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Paeds SAQsprofessional-practice-and-evidence

Paeds SAQs · professional-practice-and-evidence

Communicating risk and uncertainty to families — formative SAQs

Formative SAQs on evidence-based risk and uncertainty communication with families in paediatrics.

20 marks30 min2 min readVerification in progress

Target exams

RACP General PaediatricsMRCPCH ClinicalABP General Pediatrics
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Target exams

RACP General PaediatricsMRCPCH ClinicalABP General Pediatrics
Prompt
Communicating risk and uncertainty to families

SAQ 1 (10 marks)

A parent has read online that a daily preventive medication for their child's chronic illness "reduces harm by 50%". They are unsure whether to start it. [1]

  1. Explain why quoting "a 50% reduction" alone is a communication failure, and describe how you would reframe the benefit accurately. (4) [1] [3]
  2. Outline the presentation format and visual aid you would use to support this discussion. (3) [4] [6]
  3. Describe how you would confirm the family understood the numbers and the options before a decision. (3) [13] [14]

Model answer

"50%" is a relative risk reduction quoted without its baseline, which inflates perceived benefit. Reframe by stating the absolute baseline risk and the absolute risk reduction, so the family understands the true magnitude; for example, halving a risk from 2 in 1000 to 1 in 1000 is a 50% relative reduction and a 0.1 percentage-point absolute reduction. [1] [3]

Present the numbers as natural frequencies with one consistent denominator, and add a pictograph (icon array) so the denominator is visible; for a medication, use a drug-facts box pairing benefit and harm side by side in absolute terms, or a validated patient decision aid for the preference-sensitive choice. [4] [6]

Confirm understanding with teach-back: ask the family to restate the chance and the options in their own words, elicit their values and preferred direction, name any uncertainty honestly, and provide a written summary and a named follow-up contact. [13] [14]

Paediatrics Fellowship Pro

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References6ShowHide
  1. [1]Gigerenzer G Helping Doctors and Patients Make Sense of Health Statistics. Psychological science in the public interest, 2007.PMID 26161749
  2. [3]Paling J Strategies to help patients understand risks. BMJ, 2003.PMID 14512489
  3. [4]Zipkin DA Evidence-based risk communication: a systematic review. Annals of internal medicine, 2014.PMID 25133362
  4. [6]Schwartz LM Using a drug facts box to communicate drug benefits and harms: two randomized trials. Annals of internal medicine, 2009.PMID 19221371
  5. [13]Peters E Communicating Numeric Risk Information to Patients. Journal of general internal medicine, 2025.PMID 40301218
  6. [14]Levetown M Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics, 2008.PMID 18450887
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