The risky business of communicating science

Science Online 2012 is over, and I must admit that I’m still full of all the inputs, impressions and ideas that almost overloaded my head during those three days in North Carolina. Knowing were to start and were to end when giving highlights of the (un)conference is difficult. A blog post on my general reflections of the conference is coming up, but first I thought I’d just touch upon one of the themes I encountered at #scio12.

Risk. How do we communicate it? What is it really? What happens when a calculated, objective risk on paper is processed by a human mind? This is big challenge when communicating science – and perhaps especially in communication health research. Two of the sessions I attended at Science Online focused on risk. The first one, “Science Communication, Risk Communication and the role of social networks”, moderated by David Ropeik was a great session. David Ropeik pointed out that risk may very well be something that can be calculated to a percentage but to people it is a feeling. And feelings operate differently – and are not rational. I myself experienced that today. Being nearsighted I had a preexamination today for later lasic surgery. I had in advanced received a small folder explaining the procedure and of course – the risks. Even though the risks are relatively small, and despite the fact that I know several people who have had it done and are very happy with the result, when I read the small information brochure, I did all of a sudden have a feeling of “yikes – is this risk too big?” “How much is 1% really?” “If there were a hundred of me out there would one have worse eyesight after the procedure? Or would it look different if it was a hundred different people and not a hundred me? It is true, risk is a feeling. I felt like asking the doctor if he would do it if it was him. I wanted his feeling on this too.

Risk really is a challenge to communicate. And perhaps particularly in health, because disease and sickness is something that is very real to us and easy to imagine. In this regard, social media can be a challenge. Things have the potential to spread like viruses when they go online. Rumours of risk a radiation from the Fukushima nuclear plant made friends and family in Denmark fear for my wellbeing when I was in Kobe, Japan although I was more than 600 km away from the Fukushima plant. People in Denmark even feared that with wind coming in over Denmark from Japan they would too be at risk, if the situation got worse. And fears like that may be reinforced with unimaginable speed once they go viral.

So how do you balance communicating the facts when you at the same time risk steering fear? Are there ethical obligations to communicate all available research or the  opposite – should researchers be obligated to hold back certain kinds of information in the interest of public health, and the interest of the individual? Communication in public health is central, and reflecting on how to deal with risks should be a requirement for any public health researcher or professional (and for journalists too!). The web’s role in this is tricky. It is important to get the facts out there – and try to illustrate the proportion of risk, but the web also provides a fora where you can find confirmation of the risk of almost anything you like.

The discussions at Science Online didn’t give answers to how with deal with risk, and there most certainly is no magical solution. But the discussion triggered reflection, which should be required by all public health professionals when they communicate, whether to the public, to a journalist, at decision maker etc.

And as an end note: I did decide to go ahead with the lasic surgery – after carefully evaluating the risks and interpreting the doctors attitude and behavior. So in April, when I am without glasses, I will hopefully be able to say that it was worth the risk 🙂

12 thoughts on “The risky business of communicating science

  1. Anecdata alert, but I know several people who’ve had it, and the only complaint they’ve had is dry eyes, so they carry around drops all the time. But the vision? Amazing. My spouse went from legally blind to 20/20 in minutes, and it seemed practically miraculous to him to just put those coke-bottle glasses and contacts aside completely. Good luck. 🙂

    • Thanks Emily. I collect good experiences, and your spouse’s miraculosly improved vision will surely go into the collection. Am actually becoming quite exited abouted now (risk is a funny thing…all of a sudden my perseption of the risk for lasic surgery is changing to become smaller and smaller)

    • It is indeed a miracle – out goes the glasses. Dryness and a little bit of blurryness still, but apart from that I can see!!! It’s a brand new world! It was at least so far worth the risk!

  2. Anders Borglykke

    Dear Nina

    Excellent topic and as allways well written.

    As you may know my research revolves around risk.
    I am working on risk prediction mainly in the field of cardiovascular disease. Traditionally risk is presented as a relative risk (e.g. smokers have 2.5 times higher risk of CVD than non-smokers) or as used in risk prediction as an absolute risk (your risk of having a heart attack within the next ten years is 17%).

    First of all – the communication of risk is tricky. Would I be willing to take a newly developed drug every day for the rest of my life if the drug would cut my risk of a certain disease in half (relative meassures)? Not without knowing my absolute risk. If my absolute risk of developing the disease is 0.05% and by taking the drug lowered to 0.025% is it then worth it?

    In my field of research – different models are developed (including my own ones) to calculate individuals ten-year risk of CVD. However I have never thought of the models to be used for risk communication to patients solely. This has been tried several times, including a large intervention trial at the research centre were I am employed. Nearly 7000 participants were examined (BMI, blood pressure, serum cholesterol, smoking, diet, etc.) and their absolute risk was calculated. Those at high risk were beeing told that they would benefit from changes and offered life-style counselling, smoking cessation etc. The funny thing was (and I don’t know if that is typically Danish) but presented with their absolute risk of e.g. 10% (10 % risk that you will develop a cardiovascular event within the next ten years – which is fairly high) the typically reaction was: “Well luckily I have 90% chance of not having an event”.
    I see these models as guidelines or tools for decision-making for clinicians and luckily they are beeing used as such.

    Keep writing

    Anders

    • Dear Anders,
      Thanks for the comment and the interest in the topic.
      Your examples illustrates so perfectly that risk is a diverse thing. It is not only something that may have many different definitions when confronted to different people, but can actually technically be very different. Which makes it perhaps even more difficult for a non-clinician or technically trained person to grasp. On the other hand it may also be a help. Relative risks and absolute risks are essential to understand – and perhaps especially for the non-health-research savy (eg. journalists). Often this is what is missing when the news reports. I wonder if for example news stations have guidelines, rules or policies for how to communicate risks. If not, perhaps it would be an idea….?

      Models for calculating risk as guidelines for the clinicians are surely a great help and will hopefully continue to be so, but as you pointed out it requires some caution when moving to communicate it to non-health-professionals. At least it is essential to be aware of the subjective perception of risk and the feelings associate it with it.

      Tricky but super exiting topic

      I shall keep writing! Keep doing research!

      Nina

  3. Pernille Dam

    Dear Nina

    Risk communication is a highly interesting topic. I’d like to share an anecdote. My grandmother was resently diagnosed with hight blood pressure and her physician tried to persuade her to take antihypertensive drugs, while explaining the risk of not complying to this treatment. She replied, that her son and her son-in-law both have had cardiovascular events and both survived. So, being 80 years old, she was willing to take the risk of surviving or dying from a cardiovascular event. Eventually she told the doctor to keep his drugs to himself! Interesting how she mirrors herself in my father and my uncles stories, to modulate her own perception of risk.

    Btw are you familiar with this website, where you can look up the ‘Number needed to treat’ for drugs? It is quite interesting.

    Best wishes for your surgery

    Pernille

    • Dear Pernille,
      Thank you for the anecdote. What a cool grandmother you have! While writing that, I can’t really find out if she really is cool though. She is going against the doctor’s recommendation based on her own feelings and her own statistical calculations and then of course a personal cost-benefit analysis. And yet, she is very cool. Maybe because she was very clear on her reseasons for declining the drugs and found the exact statistics she could relate to (her son and son-in-law) which is very human. And due to her age, she is probably very wise on her own health.

      A numbers needed to treat (thanks for the link to the website) is a very useful tool. In your grandmother’s situation she would probably have prefered a number-of-family-members-needed-to-treat.

      I can’t help but wonder if a NNT would be helpful for other fields of science. Climate change people were complaining about it being difficult to communicate the real threat of climate change, because the numbers are very difficult to comprehend. But perhaps something like – Number-of-cars-needed-to-disappear would help.

      An extremely challenging but interesting topic this is.

      Nina

  4. Pingback: ScienceOnline 2012 – Behind the #scio12 hashtag « Science Tomorrow

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