In order to make informed decisions about screening and medical interventions, people need to have a good understanding of risk and probability. The communication and understanding of risk was a very popular topic at the ICOTS 9 Conference. I have written previously about risk, but want in this post I wish to introduce our new video about risk and screening, and talk more about the communication of risk.
When we teach about screening for disease, we need to be aware that many of the things we are screening for, particularly forms of cancer, can have emotional connections in our students. We may not know that one of our students has a family member who is dying of cancer. It is important that we teach about screening for cancer, but it can be a rather depressing or even trigger an emotional upset. Teachers may know their students’ circumstances and deal compassionately with this, and always speak sensitively of disease and incidence.
When we teach about probability and risk, it is important to make clear the negative impacts of a false positive diagnosis. These can have lasting effects of people’s health and well-being. In my work I spend quite a bit of time on a plane, and when I am not reading Amish romances I get to talk to all sorts of people. One very interesting conversation was with a genetic counsellor. As my son has a severe disability as a result of a pair of autosomal recessive genes, my husband and I had once visited such a counsellor, and I knew of their purpose. In this single-serving plane relationship, we got to talking about people’s perceptions of risk with regard to genetics, which I found fascinating. The genetic counsellor said she had talked to people who were horrified at a one in one thousand risk of some adverse outcome. In contrast other clients were relieved that the probability of an outcome (like the one for my son) was only one in four. The perceived impact of the probability is of course tempered by the severity of the result, and the worldview of the people concerned. It is also affected by their perception of independence in probabilistic outcomes. Unfortunately there are still people who think that with having had one child with a one-in-four outcome, the chances are increased that the next three children will be fine.
Teaching people about risk, independence and probability is a holy work. We can help people to make informed choice about their own health and that of their children. The Harding Center for Risk Literacy and Sir David Spiegelhalter and his colleagues are doing great work. I would love to hear of other websites that we can link to – please add them in the comments. I hope that our new video can likewise contribute.