Presenting the improved possibility for staying well might be better than talking about change in
risk: use of the non-occurrence probability increase (NOPI)
Engelsk titel: Presenting the improved possibility for staying well might be better than talking about change in
risk: use of the non-occurrence probability increase (NOPI)
Läs online
Författare:
Hagström, Bertil
;
Gunnarsson, Ronny K
;
Rosenfeld, Mark
Email: bertil.hagstrom@telia.com
Språk: Eng
Antal referenser: 16
Dokumenttyp:
Artikel
UI-nummer: 14099004
Sammanfattning
Objective. Talking about risk with patients is problematic since the individual's risk is not
addressed and is usually very low. This study aimed to see how fact presentation influenced the
decision-making process for general practitioners concerning treatment for the prevention of
cardiovascular disease. Rather than looking at the risk of becoming ill, often presented as high
figures of relative risk reduction (RRR), it could be useful to present the probability of staying well,
i.e. from the concept of non-occurrence probability (NOP) and non-occurrence probability increase
(NOPI) – simply a single measure of change in NOP. Design. General practitioners (GPs) had personal
response keypads to answer two questions, presented differently, concerning whether they would
allow themselves to be treated or not be treated for the risk of cardiovascular death. Setting and
subjects. Five audiences consisting of general practitioners attending lectures. Results. When the
question was presented as RRR, 68% and 86%, respectively, of the physicians responded that they
would take the decision to treat. When presented as the concept of NOPI the figures were reduced to
18% and 16%, respectively (p < 10–6). Implications. Developing tools to explain treatment effect is
crucial to enhancing health care quality. Since NOPI is one potential way of presenting prevention of
risk we encourage future research to evaluate the NOPI concept compared with RRR and absolute
risk reduction (ARR).