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Putting risk in perspective: Do people make better decisions when they understand average risk?
Date:12/13/2007

a breast cancer prevention drug, says study author Angela Fagerlin, Ph.D., research assistant professor of internal medicine at the U-M Medical School and an investigator at the VA Ann Arbor Healthcare System.

Results of the study appear in the December issue of Patient Education and Counseling.

The study authors argue that comparing individual risk against average could lead people to make poor decisions. For example, below-average risk does not mean zero risk, yet low-risk women might think they can skip their yearly mammogram. On the other hand, women at high-risk might undergo risky treatments that they might otherwise not have chosen.

When you give women their five-year risk of breast cancer, it might be 3 percent, and that 3 percent seems really low. But the way women tend to use comparative information is worrisome. Theyre focusing too much on where they stack up against average and they disregard their own individual risk information what that risk means to them, says Fagerlin, a member of the U-M Center for Behavioral and Decision Sciences in Medicine.

The study authors urge doctors and health educators to use average risk carefully when discussing individual patients options.

People should focus on what their own risk is how does that risk feel to them, and what do they think of their treatment or prevention strategies. We believe that when making a medical decision, people should consider the risks and benefits of their prevention or treatment options and they should make the best decision based on their perceptions of those risks and benefits. The decision should not be influenced by whether their risks or benefits are greater or less than another person, Fagerlin says.

The risk estimates used in the study were fictitious. The drug mentioned is modeled after tamoxifen, which can be given to women at high risk of breast cancer to help prevent the disease. The average womans lifetime risk of breast c
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Contact: Nicole Fawcett
nfawcettt@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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