We have all pictured it.
That dreaded, implausible scenario where you find yourself on the end of a phone call with your GP who has rung about a few tests you did last week.
Except, rather than hearing words of reassurance, your doctor asks you to come in to discuss the results.
It is in that moment that you realise this might be the day you hear a life-changing diagnosis.
You have a feeling that you are about to be diagnosed with one of those serious, chronic conditions that people have been incessantly warning you about developing your whole life.
Something that could rock your world and change every plan you have ever had for how you want your life to turn out.
In the moments on your way into the GP and on your way home, you will have a decision to make. That is, how will you interpret the results and the odds that you are given?
Scenarios such as these make us stop and evaluate just how reliable our interpretation of risk is. This leads to the question of what influences our ability to evaluate risk and make decisions accordingly.
What influences our interpretation of risk?
Multiple factors influence our perception of risk.
One being our personal psychosocial orientation towards risk. Some people are more risk-averse, meaning they likely only take chances when they have (what they consider to be) solid odds. In comparison, others identify as more risk-taking and therefore more willing to take a loss if they have a chance of an attractive return.
A person’s risk tolerance is likely to change over time and fluctuate in different situations.
For example, in the field of medicine and pharmacology, what is considered to be an appropriate risk-benefit ratio of a drug changes depending on the severity of the condition, the existence of other treatments and the individual-specific likelihood of positive response.
Put into practice, it follows that patients are unwilling to tolerate major side effects of a medication taken to treat headaches, because the benefit gained from treating the headache may be viewed as minimal.
However, cancer patients for whom a drug could be the difference between life-or-death outcomes are more likely to tolerate severe, quality-of-life decreasing side-effects. Such as those seen from chemotherapy – which for example can indiscriminately target the turnover of new cells in the body, not simply tumour cells. As a result, the chemotherapy can cause many of the hallmark side effects typically associated with cancer such as fatigue, hair loss, frailty, loss of appetite, nausea etc. These deleterious effects are caused by the drugs rather than the disease itself. However, patients may be willing to risk such side effects if there is a chance that the treatment could help eradicate the cancer, or even stop its proliferation.
Another element determining risk perception is the nature of the risk itself. This includes aspects such as how severe the risk is, i.e. is it life-or-death? How much control can be asserted over the outcome? As well as the timing of the possible gain or loss.
A final critical component of an individual’s interpretation of risk is their own biases in interpreting the odds of the risk occurring. Some of the biases that come into play in assessing risk include:
- Representativeness bias: this occurs when we judge the probability of an event occurring by comparing it to an existing prototype in our minds. For example,
- Anchoring and adjustment: this phenomenon functions through an individual making an initial judgement based on an early piece of information. They may later adjust their judgement, but only minimally.
- Availability bias: this involves interpreting risk based on immediately available examples for comparison that comes to mind and helps an individual make a judgement. However, examples of poor outcomes and severe consequences are more likely to come to mind.
Most of us would likely think we would do averagely in terms of being able to evaluate risk. However, how the information is framed and the number of methods used to convey and compare the information can impact an individuals ability to define personal meaning from the information.
Some threats trigger an enhanced emotional response which can skew how dangerous we interpret them to be, says Gerd Gigerenzer, risk research at the University of Potsdam, Germany. He has dubbed them “dread risks“. These are ones that pose less of a risk to us than risks we are happy to take daily. However, several relatively rare instances may have occurred in quick succession and gained media attention, for example, fueling anxiety and a disproportionate fear response.
Gerd says that this type of fear response can influence our decisions and cause us to take actions that in fact, escalate our risk of injury or mortality. For example, statistics across the world have observed a decrease in rates of diagnosis of many chronic health conditions. Experts have put this down to public avoidance of hospitals due to unwanted exposure to Covid-19.
Data from the World Stroke Organization showed a 50-70 per cent median decrease in the number of hospital admissions for stroke symptoms recorded across 100 participating countries. In addition, there has been a wide circulation of media stories concerning the number of missed cancer diagnosis this year. An article published in The Lancet in June 2020 estimated that at that point in time, data reflected significant increased in the number of preventable cancer deaths in England as a result of diagnostic delays due to the COVID-19 pandemic. It predicted approximately 59,000 – 63000 total years of lost life across only four cancers (breast, colorectal, oesophageal and lung).
Strategies to better communicate and interpret risk
In the case of Covid-19 experts have made some recommendations as to how you can minimise anxiety surrounding your risk of contraction. These include:
- Keep your perspective. Analyse whether statistics are given in absolute or relative values. Put those risk odds into perspective by comparing them to other values. Be cognizant of whether your emotions are amplifying your interpretation of these numbers.
- Ensure the information informing your feelings and decisions about your risk come from reliable, qualified sources.
- Seek professional mental health support if you find you are struggling or experiencing high levels of anxiety regarding risk exposure.