ABSTRACT
PURPOSE: Risk communication is an integral aspect of shared decision-making and evidence-based patient choice. There is currently no recommended way of communicating risks and benefits of cataract surgery to patients. This study aims to investigate whether the way this information is presented influences patients' perception of how risky surgery will be. METHODS AND ANALYSIS: Two-arm parallel randomised study and patients referred for cataract surgery were assigned to receive information framed either positively (99% chance of no adverse effects) or negatively (1% chance of adverse effects). Subsequently, patients rated their perceived risk of experiencing surgical side effects on a 1-6 scale. RESULTS: This study included 100 patients, 50 in each study group. Median (IQR) risk perception was 2 (1-2) in the positive framing group and 3 (1-3) in the negative framing group (p<0.0001). Risk framing was the only factor that was significant in risk perception, with no differences found by other patient clinical or demographic characteristics. CONCLUSION: Patients who received positive framing reported lower risk scores for cataract surgery than patients who received negative framing. Patient factors were not identified as significant determinants in patients' perceived risk. Larger longitudinal studies are warranted to further investigate.
Subject(s)
Cataract Extraction , Communication , Humans , Male , Female , Aged , Risk Assessment , Middle Aged , Surveys and Questionnaires , Aged, 80 and over , Patient Education as TopicABSTRACT
La leiomiositis intestinal es una causa rara de pseudoobstrucción intestinal crónica (POIC) y no está descrita asociada a vólvulo de sigmoides. Reportamos el caso de un paciente de 12 años con episodios recurrentes de POIC en quien se descartó enfermedad del sistema nervioso entérico. Las biopsias endorrectales y posteriormente una sigmoidectomía por vólvulo recidivante evidenciaron una miopatía con infiltrado inflamatorio de linfocitos y eosinófilos limitado a la capa muscular propia. Los estudios complementarios descartaron enfermedad sistémica. El diagnóstico final fue leiomiositis inflamatoria, una entidad rara, con muy pocos casos reportados en la literatura, de probable etiología inmunológica y pronóstico variable (AU)
Intestinal leiomyositis is a rare cause of chronic intestinal pseudo-obstruction (CIPO) and is not described associated with sigmoid volvulus. We report the case of a 12 year old patient with recurrent episodes of CIPO. Rectal biopsies were performed to rule out enteric nervous system disease. These biopsies and subsequently a sigmoidostomy made by recurrent sigmoid volvulus evidenced a myopathy with inflammatory infiltrate of lymphocytes and eosinophils limited to the muscularis propia, atrophy of myocytes and intersticial fibrosis. Complementary studies ruled out systemic disease. The final diagnosis was inflammatory leiomyositis, a rare entity, with very few cases reported in the literature that seems to have an immune etiology and variable prognosis (AU)
