Communicating complexity and understanding risk: whose responsibility is it?

I feel badly for today’s health care consumer. Our celebrated Information Age has exploded into Information Hysteria for many would-be patients – H1N1/swine flu, SARS, bird flu, vaccines and autism. So many conditions are deemed health care crises.

And what about the plethora of ‘new studies’ that herald conflicting results to what is currently considered to be gold-standard evidence-based medicine — withdrawals from the market of widely-used drugs due to cardiovascular risk, analyses showing that antidepressants (some of the most widely-prescribed drugs in the world) may be barely more effective than placebo, to name a few.

I have the luxury of being paid to learn about medicine – to interview medical opinion leaders, to read about the latest clinical trial report, drug development, diagnostic technique, or technological innovation. I have taken courses in statistics and trained as a scientist. I have the time and at least some training to consider these issues. Today’s patient, by contrast, faces an almost daily information tsunami, without the benefit of a scientific education and the bonus of an income for doing so. And we are asked to make possibly life-changing decisions based on bullet points, tweets, and soundbites.

Rarely are arguments simply black or white, right or wrong, either/or. Yet, many of today’s big issues are presented this way – war, bank bailouts, vaccines. Amidst all the shouting and dramatic headlines, I fear we are losing the ability to consider nuanced arguments. Nigel Hawkes writes in the BMJ: “Was the World Health Organization premature in declaring a pandemic? Given that swine flu was spreading fast, worldwide, that hardly seems a fair charge to make. But perhaps the definitions did not allow enough flexibility to distinguish between a lethal pandemic and a mild one.”

Thus, very few issues in life are clear-cut, yet the decision does become either-or because ultimately a decision has to be made. Where does this leave the patient? David Woods, PhD looks at how patients perceive the concept of risk (offering some surprising statistics of his own) and the role health economists and outcomes researchers play in communicating complexity.

Hawkes N. Why we went over the top in the swine flu battle. BMJ 2010;340:c789