How do parents of babies interpret qualitative expressions of probability?

Article Abstract:

When speaking with patients, physicians often use words like 'probably', 'likely', and 'rarely'. It is not at all certain that these words are understood by the patient in the same way they are intended by the doctor. In order to gain some insight into this aspect of physician-patient communication, 100 mothers, 22 pediatricians, and 28 medical students were asked to numerically rate a set of words denoting probability on a scale of one to ten. For example, a patient might regard 'unlikely' as a three in ten chance and 'rarely' and a one in ten shot. One interesting observation is that the general ranking of the test words was comparable among the groups, the physicians' and medical students' responses for each word extended over a narrower range than those of the mothers, suggesting that the professionals may show slightly more precision in the use of these words. Other studies have indicated that some patients would actually prefer numerical answers from their doctors to gain a fuller understanding of the risks being described. It is clear, however, that words connoting risk are used for several different reasons. Numerical answers may be avoided because they are unavailable. They may also be avoided because the physician does not know or does not wish to be judged on his or her precision. In addition, words may blunt a bad prognosis. 'Unlikely' may be preferable to a 'one-in-a-hundred chance of recovery' when talking to a cancer patient. Although it is probably not possible to eliminate the use of vague phrases to describe probability, it is important that the physician be aware of the potential for misunderstanding and misinterpretation, and clarify phrases for the patient as much as possible. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Services, Telecommunications systems, Physician and patient, Physician-patient relations, Communication, Communications, Patients, Patient education, Probabilities, Probability theory

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Birthweight ratio revisited

Article Abstract:

The birth weight ratio relates the birth weight of an infant to its expected weight for gestational age, or week of birth during pregnancy. This ratio is calculated by dividing the birth weight by a reference birth weight that should be derived from a population in which preterm deliveries are excluded. This calculation is more convenient to use than the determination of percentiles. Infants who are small for their gestational age are often exposed to injuries or deprivation during the pregnancy and tend to have problems with neurological development. Some studies have suggested that the stress during pregnancy has prepared these infants for premature birth, and they have less severe respiratory distress syndrome. However, a recent study showed that babies with lower birth weight ratios needed longer periods of artificial ventilation due either to chronic lung disease or severe respiratory distress syndrome. However, no significant relationship between birth weight ratio and neurodevelopmental outcome could be demonstrated. The value of the birth weight ratio in predicting the clinical outcome of babies born at less than 31 weeks' gestation was assessed. The relationship between the birth weight ratio and the short- and long-term outcome was examined for 436 babies born at less than 31 weeks' gestation. The results indicated no significant association between birth weight ratio and ventilation period, death rate, neurological effects, or intellectual outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Birth weight, Low, Low birth weight, Infant development, Birth weight

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Dexamethasone and infection in preterm babies: a controlled study

Article Abstract:

Bronchopulmonary dysplasia is the abnormal development of the bronchi and lungs, and occurs most often in the premature infant. This disorder can be treated with the corticosteroid drug, dexamethasone. However, corticosteroid treatment is associated with impaired function of the hypothalamus and the pituitary and adrenal glands, and is also linked to increased risk of infection. The incidence of these complications of corticosteroid treatment has not been fully assessed in premature infants, although some studies suggest that corticosteroid therapy in premature infants suppresses adrenal function. Dexamethasone treatment of premature infants with bronchopulmonary dysplasia has not been associated with an increased incidence of infections. In the current study, the incidence and type of infections were assessed in 24 preterm infants treated with dexamethasone and 18 preterm infants not given this drug. Dexamethasone was given to the drug-treated infants for three weeks in gradually decreasing doses (from 0.60 to 0.15 milligrams per kilogram per day). The results showed no differences in the incidence of septicemia, the bacterial infection of the blood, between the two groups. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Risk factors, Drug therapy, Diseases, Dexamethasone, Bronchopulmonary dysplasia

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