussion
Understanding how different numerical formats can bias risk perception will help decision aid developers communicate risks in a balanced, comprehensible manner and avoid accidental “nudging” toward a particular option. Decisions between probability formats need to consider the available evidence and user skills. The review may be useful for other areas of science communication in which unbiased presentation of probabilities is important.
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150 Psychology
Keywords
decision aids, risk communication, standards
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Cite This
ISO 690BONNER, Carissa, Lyndal J. TREVENA, Wolfgang GAISSMAIER, Paul K. J. HAN, Yasmina OKAN, Elissa OZANNE, Ellen PETERS, Danielle TIMMERMANS, Brian J. ZIKMUND-FISHER, 2021. Current Best Practice for Presenting Probabilities in Patient Decision Aids : Fundamental Principles. In: Medical Decision Making (MDM). Sage. 41(7), pp. 821-833. ISSN 0272-989X. eISSN 1552-681X. Available under: doi: 10.1177/0272989X21996328
BibTex
@article{Bonner2021Curre-53203,
  year={2021},
  doi={10.1177/0272989X21996328},
  title={Current Best Practice for Presenting Probabilities in Patient Decision Aids : Fundamental Principles},
  number={7},
  volume={41},
  issn={0272-989X},
  journal={Medical Decision Making (MDM)},
  pages={821--833},
  author={Bonner, Carissa and Trevena, Lyndal J. and Gaissmaier, Wolfgang and Han, Paul K. J. and Okan, Yasmina and Ozanne, Elissa and Peters, Ellen and Timmermans, Danielle and Zikmund-Fisher, Brian J.}
}
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