Obtaining consent for an operation: A choice of words or numerical probabilities?

Abstract

Questionnaires were administered to 105 consultants, junior medical staff and students at the Royal London Hospital in a study which aimed to find how the respondents would associate 46 words with percentage numbers. The words ‘certain’ and ‘never’ had a mean of 96 and 5, and a median of 100 and 0. The addition of the adjective ‘almost’ changed the median figures to 95 and 1. ‘Probable’ had a mean of 64, a median of 75 but a range of 50–80. ‘Possible’ had a mean of 32 and a median of 30, but a range of 15–50. The variation and range of all the other 46 words was even more variable and extensive, with no accurate prediction of the numerical value. However inadequate words are in communicating risk, they must still be used as a ‘discourse opener’, backed up by numerical figures. It is suggested that risk has been communicated using words and numbers. The patient may actually be more interested in what the surgeon is going to do about reducing the incidence of those risks than in the actual meaning of words.