Despoina Chatzopoulou, Arif Hanafi Bin Jalal, Danail Stoyanov, Hani J Marcus, Anand S Pandit
Improving risk communication: a proof-of-concept randomised control trial assessing the impact of visual aids for neurosurgical consent
Frontiers in surgery
central goal modern evidencebased medicine development simple easy use tools help clinicians integrate quantitative information medical decisionmaking bayesian pretestposttest probability bpp framework arguably well known tools provides formal approach quantify diagnostic uncertainty given result medical test presence clinical sign yet clinical decisionmaking goes beyond quantifying diagnostic uncertainty requires uncertainty balanced various costs benefits associated possible decision despite increasing attention recent years simple flexible approaches quantitative clinical decisionmaking remained elusive extend bpp framework using concepts bayesian decision theory integrating cost expand bpp framework allow clinical decisionmaking develop simple quantitative framework binary clinical decisions eg actioninaction treatnotreat testnotest let p pretest posttest probability patient disease show r1pp represents critical value called decision boundary terms relative cost overacting r represents critical value action inaction equally optimal demonstrate decision boundary used bedside case studies research tool reanalysis recent study found widespread misestimation pretest posttest probabilities among clinicians approach simple thought core yet previously overlooked part bpp framework unlike prior approaches quantitative clinical decisionmaking approach requires little handheld calculator applicable almost setting bpp framework used excels situations costs benefits associated particular decision patientspecific difficult quantify