There is quite a bit of evidence about best ways to convey risk information to help with policy or clinical decision making. Pictographs and bar graphs along with numbers and descriptions are considered best. Some emerging research suggests that some elements will help some patients more than others (for instance people with low numeracy).
Recently, Fagerlin, Zikmund-Fisher and Ubel published their decalogue of risk communication in the Journal of the National Cancer Institute. Their ten steps to better risk communication were:
- Use plain language to make written and verbal materials more understandable.
- Present data using absolute risks.
- Present information in pictographs if you are going to include graphs.
- Present data using frequencies.
- Use an incremental risk format to highlight how treatment changes risks from preexisting baseline levels.
- Be aware that the order in which risks and benefits are presented can affect risk perceptions.
- Consider using summary tables that include all of the risks and benefits for each treatment option.
- Recognize that comparative risk information (eg, what the average person’s risk is) is persuasive and not just informative.
- Consider presenting only the information that is most critical to the patients’ decision making, even at the expense of completeness.
- Repeatedly draw patients’ attention to the time interval over which a risk occurs.
Online software to create pictographs can therefore be quite handy. Some do so without resorting to giving each “person like you” an anthropomorphic shape .
Our favorite however, is one that shows the outcomes showing visual cues that are easily relatable, based on the iconic smiley face. We are impressed by Dr. Chris Cates’ Visual Rx tool, which is a free online tool that creates “smiley face plots” to depict the impact of a treatment on 100 people.
~Victor Montori, MD