Presenting risk information in sexual and reproductive health care.
OBJECTIVE
Presenting risk information to patients is an important part of clinical encounters. Good risk communication improves patient satisfaction with their care and the decisions they make. In sexual and reproductive healthcare (SRH), women frequently need to make decisions based on their perceived risk. Risk perception can be altered by how actual risk is presented to patients.


METHODS
Databases were searched using MeSH terms combined with a keyword search for articles relevant to SRH; the search was limited to English language.


RESULTS
Personalised risk communication where a risk score is provided, increases knowledge and slightly increases uptake of screening tests. Decision aids improve a patient's knowledge of the options, create realistic expectations of their benefits and harms, reduce difficulty with decision-making, and increase participation in the process. The most effective way to present risks uses a range of structured, tailored presentation styles; interactive formats are best. Framing the information improves patient understanding. Most people understand natural frequencies or event rates better than probability formats with varying denominators. Expressing changes in risk as an absolute risk reduction or relative risk reduction with baseline risk formats improves understanding. Descriptive terms such as 'low risk' or 'high risk' should be quantified as a frequency rather than a percentage. Using a consistent denominator to portray risk is recommended. Using the 'number needed to treat' and visual aids puts benefits or risks into perspective. The duration of risk should be presented.


CONCLUSIONS
Presenting risk information to patients can be optimised using a number of strategies.
Reader and Consultant in Obstetrics and Maternal Fetal Medicine, Institute for Women's Health, University College London, London, UK.
Anna L
AL
David
Specialty Doctor in Sexual and Reproductive Health, CNWL Camden Provider Services- Sexual and Reproductive Health, Margaret Pyke Centre, London, UK.
Hannat
H
Akintomide
clinical decision-making; communication of risk; counseling; epidemiology; informed consent; sexual and reproductive health service provision