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Patients Have Unrealistic Expectations for Treatment, Tests

Review shows most patients overestimate benefits, underestimate harms of interventions

WEDNESDAY, Dec. 24, 2014 (HealthDay News) -- Most patients overestimate benefits and underestimate harms of treatment, tests, and screenings, according to a review published online Dec. 22 in JAMA Internal Medicine.

Tammy C. Hoffman, Ph.D., and Chris Del Mar, M.D., from Bond University in Gold Coast, Australia, conducted a systematic review to examine patients' expectations of the benefits and/or harms of any treatment, test, or screening. Methodological quality was independently examined by two researchers who extracted participants' estimates of benefit and harms. Data were included from 36 articles (35 studies) involving 27,323 patients.

The researchers found that across 32 studies, 54 outcomes assessed benefit expectations; of the 34 outcomes with overestimation data, most participants overestimated benefit for 22 outcomes. The investigators could not calculate the proportion of participants who overestimated and underestimated benefit for 17 benefit expectation outcomes; however, the study authors thought participants overestimated benefits for 15 of the outcomes. Across 13 studies, expectations of harm were assessed by 27 outcomes; underestimation data were available for 15 outcomes, and most participants underestimated harm for 10 of the outcomes. For two outcomes about benefit expectations and two outcomes about harm expectations, at least 50 percent of participants made a correct estimation.

"Clinicians should discuss accurate and balanced information about intervention benefits and harms with patients, providing the opportunity to develop realistic expectations and make informed decisions," the authors write.

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