Communicating tailored risk information of cancer treatment side effects: Only words or also numbers?
Vromans,Ruben Pauws,Steffen Bol,Nadine van de Poll-Franse,L.V. Krahmer,Emiel
Vromans,Ruben
Pauws,Steffen
Bol,Nadine
van de Poll-Franse,L.V.
Krahmer,Emiel
Abstract
Background: The increased availability of patient reported outcome data makes it feasible to provide patients tailored risk information of cancer treatment side effects. However, it is unclear how such information influences patients’ risk interpretations compared to generic population-based risks, and which message format should be used to communicate such individualized statistics. Methods: A web-based experiment was conducted in which participants (n = 141) read a hypothetical treatment decision-making scenario about four side effect risks of adjuvant chemotherapy for advanced colon cancer. Participants were cancer patients or survivors who were recruited from an online Dutch cancer patient panel. All participants received two tailored risks (of which the reference class was based on their age, gender and tumor stage) and two generic risks conveying the likelihood of experiencing the side effects. The risks were presented either in words-only (‘common’ and ‘very common’), or in a combination of words and corresponding numerical estimates (‘common, 10 out of 100’ and ‘very common, 40 out of 100’). Participants’ estimation of the probability, accuracy of their estimation, and perceived likelihood of occurrence were primary outcomes. Perceived personal relevance and perceived uncertainty were secondary outcomes. Results: Tailored risks were estimated as higher and less accurate than generic risks, but only when they were presented in words; Such differences were not found in the verbal and numerical combined condition. Although tailoring risks did not impact participants’ perceived likelihood of occurrence, tailored risks were perceived as more personally relevant than generic risks in both message formats. Finally, tailored risks were perceived as less uncertain than generic risks, but only in the verbal-only condition. Conclusions: Considering current interest in the use of personalized decision aids for improving shared decision-making in oncology, it is important that clinicians consider how tailored risks of treatment side effects should be communicated to patients. We recommend both clinicians who communicate probability information during consultations, and decision aid developers, that verbal descriptors of tailored risks should be supported by numerical estimates of risks levels, to avoid overestimation of risks.
Description
Funding Information: Financial support was provided in part provided by the Data Science Center Tilburg (DSC/t) and by a grant from the Netherlands Organisation for Scientific Research (NWO) (Grant No. 628.001.030). Both DSC/t and NWO had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Acknowledgements Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
Date
2020-10-27
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Research Projects
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Keywords
Cancer, DECISION-MAKING, DESIGN, FORMATS, HEALTH-RISK, MODEL, Message format, NUMERACY, PERCEPTIONS, Patient information, Personalization, Risk communication, Shared decision-making, Tailoring, Treatment side effects, UNCERTAINTY, VISUAL AIDS, SDG 3 - Good Health and Well-being
Citation
Vromans, R, Pauws, S, Bol, N, van de Poll-Franse, L V & Krahmer, E 2020, 'Communicating tailored risk information of cancer treatment side effects : Only words or also numbers?', BMC Medical Informatics and Decision Making, vol. 20, no. 1, 277, pp. 277. https://doi.org/10.1186/s12911-020-01296-7