Healthcare workers frequently need to discuss risks with patients. When defined as the chances that an activity or hazard will give rise to harm, risk is generally given in terms of numerical odds or probabilities and the risk is used as a mathematical term.
There are two aspects to risk that must be considered when describing risk: the first is the frequency of the risk and the second is the amount of associated harm. For instance, the risk of scar rupture during vaginal birth after caesarean section has a frequency of 1:100, which is moderate, but this must be qualified by the amount of associated harm, such as stillbirth or major haemorrhage.
Research has shown that most people, whether they be healthcare workers or patients, find it hard to understand risk in terms of numerical odds and probabilities. In addition, patients and their carers may not understand certain terms that are used by healthcare workers to explain risk.
The RCOG produces guidelines and parallel patient information. The patient information aims to educate and improve delivery of health care and women’s understanding of their care. The aim of this advice is to provide a standardised approach that is methodologically robust to ensure that developers of guidelines:
- Use epidemiological definitions optimally and appropriately in the guideline using standardised linguistic and numerical descriptions of risk
- Define levels of risk for clinicians and patients
- Describe how to present information on risk to patients in the best possible way.
It is envisaged that this advice will be used as an aid by those who develop and write guidelines and patient information.