title: Is it worth the risk? A systematic review of instruments that measure risk propensity for use in the health setting.
abstract: In this era of shared doctor-patient decision-making, eliciting and incorporating patients' treatment choices is essential to ensure all patients receive the treatment that is right for them. Clinicians and researchers should fully understand the many factors that influence and guide patients in their preferences for treatment. One of these influences is an individual's general risk propensity or willingness to take risks, yet there is little in the literature about methods for measuring risk propensity. A systematic review was undertaken to identify instruments that measure risk propensity and to appraise their validity and relevance for a clinical setting. Of 3546 articles, 139 were potentially relevant. From these, 14 instruments were identified. Eight measured risk propensity, whereas six measured personality traits associated with risk propensity. Most instruments demonstrated good internal reliability but their appropriateness for patients, particularly older adults, remains unclear. While no instrument was specific to or tested in a clinical setting, instruments that directly measured risk propensity were considered to be the most useful for clinical populations. The further adaptation and validation of these instruments among older adults are important avenues for future research.
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Central Sydney Area Health Service and the University of Sydney, P.O. Box M157, Missenden Rd., NSW 2050, Australia. james.harrison@email.cs.nsw.gov.au
authors.forename: James D
authors.initials: JD
authors.lastname: Harrison
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.forename: Glenn
authors.initials: G
authors.lastname: Salkeld
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D002755:Choice Behavior; D016206:Databases, Bibliographic; D006302:Health Services Research; D006801:Humans; D017060:Patient Satisfaction; D011594:Psychometrics / Q000295:instrumentation*; D018570:Risk Assessment / Q000379:methods*; D012309:Risk-Taking