When does healthcare transparency morph into 'too much information?'

If you have a teenager or two living at home, it's not uncommon to hear them utter the term "TMI"--too much information--when you're trying to explain something to them. But can there ever be TMI when it comes to taking care of our own health?

In this era in which concepts such as "transparency in healthcare" or "informed consumers" are used often, some are saying that too much patient information could have a detrimental impact.

In the current issue of the ethics journal the Hastings Center Report, one author suggests that giving patients additional information about the risks and benefits of a medical intervention may not always be helpful--and in the long run could lead them into making what would be considered irrational decisions.

This discussion comes at a time when many patient advocates have used the term "quantitative imperative"--or the responsibility to reveal risk-related data to patients to help them make informed decisions.

It's a concept that is not only supported by face-to-face discussions with healthcare providers, but also decision aids--such as websites, pamphlets, videos, or computer programs--that can better explain data related to treatments or medical conditions.

However, disclosure of this quantitative data sometimes can backfire, writes Peter Schwartz, a faculty investigator at the Indiana University Center for Bioethics. The problem lies in the numbers, he says.

One difficulty is that more than half of adults have a tough time understanding or applying concepts using math and probabilities. He cites national studies that suggest at least 22 percent of adults only have the most basic quantitative skills--such as counting--while about 33 percent may only be able to do simple math.

Even for those who are comfortable with math, they may be biased or not fully understand the risks involved. For instance, they may place heavy emphasis on small risks or, on the other hand, they may show "optimism bias"--which exaggerates the chance that they will be one of the "lucky" ones when it comes to a treatment.

Either way, these biases can cause patients to make decisions about their medical interventions that may not be based on reason or actual facts, he notes.

He's right that this issue of disclosing quantitative information is likely to become more pressing with advances in epidemiology and genetics. Maybe we do need to get a better grasp on how individuals process information about their own health.

Schwartz argues that providers should not always disclose all available quantitative data to all patients. He cautions that while the data should always be available to patients who request it, "the question is, how to offer it and in what form."

Personally, I think that more information is better--like when it comes to communicating with teenagers. - Janice