How age, outcome severity, and scale influence general medicine clinic patients’ interpretations of verbal probability terms

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Abstract
Objective: To assess whether the type of scale used (scaling effects) and the severity of outcome (outcome severity) influence patients’ numerical interpretations of verbal probability expressions. Design: Cross-sectional survey of patients in a general medicine clinic. Setting: A university-based Department of Veterans Affairs Medical Center. Participants: 210 patients seen consecutively in a general medicine clinic. Measurements and results: The patients were randomized to scale and health outcome (complications of surgery). Two scales (a long form and a short form ) were used to expressly allow patients to choose probabilities less than 1%. The long form had a lower bound of “Conclusions: These findings suggest that the severity of the associated outcome and the scale used to elicit patients’ numerical estimates of verbal probability expressions influence patients’ quantitative interpretations of the verbal probability statement; and older patients respond with higher probabilities of negative outcomes than do younger patients. Future studies must continue to explore whether verbal probability expressions are adequate for communicating medical risk to patients or whether patients should be provided with numerical estimates of frequency.

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