Talking with patients about risks: do's and don'ts

To make wise decisions about their health, patients often need to know their disease risk or the risks associated with a screening test or a medication, but risk can be a difficult concept to understand — and to explain. One study found that even physicians tend to overestimate the risk of a condition and underestimate the risk of treatment.¹

To improve your communication with patients about risk, follow these do's and don'ts.

Do use absolute risk: “This medication will reduce your risk of X from 6 in 1,000 to 3 in 1,000.”

Don’t use relative risk: “This medication will reduce your risk of X by 50 percent.”
Relative risk reduction makes changes in risk appear larger, which can unduly influence a patient’s decision.

Do use simple frequencies: “Two in 5 people will get X.”
Don’t use percentages: “You have a 40-percent chance of getting X.”
The frequency (or number of times an event occurs) is generally easier for patients to understand.

Do reduce risk estimates to smaller numbers where possible: “3 in 10” versus “30 in 100.”

Don’t reduce risk estimates to a single person: “1 in 5.”
Patients overestimate risk when it is presented in a “1 in X” format because they overidentify with the single person.

Do use clear, plain language: “Normal test result.”

Don’t use technical language: “Negative test result.” 

Even highly literate patients can misunderstand technical phrases.

1. Hoffmann TC, Del Mar C. Clinicians' expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2017;177(3):407-419.

Read the full FPM article: “Five Ways to Communicate Risks So That Patients Understand.”