Helping Patients Decide: Ten Steps to Better Risk Communication.

Posted: Dec 20, 2011
J Natl Cancer Inst. 103. 19. 1436-43.
KEYWORDS: Knowledge/Attitudes/Beliefs, Low Literacy, Consent, Verbal Communications


Applying specific communication strategies that improve understanding of risk and benefits may help patients' decision making.

Why this item may be useful

The authors describe ten methods that have been empirically proven to enhance patients’ understanding of risks and benefits associated with cancer therapies (standard and experimental) and/or help them make informed and unbiased treatment decisions. The authors focus on communication strategies for health care providers who discuss treatments with their patients. Providers recruiting to clinical trials may use the recommendations on how best to communicate complex information to patients delineated herein as a resource/guide.


  • Many patients lack health literacy and numeracy skills. As a result, patients have difficulty understanding medical and numerical information (e.g., risk and benefit statistics).
  • The following strategies may improve comprehension of medical information: using plain language, avoiding information overload (presenting only information that is most critical to patients’ decision making), and using summary tables.
  • The following strategies may improve comprehension of numerical data: presenting information in pictographs, using absolute rather than relative risks, using frequencies, using an incremental risk format to show how treatment changes risk from baseline levels, and drawing patients’ attention to the time interval over which a risk occurs.
  • The order in which risk and benefits are presented can affect patients’ decisions, as information presented last is most easily recalled.