RAddressing the patient, who is understandably all ears to the situation of difficulty and uncertainty in which he finds himself, may not be easy for an inadequately trained specialist to do so. Know the effect of choosing some words over others when communicating the outcome of a diagnostic test, for example, it is not secondary because the patient’s understanding and perception, strongly influenced by anxiety, of his or her situation and what to expect will depend on it.
Physicians and patients: evidence-based communication strategies
Clinical experience and character are not enough. In fact, the mechanisms underlying communication and how it influences patient choices has long been the focus of highly practical research, because they are potentially capable of providing healthcare personnel, such as doctors and nurses, some simple rules to follow in the inevitably complex interaction with one’s clients. Hands-on doctor-patient communication sessions were also held at Asco, the largest medical oncology congress.
Understanding the numbers, communicating uncertainty
The first aspect to consider is the widespread lack of familiarity with numbers and percentages, which collides with the fact that each case is unique and therefore statistics also serve to communicate uncertainty. For example, when a diagnostic test is performed, its exact prognostic value is not always easy to explain. Which strategy is clearer to the layman? A recent study by the Ludwig-Maximilians-Universität München on one hundred patients with an average age of thirty, called to evaluate the risk of having cancer on the basis of the result of a positive ultrasound examinationindicating the presence of a thyroid nodule. Well, it can be seen that understanding is simpler when the information is provided directly in these terms: «Out of 1000 patients, 130 have potentially pathological ultrasound findings. Of these 130, 20 actually have thyroid cancer. On the other hand, of the other 870 patients who do not have this ultrasound finding, 30 still have cancer ».
On the other hand, the following presentation is more difficult to understand: «Out of 1000 patients, 50 have thyroid cancer. Of these 50, 20 have potentially pathological ultrasound findings. On the other hand, of the 950 patients who do not have thyroid cancer, there are 110 who still have significant ultrasound findings.
Talking to a doctor helps contextualize the origin of otherwise causeless symptoms.
Give time and picture materials
Also, understanding is better when time is given to listen again, calmly, even two or three timesexplanation and when illustrated materials and infographics are provided.
Thus, as the study authors also conclude, engaging in the communication of statistical information is the only way to ensure that patients correctly understand the results of their tests and who can therefore make reasonable and shared decisions with their doctor on what to do.
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