Risk communication interventions may be most productive if they include individual risk estimates in the discussion between professional and patient. Patient decisions about treatment appear more amenable to change by these interventions than attendance for screening or modification of risky behavior.

Discussing risks and benefits of treatments or care options is becoming an increasingly important part of modern health care. This paper reviews the literature about manipulations of risk and benefit information in the clinical setting. There is a paucity of evidence in this field, particularly when examining specific manipulations. Only three categories of manipulation had three or more studies. The available evidence shows that the way information is presented can have significant effects on decisions made. The largest effects are evident when relative risk information is presented, as compared with absolute risk data. In addition, "loss framing" is more effective in influencing screening uptake behaviors than "gain framing" (odds ratio 1.18 [95% confidence interval 1.01-1.38]). There is also a pattern of evidence from studies comparing simpler with more complex information, more data with less, and those comparing numerical with verbal descriptions of risks. These studies suggest that providing more information, and which is more understandable to the patient, is associated with improved patient knowledge and a greater wariness to take treatments or participate in trials. These findings can contribute to efforts to improve communication between professionals and patients.

Using the example of communication about risk in a primary care setting, this paper puts forward a method of developing and evaluating a detailed search strategy for locating the literature for a systematic review of à diffuse' subject. The aim of this paper is to show how to develop a search strategy that maximizes both recall and precision while keeping search outputs manageable. Six different databases were used, namely Medline, Embase, PsychLIT, CancerLIT, Cinahl and Social Science Citation Index (SSCI). The searches were augmented by hand-searching, contacting authors, citation searching and reference lists from included papers. Other databases were searched but yielded no extra references for this subject matter. Of the 99 papers included, 80 were indexed on Medline. The Medline search strategy identified 54 of them and the remaining 26 were located on other databases. The 19 further unique references were found using the other databases and methods of retrieval. A combination of several databases must be used to maximize recall and to increase the precision of searches on individual databases, thus improving the overall efficiency of the search. AimTo demonstrate an efficient approach to locating the maximum amount of primary research on a diverse subject for a systematic review, using the example of communication about risk in primary care. This paper looks at how to develop and evaluate a search strategy that maximizes both recall and precision while endeavouring to ensure that the search is kept within manageable limits.

Sociologists repeatedly appeal to notions of altruism, bureaucratisation and self interest in their efforts to explain the changing place of the professions in contemporary society. We treat these three readings as 'institutional logics' key to understanding the way in which doctors respond to the appraisals system at the heart of the UK's approach to revalidation. Our analysis of a survey of 998 GPs working in Wales points to an altruistic commitment to learning and improvement, bureaucratic demands for the reporting of information and self-regarding resentment of changes in the occupational package provided by general practice. But the data also demonstrate that the maintenance of the appraisal regime is dependent on the preparedness and capacity of individual GPs to do micro-level institutional work on all these fronts.