Evaluation of risk communication in a mammography patient decision aid

Krystal A. Klein, Lindsey Watson, Joan Ash, Karen Eden

Research output: Contribution to journalArticle

7 Scopus citations


Objectives: We characterized patients' comprehension, memory, and impressions of risk communication messages in a patient decision aid (PtDA), Mammopad, and clarified perceived importance of numeric risk information in medical decision making. Methods: Participants were 75 women in their forties with average risk factors for breast cancer. We used mixed methods, comprising a risk estimation problem administered within a pretest-posttest design, and semi-structured qualitative interviews with a subsample of 21 women. Results: Participants' positive predictive value estimates of screening mammography improved after using Mammopad. Although risk information was only briefly memorable, through content analysis, we identified themes describing why participants value quantitative risk information, and obstacles to understanding. We describe ways the most complicated graphic was incompletely comprehended. Conclusions: Comprehension of risk information following Mammopad use could be improved. Patients valued receiving numeric statistical information, particularly in pictograph format. Obstacles to understanding risk information, including potential for confusion between statistics, should be identified and mitigated in PtDA design. Practice implications: Using simple pictographs accompanied by text, PtDAs may enhance a shared decision-making discussion. PtDA designers and providers should be aware of benefits and limitations of graphical risk presentations. Incorporating comprehension checks could help identify and correct misapprehensions of graphically presented statistics.

Original languageEnglish (US)
JournalPatient Education and Counseling
StateAccepted/In press - Jun 2 2015


  • Mammography
  • Patient decision aid
  • Risk communication
  • Women's health

ASJC Scopus subject areas

  • Medicine(all)

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