The Art and Science of Teratogen Risk Communication
The Art and Science of Teratogen Risk Communication
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DOI：
10.1002/ajmg.c.30308
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发表时间：
2011-08-15
影响因子：
3.1
通讯作者：
Polifka, Janine E.
中科院分区：
文献类型：
--
作者：
Conover, Elizabeth A.;Polifka, Janine E.
尽管在临床畸形学方面取得了科学进展，但怀孕期间的暴露仍然引起极大的焦虑和误解。患者和卫生保健提供者经常被要求确定科学研究的健康影响，这可能涉及有限和矛盾的数据。这些发现通常以数字形式传达，这对于患者及其健康提供者来说是一种特别难以理解和解释的信息形式。几乎一半的普通人口（以及相当一部分医生）在计算方面有困难。低计算能力的患者倾向于以绝对的方式解释信息，忽略不确定性，更难以使用数字信息来告知他们的选择，并且更容易受到情绪和呈现信息时使用的格式的影响。表达概率的方法包括积极或消极的框架，相对风险与绝对风险的使用，以及比率和百分比。卫生服务提供者应以便于理解和导致知情行为的方式传达风险分析。当风险不仅仅是数字，而是在个人生活环境和价值观的背景下加以考虑时，更有可能实现这一目标。大多数致畸风险沟通是通过电话进行的;这既有优势，也有挑战。提出了改进风险沟通的策略。这些包括避免使用相对风险，使用一致的分母，以各种方式（积极与消极）框定信息，明智地使用口头限定语，以及使用视觉辅助工具。(C)2011 Wiley-Liss，Inc.
Despite scientific advances in clinical teratology, exposures during pregnancy still cause great anxiety and misunderstanding. Patients and health care providers are frequently called upon to determine the health implications of scientific studies, which may involve limited and contradictory data. These findings are often conveyed numerically, which is a particularly difficult form of information for both patients and their health providers to understand and interpret. Almost half of the general population (and a substantial minority of physicians) have difficulty with numeracy. Patients with low numeracy tend to interpret information in an absolute manner and ignore uncertainty, have more difficulty using numeric information to inform their choices, and are more easily influenced by emotion and the format used in presenting information. Formats involved in conveying probability include positive or negative framing, use of relative versus absolute risk, and ratios and percentages. Health providers should communicate risk analysis in a fashion that facilitates comprehension and results in informed behavior. This is more likely to be achieved when risks are conceptualized as more than just numbers, and are considered in the context of individuals' life circumstances and values. Most teratogen risk communication is done over the telephone; this presents both advantages and challenges. Strategies are suggested to improve risk communication. These include avoiding the use of relative risk, using a consistent denominator, framing the information in a variety of ways (positive vs. negative), using verbal qualifiers judiciously, and employing visual aids. (C) 2011 Wiley-Liss, Inc.