Four mistakes to avoid when talking with patients about risk

Helping patients understand their risk of developing a certain disease or the risks associated with a screening test can be complicated. Don’t make these four mistakes.

Mistake #1: Using relative risk.

With relative risk reduction, changes in risk appear larger, which is more persuasive but can unduly influence a patient’s decision. Absolute risk reduction is a more effective way to express risk without influencing the patient’s decision. So, instead of saying, “This medication will reduce your risk of X by 50 percent” (relative risk reduction), you could say, “This medication will reduce your risk of X from 6 in 1,000 to 3 in 1,000” (absolute risk reduction).

Mistake #2: Using percentages.

Patients tend to understand risks better when you use simple frequencies (“Two in 5 people will get X”) rather than percentages (“You have a 40-percent chance of getting X”). Simple frequencies are also preferred over fractions (“Two-fifths of people will get X”).

Mistake #3: Using “1 in X.”

Although you do want to reduce simple frequencies to smaller numbers where possible (e.g., “3 in 25” versus “24 in 200”), try to avoid using “1 in X.” Patients overestimate risk when it is presented in a “1 in X” format because they over-identify with the single person.

Mistake #4: Using technical language.

Instead of using technical terms with patients, use clear, plain language. For example, don't say “negative test result,” say “normal test result.”

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