Risk communication

In the domain of healthcare, risk communication is about presenting benefits and harms of different options, in situations in which people need information to make decisions.

Risk communication serves to inform the patient (and family), so that they understand the potential risks, supports them in making informed decisions regarding threats to health and safety, and encourages them to participate in minimising or preventing these risks (RISC Amsterdam, n.d.).

There are different complexities surrounding risk communication. Dutch legislation requires doctors to always inform patients about potential benefits and harms (WGBO, 2017). However, there are exceptions, such as very acute situations and situations in which there is strong evidence that an option has many benefits and no (or hardly any) harms. In the case of the latter, the doctor can direct and guide the patient towards the option he concludes to be best (paternalistic approach). However, in the case of uncertainty, the doctor will facilitate the patient’s decision by providing him with transparent information. The patient can then make a decision without further help of professionals (informed decision making), or with active guidance (shared decision making).

There is a plethora of tools that help communicate risks, such as online quiz De Risicotest (PreventieConsult, n.d.), infographicsand leaflets. Risk communication tools can convey information in different ways: via numbers (tables, statistics), visual display (pie charts, graphs, or visuals as in Figure 1), or verbal terms (using terms as ‘high risk’, ‘small chance’).

Figure 1: visual displaying benefits and risks of medicines for treating urgency incontinence in women (AHRQ, 2014).
Figure 1: visual displaying benefits and risks of medicines for treating urgency incontinence in women (AHRQ, 2014).

These risk communication strategies bring forth different difficulties for people to understand the information. The three main issues are the involvement of:

  • Numerical probability information, which many people find difficult to understand.
  • Abstract epidemiological information, which often lacks an intuitive meaning.
  • Unbalanced information, which is the overemphasis of benefits and the underemphasis of risks.

Designers can contribute greatly by bridging the gap between doctor and patient. Risk communication strategies should be created in which the designers’ skill is required to, for example, craft a user journey to determine when and how risks can be communicated in an understandable way. Empathy on the designer’s part is needed to understand the user’s context and determine whether informed or shared decision making should be supported. Naturally, knowledge regarding Medisign is necessary for the designer to be able to make these decisions.

References and Interesting Links:

  • PreventieConsult. (n.d.). Retrieved May 1, 2018, from https://www.testuwrisico.nl/
  • RISC Amsterdam. (n.d.). Retrieved May 1, 2018, from https://www.riscamsterdam.com/en/
  • The SHARE Approach-Communicating Numbers to Your Patients: A Reference Guide for Health Care Providers. (2014, July 25). Retrieved May 1, 2018, from https://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/tools/tool-5/index.html
  • Wet op de geneeskundige behandelingsovereenkomst (WGBO). (2017, October 20). Retrieved May 1, 2018, from https://www.dwangindezorg.nl/rechten/wetten/wgbo

Interesting Links:

  • Damman OC, Bogaerts NM, van den Haak MJ, Timmermans DR. How lay people understand and make sense of personalized disease risk information. Health Expect 2017; doi: 10.1111/hex.12538.
  • Damman OC, Bogaerts NMM, Van Dongen D, Timmermans DRM. Barriers in using cardiometabolic risk information among consumers with low health literacy. British Journal of
  • Health Psychology 2016; 21(1):135-56.
  • Galesic M, Garcia-Retamero R. Statistical numeracy for health: A cross-cultural  comparison with probabilistic national samples. Arch Intern Med 2010; 170:462-468.
  • Hofman, Del Mar; Patients’ expectations of the benefits and harms of treatments, screening and tests:  a systematic review. JAMA Intern Med 2015;175(2):274-286

Topic Contributors: Michael Soenthorn Speek