Do visual aids influenced patients' risk perceptions for rare and very rare risks?
Liana Fraenkel, Valerie Reyna, Raluca Cozmuta and 3 others
PMID 30305252WHAT IT FOUND
Visual aids did not consistently change patients' ability to distinguish rare from very rare medication risks.
For less-educated patients, combined graphic and balance-scale images changed perceptions for 2% risk but not 0.2% risk.
Key findings
01For college graduates, responses to the 2% and 0.2% infection-risk scenarios did not differ.
02Among participants without a college education, the combined graphic and conceptual illustration format produced different ratings for the 2% and 0.2% risks, with lower perceived risk, worry, and risk-benefit expectation and greater likelihood of starting the medication for the 2% risk.
03Compared with numbers only, the combined format made less-educated patients viewing the 2% scenario less worried, more likely to start the medication, and less likely to say risks outweighed benefits; perceived riskiness did not differ significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The medication decision was hypothetical, so it may not reflect what patients do when a real rheumatologist recommends a new pill. Only 655 of 2093 mailed surveys were completed, a 31.3% response rate, so patients who responded may differ from those who did not. The study did not correct for multiple comparisons, so some apparent differences may be false positives. Each participant saw only one scenario, so the design could not directly compare how the same person judged 2% versus 0.2% risk. The combined visual aid made the higher 2% risk seem more acceptable than the lower 0.2% risk for less-educated patients, which is opposite to what the authors expected and remains unexplained. The supplied text does not name a single primary outcome, so the key result is based on several planned comparisons.
Declared interests
The supplied article text does not include a funding or conflict-of-interest declaration. The publication metadata lists NIH extramural research support.
The easy way to misread this
Do not assume that adding a graphic or balance-scale explanation will help patients choose between a 2% and 0.2% infection risk. In college graduates it did not, and in less-educated patients the combined format made the higher 2% risk seem more acceptable than the lower 0.2% risk. The study was a hypothetical mailed survey, not a nurse-delivered education trial.