Peder A. Halvorsen, MD; Randi Selmer, PhD; Ivar Sønbø Kristiansen, MD, PhD, MPH
Acknowledgments: The authors thank Arthur Elstein, Dorte Gyrd-Hansen, Jørgen Nexøe, and Henrik Støvring for comments on the paper. The authors also thank the residents of Finnmark, Norway, for their willingness to contribute to the study and the Norwegian Institute of Public Health for conducting the practical part of the data collection.
Grant Support: By governmental funds held by the University of Tromsø, Tromsø, Norway.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Peder A. Halvorsen, MD, Nordlys Legesenter, N-9509 Alta, Norway; e-mail, email@example.com.
Current Author Addresses: Dr. Halvorsen: Nordlys Legesenter, N-9509 Alta, Norway.
Dr. Selmer: Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway.
Dr. Kristiansen: Institute of Health Management and Health Economics, University of Oslo, PO Box 1089, Blindern, N-0317 Oslo, Norway.
Author Contributions: Conception and design: P.A. Halvorsen, R. Selmer, I.S. Kristiansen.
Analysis and interpretation of the data: P.A. Halvorsen, I.S. Kristiansen.
Drafting of the article: P.A. Halvorsen, I.S. Kristiansen.
Critical revision of the article for important intellectual content: R. Selmer, I.S. Kristiansen.
Final approval of the article: P.A. Halvorsen, R. Selmer, I.S. Kristiansen.
Statistical expertise: R. Selmer.
Halvorsen PA, Selmer R, Kristiansen IS. Different Ways to Describe the Benefits of Risk-Reducing Treatments: A Randomized Trial. Ann Intern Med. 2007;146:848-856. doi: 10.7326/0003-4819-146-12-200706190-00006
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Published: Ann Intern Med. 2007;146(12):848-856.
Considerable resources are devoted to drug therapies that are aimed at modifying risk factors, such as hypertension, elevated cholesterol levels (1), and osteoporosis. For individual patients, the choice to begin preventive drug therapy should be consistent with their values and preferences. Thus, to engage meaningfully in shared decision making and to provide truly informed consent, patients need to have a clear understanding of the benefits and harms of a treatment. Strong and consistent evidence shows that stated preferences for medical interventions may depend on how the treatment effects are described. For example, the likelihood of choosing a therapy may depend on whether its benefits are presented as absolute risk reductions or relative risk reductions (2) or as losses versus gains (3–5). These effects suggest the potential for influencing the patient's response by describing treatment effects in a certain way. We explore laypersons' responses to different ways of explaining possible outcomes of an intervention.
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Cardiology, Emergency Medicine, Acute Coronary Syndromes, Coronary Heart Disease, Prevention/Screening.
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