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Comment & Response
August 2017

Discrepant Expectations About Benefits and Harms

Author Affiliations
  • 1University Hospital, Amiens, France
JAMA Intern Med. 2017;177(8):1225-1226. doi:10.1001/jamainternmed.2017.2377

To the Editor The systematic review by Hoffmann and Del Mar1 in a recent issue of JAMA Internal Medicine showed robust but sad evidence that most health care professionals divergently misconceive benefits and harms of their interventions (treatments, screenings, tests) and deserves comment.

First, the various explanations have overlooked (1) an enduring but obvious innumeracy2 and (2) illiteracy that is not openly acknowledged. In their review, Hoffmann and Del Mar rightly used the terms “benefits” and “harms,” but PubMed search results reach 2818 for “benefit-risk”and 1159 for “benefit/risk” vs 8 for “potential benefit” and “risk of harm” combined, 123 for “benefit-harm,” and 33 for “benefit/harm.” When health care professionals intervene, benefits are guaranteed while harms are only a “potential risk”.