INTRODUCTION
METHODS
RESULTS
Authors and year | Research question | Primary outcome measured | Sample size* | Sample description* | Health condition or situation | Severity of health event specified? | Study of EC† terms? | Risk of bias assessment |
---|---|---|---|---|---|---|---|---|
Lichtenstein and Newman 1967 27 | To assess numerical estimates and symmetry of interpretation of “mirror image” pairs of terms (e.g., “quite likely”-“quite unlikely”) | Numerical estimates | 188 | Adult males | Not specified | No | No | A little concern |
Budescu et al. 1985 28 | To assess variability in the mapping of phrases to numbers | Numerical estimates | 32 | Faculty and graduate students of a university | Not specified | No | No | Moderate concern |
Reagan et al. 198929 | To map verbal probability words to numbers | Numerical estimates | 100 | Undergraduate students | Not specified | No | No | Moderate concern |
Shaw and Dear 199030 | To evaluate understanding of probability expressions and preference for receiving information | Numerical estimates, format preference | 100 | Adult female parents | Aspects of neonatal care | No | No | No concern |
Weber and Hilton 199031 | To examine the role of context in the interpretation of probability words | Numerical estimates | 85 | Undergraduate students | Varying disease types and side effects | Some specified as severe life-threatening events, others unspecified | No | Moderate concern |
Freeman et al. 19926 | To identify patients’ preferred risk language and physicians’ predictions about patient preferences | Format preference | 208 | Adult female patients with children from family practices | Vaccine risk | No | No | Moderate concern |
Woloshin et al. 199432 | To assess patients’ interpretation of probability terms | Numerical estimates; format preference | 307 | Adult patients from a family practice | Medication side effect or complication risk from procedure | Minor vs major complications | No | Moderate concern |
Hallowell et al. 1997 33 | To evaluate female patient preferences in formats used to present risk information during genetic counseling for breast and ovarian cancer | Format preference | 43 | Adult female patients presenting for genetic counseling in cancer clinic | Breast and ovarian cancer risks | No | No | A little concern |
Franic et al. 200034 | To evaluate format preference in patient medication package inserts | Format preference | 74 | Adult female patients from academic university | Adverse drug reactions | No | No | High concern |
Biehl et al. 200135 | To compare the interpretation of probability terms of adults with adolescents | Numerical estimates | 34 | Adults from a community center | Not specified | No | No | A little concern |
Kaplowitz et al. 200236 | To evaluate how patients want, request, and receive cancer prognosis information | Format preference | 352 | Patients from the American Cancer Society (ACS) mailing list in Michigan, US | Cancer prognosis information | No | No | A little concern |
Berry et al. 200237 | To assess the interpretation of verbal probability descriptors | Numerical estimates | 268 | Undergraduate and graduate students | Throat infection or ear infection; fictitious medication side effect | Mild vs severe side effects | Yes | Moderate concern |
Berry et al. 200338 | To compare the understanding of verbal and numerical descriptions of medication side effects | Numerical estimates | 360 | Adults from various public settings | Fictitious medication side effect | Mild vs severe side effects | Yes | A little concern |
Budescu et al. 200339 | To determine the directionality of probability phrases | Numerical estimates | 27 | Undergraduate students | Medical context; general medication administration | No | No | Moderate concern |
Davey et al. 200340 | To evaluate women’s understanding of diagnostic test results | Numerical estimates | 37 | Adult women who had previously participated in a population survey | Breast cancer risk | No | No | A little concern |
Lobb et al. 200341 | To evaluate how women wanted their risk of breast cancer to be described in consultation | Format preference | 193 | Adult women from cancer clinics | Breast cancer risk | No | No | Moderate concern |
Berry et al. 200442 | To evaluate people’s interpretation of EC verbal descriptors for medication side effect risks | Numerical estimates | 188 | Adults from various public places | Over-the-counter painkiller medication side effects | No | Yes | A little concern |
Berry et al. 200443 | To compare doctors’ and lay people’s interpretation of the EC verbal descriptors | Numerical estimates | 134 | Undergraduate and postgraduate students | Medication side effect | No | Yes | A little concern |
Knapp et al. 200444 | To explore whether the EC verbal descriptors effectively convey the risk of side effects | Numerical estimates | 120 | Adults from cardiac rehabilitation clinics following a recent admission | Medication side effects for cardiac medication | No | Yes | A little concern |
Berry and Hochhauser 200645 | To assess how verbal descriptors affect people’s perceptions of clinical trial participation risks | Numerical estimates | 96 | Adults from a train station | Fictional serious skin condition | No | No | A little concern |
Hubal and Day 200646 | To evaluate the understanding of verbal probability terms and effects of alternative formats | Numerical estimates | 222 | Undergraduate students | Medication side effect | No | No | Moderate concern |
Young and Oppenheimer 200647 | To assess how different formats of risk information influence medication compliance | Numerical estimates | 120 | Adult students from a university | Medication side effect | No | Yes | Moderate concern |
France et al. 200848 | To compare the understanding of frequency of side effects when expressed in percentages or descriptive language | Numerical estimates, % correctly identified | 50 | Patients in the chest pain unit of an urban emergency department who had one or more ischemic heart disease factors | Risks of treatment for acute myocardial infarction | Severe vs less severe side effects | No | No concern |
Graham et al. 200949 | To identify women’s preference and interpretation of language for description of the size of treatment complication risks | Format preference‡ | 262 | Adult female patients undergoing routine follow-up visits for breast cancer | Breast cancer risk | No | No | A little concern |
Knapp et al. 200950 | To assess the effectiveness of presenting side effect risk information in different formats | Numerical estimates | 148 | Adult users of an online cancer information website | Medication side effect | No | No | No concern |
Nagle et al. 200951 | To evaluate female patients’ preference on risk of disease | Format preference | 294 | Adult female patients from a maternity unit | Down syndrome risk | No | No | No concern |
Cheung et al. 201052 | To compare patients’ preference for risk presentation in medications | Format preference | 240 | Adult patients from arthritis clinics in a hospital and outpatient practice | Pain relief medication | No | Yes | A little concern |
Vahabi 201053 | To evaluate whether format preference influences comprehension | Format preference | 180 | Adult female patients from various community settings | Breast cancer risk | No | No | High concern |
Peters et al. 201454 | To measure risk comprehension and willingness to use a medication when presented with different formats | Numerical estimates | 905 | Adult participants from a paid online questionnaire | Cholesterol medication | No | Yes | No concern |
Knapp et al. 201455 | To evaluate recommendations on communicating frequency information on side effect risk | Numerical estimates | 339 | Adult users of an online cancer information website | Medication side effects | No | No | A little concern |
Webster et al. 201756 | To assess how people interpret the EC verbal descriptors | Numerical estimates, % correctly identified | 1003 | Adult users of an online survey conducted by a market research company | Medication side effects | Mild vs severe side effects | Yes | A little concern |
Carey et al. 2018 57 | To assess patients’ interpretation of verbal descriptor chance of remission and preferences for format of risk communication | Numerical estimates, format preference | 210 | Adult medical oncology outpatients with a diagnosis of cancer | Cancer long-term side effects and chances of remission | No | No | A little concern |
Wiles et al. 202058 | To determine the perceived risk of surgical complication risk using verbal probability terms | Numerical estimates | 290 | Adult patients attending a pre-operative assessment in a clinic | Major adverse postoperative complication | No | No | No concern |
Verbal probability term | Number of studies | Average numeric estimate, random effects model (%) | 95% CI (%) | Minimum sample average (%)* | Maximum sample average (%)* | Range of individual estimates (%)† |
---|---|---|---|---|---|---|
Rare(ly) | 7 | 10.00 | [7.99, 12.01] | 7.0 | 21 | 0–80 |
Rare-severe event | 3 | 10.06 | [5.45, 14.68] | 6.3 | 34.8 | – |
Rare-mild event | 3 | 14.14 | [7.88, 20.40] | 9.6 | 39.3 | – |
Uncommon | 4 | 17.64 | [13.19, 22.09] | 13.3 | 22.9 | 0–90 |
Unlikely | 6 | 17.71 | [14.86, 20.55] | 13.3 | 27 | 0–85 |
Common-severe event | 3 | 43.08 | [40.27, 45.88] | 41.9 | 45.6 | – |
Possible(ly) | 6 | 43.28 | [36.66, 49.89] | 36.9 | 62 | – |
Common-mild event | 3 | 50.47 | [45.59, 55.34] | 48 | 58 | – |
Common | 6 | 58.73 | [50.40, 67.06] | 34.2 | 70.5 | 10–100 |
Very common | 3 | 60.10 | [42.36, 77.85] | 38.5 | 71.6 | 5–100 |
Probable(ly) | 5 | 69.87 | [67.07, 72.67] | 66 | 73.9 | 20–100 |
Likely | 6 | 71.87 | [69.90, 73.84] | 66 | 94 | – |
Usual(ly) | 3 | 75.38 | [71.53, 79.23] | 72 | 78 | – |
Very likely | 3 | 84.30 | [79.43, 89.17] | 75.2 | 93 | 20–100 |
Study * | Sample size | n (%) | |||
---|---|---|---|---|---|
Preferred verbal | Preferred numeric | Preferred combination | No preference | ||
Woloshin et al. 198425 | 307 | 91 (29.6) | 135 (43.9) | 81 (26.3) | NA |
Shaw and Dear 199023 | 81 | 43 (53.1) | 30 (37.0) | NA | 8 (9.9) |
Freeman and Bass 19926 | 208 | 89 (42.7) | 119 (57.2) | NA | NA |
Hallowell et al. 1997 33 | 43 | 3 (7) | 9 (21) | 22 (52) | 8 (19) |
Franic and Pathak 200026 | 74 | 4 (5.4) | 70 (94.6) | NA | NA |
Lobb et al. 2003 41 | 109 (unaffected by condition) | 24 (22.1) | 55 (50) | 20 (18.3) | 10 (9.6) |
84 (affected by condition) | 15 (17.9) | 16 (19.2) | 45 (53.8) | 8 (9) | |
Graham et al. 2009 49 | 262 | 136 (52) | 125 (47.7) | NA | 1 (0.3) |
Nagle et al. 200938 | 294 | 85 (28.9) | 132 (44.9) | 76 (25.8) | NA |
Cheung et al. 201039 | 240 | 60 (25.0) | 180 (75.0) | NA | NA |
Vahabi 201040 | 180 | 61 (33.9) | 119 (66.1) | NA | NA |
Carey et al. 2018 57 | 210 | 59 (28) | 33 (16) | 79 (38) | 39 (18) |