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BMJ Evid Based Med. 2018 Feb;23(1):29-33. doi: 10.1136/ebmed-2017-110829.

Key Concepts for Informed Health Choices: a framework for helping people learn how to assess treatment claims and make informed choices.

Author information

Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway.
The James Lind Initiative, National Institute for Health Research, Oxford, UK.
Students for Best Evidence, UK Cochrane Centre, Oxford, UK.
Centre for Evidence Based Medicine, University of Oxford, Oxford, UK.
Makerere University College of Medicine, Makerere University, Kampala, Uganda.
Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.


Many claims about the effects of treatments, though well intentioned, are wrong. Indeed, they are sometimes deliberately misleading to serve interests other than the well-being of patients and the public. People need to know how to spot unreliable treatment claims so that they can protect themselves and others from harm. The ability to assess the trustworthiness of treatment claims is often lacking. Acquiring this ability depends on being familiar with, and correctly applying, some key concepts, for example, that' association is not the same as causation.' The Informed Health Choices (IHC) Project has identified 36 such concepts and shown that people can be taught to use them in decision making. A randomised trial in Uganda, for example, showed that primary school children with poor reading skills could be taught to apply 12 of the IHC Key Concepts. The list of IHC Key Concepts has proven to be effective in providing a framework for developing and evaluating IHC resources to help children to think critically about treatment claims. The list also provides a framework for retrieving, coding and organising other teaching and learning materials for learners of any age. It should help teachers, researchers, clinicians, and patients to structure critical thinking about the trustworthiness of claims about treatment effects.


causal inferences; concepts; critical appraisal; critical thinking; epistemology; treatment claims


Conflict of interest statement

Competing interests: DN has received expenses and fees for his media work. He holds grant funding from the NIHR School of Primary Care Research and the Royal College of General Practitioners. CH has received expenses and fees for his media work. He holds grant funding from the NIHR, the NIHR School of Primary Care Research, The Wellcome Trust and the WHO. IC declares no competing interest.

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