Reaping the Benefits and Avoiding the Risks: Unrealistic Optimism in the Health Domain

Abstract

People's perceptions of benefits and risks play a key role in their acceptance or rejection of medical interventions, yet these perceptions may be poorly calibrated. This online study with N = 373 adults aged 19-76 years focused on unrealistic optimism in the health domain. Participants indicated how likely they were to experience benefits and risks associated with medical conditions and completed objective and subjective numeracy scales. Participants exhibited optimistic views about the likelihood of experiencing the benefits and the side effects of treatment options described in the scenarios. Objective and subjective numeracy were not associated with more accurate ratings. Moreover, participants' underestimation of the risks was significantly greater than their overestimation of the benefits. From an applied perspective, these results suggest that clinicians may need to ensure that patients do not underestimate risks of medical interventions, and that they convey realistic expectations about the benefits that can be obtained with certain procedures.

Risk Perception: Reflections on 40 Years of Research

“…Specifically, research suggests that many people judge themselves to be less at risk for various hazards when they compare themselves with others (Shepperd, Waters, Weinstein, & Klein, 2015). For example, a recent study showed that even if risk and benefit information (as percentage range) about medical interventions was provided, participants showed positive optimism about the probability of experiencing side effects or benefits (Hanoch, Rolison, & Freund, 2019). This implies that patients may have unrealistic expectations regarding a treatment, even if numerical information is provided.…”

Knowledge and perceptions about perioperative stroke: a cross-sectional survey of patients scheduled for non-neurologic and non-cardiac surgery

“…13 A recent study showed that patients' underestimation of risks was significantly greater than their overestimation of benefits associated with medical or surgical care. 22 Of particular relevance to this study, non-surgical patients at high risk for stroke typically underestimate this risk. 16,20,23 Risk perception may be imprecise for a variety of reasons: sex, ethnicity, and education levels have been implicated.…”

Patient Perspectives on Treatment Options for Older Women With Hormone Receptor–Positive Breast Cancer

“…This feeling of personal exceptionalism and desire to pursue low-value services is likely associated with a tendency for patients and clinicians alike to overestimate the benefits and underestimate the risks of medical treatment. 31 , 32 , 33 For example, a study 13 of surgeons and radiation oncologists found that physicians overestimate patients’ life expectancies, incorrectly attribute radiotherapy to an improvement in survival rather than an improvement in local recurrence, and overestimate the risk of recurrence with radiotherapy omission in older women. One strategy to improve accurate risk communication is to optimize the format in which clinicians provide estimations.…”