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Zackary Berger, MD, PhD Johns Hopkins General Internal Medicine
Acknowledgment ,[object Object],[object Object],[object Object]
Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
‘‘ If One Is Not Infected With HIV, Is It Possible to Have a Positive Test Result?: Answers by 20 AIDS Counselors  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
What does a positive HIV test mean? ,[object Object]
Term from Gigerenzer G et al. Helping Doctors And Patients Make Sense of Health Statistics. Psychological Science in the Public Interest 2008;8(2):53.
Learning objectives ,[object Object],[object Object],[object Object],[object Object],[object Object]
Risk is Hard ,[object Object],[object Object],[object Object]
What’s your numeracy? Rate yourself from 1-5 ,[object Object],[object Object],[object Object],[object Object]
What’s your numeracy?: 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rank the lifetime odds of the following causes of death
Lifetime odds of death due to various causes (NCHS 1995) Cause of Death Lifetime Odds Heart Disease 1-in-5 Cancer 1-in-7 Stroke 1-in-23 Accidental Injury 1-in-36 Motor Vehicle Accident* 1-in-100 Intentional Self-harm (suicide) 1-in-121 Falling Down 1-in-246 Assault by Firearm 1-in-325 Fire or Smoke 1-in-1,116 Natural Forces (heat, cold, storms, quakes, etc.) 1-in-3,357 Electrocution* 1-in-5,000 Drowning 1-in-8,942 Air Travel Accident* 1-in-20,000 Flood* (included also in Natural Forces above) 1-in-30,000 Legal Execution 1-in-58,618 Tornado* (included also in Natural Forces above) 1-in-60,000 Lightning Strike (included also in Natural Forces above) 1-in-83,930 Snake, Bee or other Venomous Bite or Sting* 1-in-100,000 Earthquake (included also in Natural Forces above) 1-in-131,890 Dog Attack 1-in-147,717 Asteroid Impact* 1-in-200,000** Tsunami* 1-in-500,000 Fireworks Discharge 1-in-615,488
Risk and application to patient-provider encounter ,[object Object],[object Object]
Questions to Ask About All Risks ,[object Object],[object Object],[object Object],[object Object]
Factors in risk perception: Innumeracy  (Klein and Stefanek 2007) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Theoretical framework of numeracy in decision making Lipkus and Peters,  Health Education & Behavior, Vol. 36(6): 1065-1081 (December 2009)
Factors in risk perception: Heuristics/Availability  (Klein and Stefanek 2007)  ,[object Object],[object Object],[object Object]
  Factors in risk perception: Motivation  (Klein and Stefanek 2007)  ,[object Object],[object Object],[object Object]
Factors in risk perception (Klein and Stefanek 2007): Emotion ,[object Object],[object Object],[object Object]
Cases for role-play and discussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Effective Risk Communication ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Poor Risk Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Improved Risk Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Graphical techniques for conveying risk  Lipkus,  JNCI Monographs 1999(25) 
Tips for the Visual Communication of Risk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The importance of verbal communication ,[object Object],[object Object]
 
References

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Risky Business: Risk communicat ion in the provider-patient encounter

  • 1. Zackary Berger, MD, PhD Johns Hopkins General Internal Medicine
  • 2.
  • 3.
  • 4.
  • 5.  
  • 6.
  • 7. Term from Gigerenzer G et al. Helping Doctors And Patients Make Sense of Health Statistics. Psychological Science in the Public Interest 2008;8(2):53.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Rank the lifetime odds of the following causes of death
  • 13. Lifetime odds of death due to various causes (NCHS 1995) Cause of Death Lifetime Odds Heart Disease 1-in-5 Cancer 1-in-7 Stroke 1-in-23 Accidental Injury 1-in-36 Motor Vehicle Accident* 1-in-100 Intentional Self-harm (suicide) 1-in-121 Falling Down 1-in-246 Assault by Firearm 1-in-325 Fire or Smoke 1-in-1,116 Natural Forces (heat, cold, storms, quakes, etc.) 1-in-3,357 Electrocution* 1-in-5,000 Drowning 1-in-8,942 Air Travel Accident* 1-in-20,000 Flood* (included also in Natural Forces above) 1-in-30,000 Legal Execution 1-in-58,618 Tornado* (included also in Natural Forces above) 1-in-60,000 Lightning Strike (included also in Natural Forces above) 1-in-83,930 Snake, Bee or other Venomous Bite or Sting* 1-in-100,000 Earthquake (included also in Natural Forces above) 1-in-131,890 Dog Attack 1-in-147,717 Asteroid Impact* 1-in-200,000** Tsunami* 1-in-500,000 Fireworks Discharge 1-in-615,488
  • 14.
  • 15.
  • 16.
  • 17. Theoretical framework of numeracy in decision making Lipkus and Peters, Health Education & Behavior, Vol. 36(6): 1065-1081 (December 2009)
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.  
  • 23.
  • 24.
  • 25.
  • 26. Graphical techniques for conveying risk Lipkus, JNCI Monographs 1999(25) 
  • 27.
  • 28.
  • 29.