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Research Letter | Less Is More

Physician Understanding and Ability to Communicate Harms and Benefits of Common Medical Treatments ONLINE FIRST

Mona Krouss, MD1; Lindsay Croft, PhD, MS2; Daniel J. Morgan, MD, MS2,3
[+] Author Affiliations
1Department of Medicine, University of Maryland Medical Center, Baltimore
2Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
3VA Maryland Healthcare System, Baltimore
JAMA Intern Med. Published online August 29, 2016. doi:10.1001/jamainternmed.2016.5027
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This survey study describes academic internal medicine physicians' understanding of benefits and harms of common medical interventions, their use of statistical terms in patient communication, and their awareness of high-value health care campaigns.

Effective patient care requires not only a working knowledge of recommended tests and therapies but also an understanding of the frequency of harms and benefits for each. To make educated decisions, patients must understand harms and benefits of treatments. Unfortunately, patients consistently overestimate benefits and underestimate harms of medical tests and procedures.1 Likewise, physicians are poor at assessing treatment effect size and other aspects of numeracy. Some have hypothesized that clinicians, similar to patients, overestimate risks and underestimate harms.2 We evaluated physician understanding of harms and benefits of common tests and therapies.

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Combined Resident and Attending Physician Responses to Survey Questions

Green dots indicate the correct response, and red, incorrect response. Each dot corresponds to 1 physician, and the number of dots in each column corresponds to number of responses. BP indicates blood pressure.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Submit a Comment
A free resource to improve numeracy in medicine
Posted on August 31, 2016
Bonny P McClain
Data & Donuts
Conflict of Interest: None Declared
I will gladly forward a free proof of my simple guidebook to Improving Numeracy in Medicine to anyone with an interest. We discuss effect sizes at the point of care such as Number Needed to Treat (NNT), Number Needed to Harm (NNH), and Number Needed to Screen (NNS).
bonny@dataanddonuts.org
Another useful EBM resource
Posted on September 13, 2016
Tanya MacLeod
Dalhousie
Conflict of Interest: None Declared
Another useful resource that summarizes the key terms in EBM is a summary sheet created by Loren Reiger, RxFiles, Saskatchewan, Canada:

http://www.rxfiles.ca/rxfiles/uploads/documents/cht-ebm-overview.pdf
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