Dr. Bray Links

Thursday, January 19, 2017

Clinicians Often Underestimate Harms of Tests and Treatments

Clinicians are likely to underestimate harms and overestimate benefits of tests and treatments, according to the results of a review of 48 studies published online January 9 in JAMA Internal Medicine.

"[P]atients cannot be assisted to make informed decisions if clinicians themselves do not have accurate expectations of intervention benefits and harms," write study authors Tammy Hoffman, PhD, and Chris Del Mar, MD, from the Centre for Research in Evidence-Based Practice at Bond University in Queensland, Australia.

The review showed that the majority of clinicians correctly estimated harms only 13% of the time, and benefits only 11% of the time. Previous studies on patient expectations show that they, too, overestimate benefits and underestimate harms of many aspects of their care.

The clinicians' estimates varied widely across specialties and treatments. For example, more than 90% overestimated hormone replacement therapy's ability to reduce the risk for hip fracture, whereas more than 90% underestimated the risk for fatal cancer from bone scans.

"This was a very nicely done systematic review," Daniel Matlock, MD, MPH, from the Department of Medicine at the University of Colorado School of Medicine, Denver, told Medscape Medical News. "Bottom line, this kind of highlights that doctors are human and subject to a lot of these same data biases that patients are as well."


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