Risk Thresholds and Risk Classifications Pose Problems for Person-Centred Care

Area of Science:

• Medical Decision Making
• Bioethics
• Health Informatics

Background:

• Continuous risk scores are frequently categorized into discrete risk levels (e.g., high, moderate, low).
• This mono-criterial classification raises ethical concerns regarding informed consent and individual preferences.
• Current risk stratification may not adequately capture the multifaceted considerations important to patients.

Purpose of the Study:

• To propose and conceptually demonstrate preference-sensitive, multi-criteria decision support tools.
• To address the ethical and legal challenges posed by single-criterion risk labeling.
• To illustrate an alternative approach to risk communication that avoids arbitrary risk categories.

Main Methods:

• Conceptual development of decision support tools based on multi-criteria analysis.
• Demonstration of a proof-of-method for preference-sensitive decision support.
• Illustrative use of the statin decision as a case study (without empirical data).

Main Results:

• A conceptual framework for multi-criteria decision support was developed.
• The proposed method bypasses the need for discrete risk-level classifications.
• The statin decision example illustrates the potential of this approach.

Conclusions:

• Preference-sensitive, multi-criteria decision support tools can overcome limitations of traditional risk stratification.
• This approach enhances the quality of informed consent by incorporating individual values.
• Future development should focus on implementing such tools to improve patient-centered care.