Joey Z Gu, Grayson L Baird, Antonio Escamilla Guevara, Young-Jin Sohn, Melis Lydston, Christopher Doyle, Sarah E A Tevis, Randy C Miles
A systematic review and meta-analysis of English language online patient education materials in breast cancer: Is readability the only story?
Breast (Edinburgh, Scotland)
efficient health care requires informed doctors patients current healthcare system falls short counts doctors patients understand available medical evidence illustrate extent problem setting cancer screening representative sample 5000 women nine european countries 92 overestimated reduction breast cancer mortality mammography factor 10200 know similar sample 5000 men respect psa screening number 89 300 us citizens regularly attended one cancer screening test 90 never informed biggest harms screeningoverdiagnosis overtreatmentby physicians among 160 german gynecologists 80 understand positive predictive value positive mammogram estimates varying 1 90 national sample 412 us primary care physicians 47 mistakenly believed cancers detected screening test proves test saves lives 76 wrongly thought screendetected cancers better 5year survival rates cancers detected symptoms would prove screening test saves lives 20 german gynecologists single one provided woman information benefits harms cancer screening required order make informed choice risk literacy scarce health care one frequently discussed explanation assumes people suffer cognitive deficits make predictably irrational basically hopeless dealing risks need nudged healthy behavior yet research demonstrated problem lies less stable cognitive deficits information presented physicians patients includes biased reporting medical journals brochures media uses relative risks misleading statistics motivated conflicts interest defensive medicine promote informed physicians patients done every medical school teach students understand evidence general health statistics particular cultivate informed patients elementary high schools start teaching mathematics uncertaintystatistical thinking guidelines complete transparent reporting journals brochures media need better enforced laws need changed order protect patients doctors alike practice defensive medicine instead encouraging critical mass informed citizens resolve healthcare problems constitute major triggering factor better care