Reference frame and emotions may contribute to discrepancies in patient and clinician risk estimates in Long QT syndrome

Patient Educ Couns. 2019 Dec;102(12):2296-2301. doi: 10.1016/j.pec.2019.06.021. Epub 2019 Jun 22.

Abstract

Objective: Patients and clinicians need to have similar understandings of cardiac risk, so patients can make informed decisions. The aim of this study was to assess the concordance of risk estimates between Long-QT-Syndrome (LQTS) patients and an experienced clinician.

Methods: This cross-sectional study included 86 LQTS patients recruited from a clinical registry. Participants completed two questions on their risk of cardiac arrest; likelihood (1=very-unlikely to 5=very-likely), and chance (%), and an experienced clinician computed the same based on risk factors.

Results: 30% and 55% of patients had concordant perceptions with the clinician estimate on the chance and likelihood questions respectively. The patients who overestimated their risk (%) had significantly greater emotional responses and concerns about their LQTS. 22 (29%) patients reported a risk of 50% or greater, in contrast to the clinician's risk estimates not exceeding 30%.

Conclusion: Many LQTS patients had discordant risk perceptions to the clinician's. Patients and clinicians may have different frames of reference, and patients' estimates are linked with emotions.

Practical implications: Clinicians need to take into account LQTS patients' different frame of reference when discussing risk information. This will support shared decision making.

Keywords: Illness perceptions; Long QT syndrome; Risk perceptions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Emotions
  • Female
  • Heart Arrest / diagnosis
  • Heart Arrest / psychology*
  • Humans
  • Illness Behavior*
  • Long QT Syndrome / genetics
  • Long QT Syndrome / psychology*
  • Male
  • Middle Aged
  • New Zealand
  • Perception*
  • Registries
  • Risk Assessment
  • Risk Factors