Risk communication and risk perception: different ways of communicating, different ways of sharing clinical decisions

Abstract

An informed clinical decision arises from a dialogue, where the patient shares biopsychosocial information, preferences and values with his/her physician. Physicians share information about epidemiology and the risk of interventions. We can communicate risk using words, numbers or graphs and the chosen format influences patient’s perceptions and behaviour. The format is not always understood, and the inability to reason with numbers (innumeracy) constitutes an important barrier to communicate in an effective way. Despite that, the impact of innumeracy can be lessened through communicational strategies. Frequencies, absolute risk reduction and pictograms convey risk information in a more realistic and understandable way, irrespective of numeracy. There is always uncertainty about risk estimates, but physicians should focus on helping patients dealing with uncertainty. Furthermore, we should understand risk in an individualized context by taking into account personal factors that influence benefits or harms related to the proposed interventions. Regardless of population policies, decisions about health are always made by the patient, who is an autonomous and free person.