Helping patients decide: ten steps to better risk communication

J Natl Cancer Inst. 2011 Oct 5;103(19):1436-43. doi: 10.1093/jnci/djr318. Epub 2011 Sep 19.


With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. Many Americans have low numeracy skills making the cognitive demands even greater whenever, as is often the case, patients are presented with risk statistics and asked to make comparisons between the risks and benefits of multiple options and to make informed medical decisions. In this commentary, we highlight 10 methods that have been empirically shown to improve patients' understanding of risk and benefit information and/or their decision making. The methods range from presenting absolute risks using frequencies (rather than presenting relative risks) to using a risk format that clarifies how treatment changes risks from preexisting baseline levels to using plain language. We then provide recommendations for how health-care providers and health educators can best to communicate this complex medical information to patients, including using plain language, pictographs, and absolute risks instead of relative risks.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Choice Behavior
  • Cognition
  • Communication*
  • Comprehension*
  • Decision Making*
  • Emotions
  • Evidence-Based Medicine
  • Health Literacy
  • Humans
  • Neoplasms / prevention & control
  • Neoplasms / therapy*
  • Odds Ratio
  • Probability
  • Risk Assessment* / methods
  • Risk Factors
  • Time Factors
  • Truth Disclosure*
  • Uncertainty
  • United States