Talking about risk

Spot the odd one out!

• Hyperlipidaemia

• Rheumatoid arthritis

• Eczema

• Bronchiolitis

Spot the odd one out!

• Fasting blood glucose 7.5

• PSA 7.5

• Serum potassium 6.0

• Ferritin 30

Salzburg statement on shared decision making

• Ethical imperative to share important decision making

• Stimulate a two way flow of information• Provide accurate information about

options, uncertainties, benefits and harms• Tailor information to individual patient

needs and allow time for consideration• Acknowledge that most decisions do not

have to be taken immediately

Children age 6m to 2y, bilateral AOM at 3-7 days treated with antibiotics

Harms of antibiotics age 6m to 15y

Consultation steps

• Describe the clinical condition• Explore ICE

My friend John

Statement as a question

Square search

• Describe the options and outline the dilemma• Offer a more detailed discussion • Work through the PDA• Allow the patient time for consideration. Offer a

copy of the PDA

Cautions

• Balance the discussion including both positive and negative sides

• Try to use phrases such as ‘a patient like you’

• Beware of the ‘friend of a friend’

• Explore understanding of severity of risk

• http://www.npc.nhs.uk/evidence/eidm3_individuals/movie/index.php