RT Journal Article
SR Electronic
T1 Inaccurate Risk Perceptions and Individualized Risk Estimates by Patients with Type 2 Diabetes
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 510
OP 519
DO 10.3122/jabfm.2014.04.140058
VO 27
IS 4
A1 Barry G. Saver
A1 Kathleen M. Mazor
A1 J. Lee Hargraves
A1 Marcela Hayes
YR 2014
UL http://www.jabfm.org/content/27/4/510.abstract
AB Background: We evaluated how diabetic patients understand and respond to the presentation of personalized risk information. Methods: This was a mixed methods study involving 56 patients with type 2 diabetes and at least 1 additional cardiovascular risk factor. We assessed participants' perceptions of diabetes-related risks; asked them to rank order 6 events (death, heart attack, stroke, blindness, amputation, and kidney failure) by likelihood of occurrence in a specified time frame; presented them with personalized risk estimates; and asked them to re-rank the risks. The final 18 participants were tested to verify understanding before re-ranking risks. Qualitative analysis of interview transcripts identified themes and concepts underlying participants' ways of perceiving and reacting to risk. Results: While mortality was the most likely outcome for almost all participants, nearly all estimated it to be least likely; only 28% adjusted their mortality rankings to match model predictions. Some did not understand the risk information: only two thirds of those asked could rank risks according to the information presented. Risk perceptions were influenced by factors including “knowing myself,” powerful anecdotes, and belief that a “warning shot” would occur before death. Conclusions: Personalized risk estimates, particularly about mortality, had limited salience. Some participants could not understand the information, despite presentation in ways suggested by previous research.