Effects of presenting risk information in different formats to cardiologists. A Latin American survey

OBJECTIVE

Previous publications demonstrated that the presentation of treatment benefits in terms of relative risk reduction (RRR) rather than in terms of absolute risk reduction (ARR) or number of patients to treat (NNT) might favor the perception of outcome effectiveness. The objective was to perform a cognitive evaluation to assess how the manner in which risks and benefits of screening methods and treatments are presented can affect medical care decision-taking in a sample of cardiologists.

METHODS

Four-hundred and six Latin American cardiologists answered a questionnaire reporting the results of clinical trials presented as RRR, ARR or NNT, associated or not to biased graphs.

RESULTS

Cardiologists' decision-taking was different when comparing treatment benefits presented as RRR (62.2%) vs. ARR (40.4%) (p=0.000000), and as RRR vs. NNT (44.4%) (p=0.000000). However, their decision-taking was similar when information was presented as NNT or ARR (p=0.073). The inclusion of biased graphs was misinterpreted as an actual data difference (RRR: 61.6% vs. ARR: 14.0%, p=0.000000).

CONCLUSIONS

This study demonstrated that Latin American cardiologists could misinterpret statistical data when information of clinical trials is presented in terms of RRR. We emphasize the need to enhance cardiologists' training in quantitative techniques, to improve medical care decision-making.

Boris Johnson: the moral case for government resignations in July 2022

Although comparatively rare, political resignations are essential for the health of democracy and political institutions. Protagonists risk their political careers when resigning but can hold governments to account and make real the Nolan principles of public life. In July 2022, an unprecedented 62 resignations ended Boris Johnson's time as British prime minister to be replaced first by Liz Truss and then, 44 days later, by Rishi Sunak, the second minister to resign. An inductive, qualitative, content analysis of the resignation letters elucidates the reasons for the resignations and highlights the ethical dilemmas that confronted would be resignees. Events lessened the effectiveness of government, triggered fears for the electoral prospects of the Conservative Party and separately challenged individuals' personal integrity. Considerations that prevented resignees acting earlier-promises that things would change, competing loyalties, fear of reprisal, love of job, attachment to status and allegiance to ideological faction-may partially explain why much of government remained in post in July.