The risk in prenatal screening tests is hard to visualize for some patients.
Not everybody is familiar with the meaning of statistical risk.
So sometimes it is important to explain patients their risk status with some examples. While some consider 1/ 250 as a relaxing result for their trisomy 21 risk, some couples are very much scared and anxious by a result of 1/650, for example.
This is also true for operational (surgical) risks, or for any risk that comes with the nature of any intervention, such as amniocentesis, cordocentesis, chorion villus biopsy.
What are your examples to explain "a risk associated with a procedure" to a person who does not have an idea of statistical risk?
Big numbers beyond say 1 in 10 represent a challenge to many patients but many can relate to days of the year. So if a risk is 1 in 750 you could give as an example - if you pick a date sometime in the next 2 years and I can correctly guess the date, that is about 1 in 700.
For 1 in 18000 you could say if you pick a date sometime in the next 5 years and I can correctly guess the date, that is about 1 in 18000.
Sometimes may be helpful to present to parents not the risk of aneuploidia, but the possibility of healthy child birth, in this case we can get rational decision for performing or not any diagnostic interventions. Best regards!
There are many "standard" risk comparators that can be found using google. For example the risk of death by lightning is about 1 in 10 million. Here is one example:
http://www.riskcomm.com/visualaids/riskscale/datasources.php
http://www.nsc.org/learn/safety-knowledge/Pages/injury-facts-odds-of-dying.aspx
http://www.nsc.org/learn/safety-knowledge/Pages/injury-facts-chart.aspx
These are of course not for advising prospective parents but they give some ideas on how such comparable risks can be established and worked up to use in your work.
Hope this helps.
very interesting comments and answers, I am sure there is more to come. The explanation of the risk to any patient is very critical in medicine, and especially in perinatal medicine and all surgical branches.
Looking forward to hear more answers...
While explaining the risk involved in a prenatal screening procedure or test to a patient, it is important to use simple terminologies, descriptions and examples to clarify issues as most of these patients do not understand medical terminologies or mathematics. More so, they easily get scared when the word risk is mentioned. What I do in practice is to allay fears and anxiety and make it clear to the patient that she may not suffer the risk. Then in explaining the risk ratio, I prefer to talk in terms of 1 out of 250 patients for example depending on the risk associated with the test involved. So I make it clear she may be lucky to be amongst the 249 who may not suffer the risk but should bear in mind that the risk of being the 1 who will suffer the risk is still there. They feel better when they compare the figures in simple ways like this.
another aspect not considered is the risk of 'abnormal' results, but without clinical known relevance. How to handle this information is still a specific problem for clinicians and society.
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