My Portuguese is very limited, but I’ve flipped through it and I think the translator, Marcio Moacyr de Vasconcelos, a Pediatric neurology fellow at George Washington University and Adjunct Professor of Pediatrics at Universidade Federal Fluminense, has done a creditable job. I’ll try to get a picture of the cover somewhere on this web site soon.

“a thoughtful exposition of the breadth of the medical decision issues to which the analyses of decision theory have often been applied. The authors’ approach to medical decision making ensures that readers from different backgrounds understand the concepts by expressing them in words, elaborated with concrete numerical examples and graphs, instead of expecting symbolic formulas to communicate….This book has the potential for teaching practicing physicians to make good decisions and to make decisions well.”
–Doody’s Review Service

The article does a fine job of reviewing and highlighting key research in patient risk communication. It offers clinically-relevant guidance for physicians seeking to educate their patients that is very much in the MDM:APG spirit. It also links to Dr. Chris Cates’s Visual Rx web site, which provides a form that can generate pictograms for representing number needed to treat or number needed to harm data (Dr. Cates, if you’re reading this, I’d love to see version that can combine both efficacy and adverse event data and produce a unified plot of NNT/NNH – something I’ve been meaning to do with my own (nonvisual) NNT/NNH calculator).

It’s great to see this kind of discussion appearing in publications like these that reach a large community of practice.

The study of risk communication is an active one. Determinants of whether or not lay people achieve adequate comprehension of risk information are multifaceted, and include how the risk communicator understands the risk information, his or her mental model of what the lay person knows, the format and context of the risk communication, the lay person’s own numeracy and health literacy, the human cognitive processes involved in judgment and decision making, and cultural expectations around the discussion of medical and environmental risk.

Due to the growing requirements to communicate numerical information to lay individuals, there has recently been a significant push to conduct research that can provide direct guidance regarding how to best present numerical information in order to increase the likelihood of informed decisions. Accuracy is one key goal; evaluability (the ability to make a meaningful interpretation of risk so that it can be used in judgments and decisions- cf. Hsee C, The Evaluability Hypothesis: An Explanation for Preference Reversals between Joint and Separate Evaluations of Alternatives. Organ Behav Hum Decis Process, 1996;67:3) is a conceptually distinct goal, and both are important. Look for a lot more research on these topics in the next few years.

Any translation is exciting, but I’m particularly happy about this because I had the great pleasure of spending five weeks teaching Brazilian health care faculty in southern Brazil about a dozen years ago and I really enjoyed the people, the country, and the language. Otima!

The link is here.