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Healthy Skepticism Library item: 14010

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Sorensen L, Gyrd-Hansen D, Kristiansen IS, Nexoe J, Nielsen JB.
Laypersons' understanding of relative risk reductions: a randomised cross-sectional study.
BMC Med Inform Decis Mak 2008 Jul 17; 8:(1):31
http://www.biomedcentral.com/1472-6947/8/31


Abstract:

BACKGROUND: Despite increasing recognition of the importance of involving patients in decisions on preventive healthcare interventions, little is known about how well patients understand and utilise information provided on the relative benefits from these interventions. The aim of this study was to explore whether lay people can discriminate between preventive interventions when effectiveness is presented in terms of relative risk reduction (RRR), and whether such discrimination is influenced by presentation of baseline risk.

METHODS: The study was a randomised cross-sectional interview survey of a representative sample (n=1,519) of lay people with mean age 59 (range 40-98) years in Denmark. In addition to demographic information, respondents were asked to consider a hypothetical drug treatment to prevent heart attack. Its effectiveness was randomly presented as RRR of 10, 20, 30, 40, 50 or 60 percent, and half of the respondents were presented with the baseline risk of heart attack. The respondents were also asked whether they were suffering from hypercholesterolemia or had experienced a heart attack.

RESULTS: In total, 873 (58 ) of the respondents consented to the hypothetical treatment. While 49 accepted the treatment when RRR=10%, the acceptance rate was 58-60% for RRR>10. There was no significant difference in acceptance rates across respondents irrespective of whether they had been presented with information on baseline risk or not.

CONCLUSION: In this study, lay peoples decisions about therapy were only slightly influenced by the magnitude of the effect when it was presented in terms of RRR. The results may indicate that lay people have difficulties in discriminating between levels of effectiveness when they are presented in terms of RRR.


Notes:

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909