Eurekalert: Researchers at the University of California have developed an innovative new visual tool to help patients decide among different treatment options.
The new tool, described in PLoS Medicine, presents the risks and benefits of these different options in the form of a roulette wheel. The patient spins the wheel, and can then directly visualize the chances of a particular treatment leading to benefit or harm.
The researchers, led by Jerome Hoffman, show how the roulette wheel could help a healthy 65-year old man decide whether or not to be screened for prostate cancer (the screening test is a blood test called the PSA).
By spinning the roulette wheel, the man sees that if he decides to get a PSA test, he may slightly lower his risk of dying from prostate cancer but he also greatly increases the chances of becoming incontinent and/or impotent from prostate cancer treatment. The roulette wheel shows him that his chances of developing symptoms of prostate cancer are very small, whether or not he gets screened.
[O]ne of the problems with shared decision making, they say, is that physicians have traditionally presented the risks and benefits of different treatments in the form of numbers, which many people have trouble understanding. "It is hard for anyone to comprehend the difference between a 7% chance and an 8% chance," they say, "and this is exacerbated when we try to deal in more extreme probabilities, such as 3 in 10,000." The researchers believe that the roulette wheel could be an important advance in shared decision making because patients are offered visual--rather than numerical--displays of the probability of benefits and harms.
The new tool, described in PLoS Medicine, presents the risks and benefits of these different options in the form of a roulette wheel. The patient spins the wheel, and can then directly visualize the chances of a particular treatment leading to benefit or harm.
The researchers, led by Jerome Hoffman, show how the roulette wheel could help a healthy 65-year old man decide whether or not to be screened for prostate cancer (the screening test is a blood test called the PSA).
By spinning the roulette wheel, the man sees that if he decides to get a PSA test, he may slightly lower his risk of dying from prostate cancer but he also greatly increases the chances of becoming incontinent and/or impotent from prostate cancer treatment. The roulette wheel shows him that his chances of developing symptoms of prostate cancer are very small, whether or not he gets screened.
[O]ne of the problems with shared decision making, they say, is that physicians have traditionally presented the risks and benefits of different treatments in the form of numbers, which many people have trouble understanding. "It is hard for anyone to comprehend the difference between a 7% chance and an 8% chance," they say, "and this is exacerbated when we try to deal in more extreme probabilities, such as 3 in 10,000." The researchers believe that the roulette wheel could be an important advance in shared decision making because patients are offered visual--rather than numerical--displays of the probability of benefits and harms.
Mahalanobis - am 2006-06-13 13:11
R Killingsworth (anonymous) meinte am 25. Jun, 10:06:
You've misstated the choice
Deciding to get an annual PSA test *in itself* entails no risk whatever of developing incontinence or impotence. You don't incur that risk unless you opt for treatment following a "bad" PSA test result -- but that is a second decision, one that you can postpone until you face it, and you can then decide not to seek treatment. Until then, if you get "good" test results, you gain some peace of mind.
