Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
LetterLetters

Misleading communication aid

Roger Suss
Canadian Family Physician June 2020, 66 (6) 393;
Roger Suss
Winnipeg, Man
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

The systematic review comparing various osteoarthritis treatment options is a valuable summary of the evidence and I thank the authors for their work.1

Unfortunately the simplified decision aid with the page of 100-face diagrams is misleading and does not accurately and clearly summarize the evidence collected.2 Meaningfully improved pain is not defined in the article so it is not clear exactly what is being measured in the diagrams. It looks as though 94% of the patients to whom I prescribe exercise will have improvement (54% of them owing to the exercise and 40% related to natural variation in disease severity). This leaves only 6% who will get worse or stay the same. One has to read the text in detail to discover the statistical compromises that resulted in this implausible finding.

The accompanying table lists opioids as being likely harmful, but the 100-face diagram makes them look modestly beneficial. Only the text makes it clear that this is because the diagram represents short-term outcomes and the table focuses on long-term outcomes (which is appropriate for a chronic disease).

Glucosamine, chondroitin, and viscosupplementation appear twice on the page of 100-face diagrams, but only the text explains that the benefits are unclear because industry-funded trials with positive results could not be replicated.

I am glad that I read the whole article and it will help me with quantifying benefits when sharing decision making with my patients, but I will definitely not be using the 100-face diagram as a communication aid. It is not a good summary of the evidence so carefully collected in the systematic review.

Footnotes

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Ton J,
    2. Perry D,
    3. Thomas B,
    4. Allan GM,
    5. Lindblad AJ,
    6. McCormack J,
    7. et al
    . PEER umbrella systematic review of systematic reviews. Management of osteoarthritis in primary care. Can Fam Physician 2020;66:e89-98. Available from: https://www.cfp.ca/content/66/3/e89. Accessed 2020 May 11.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Lindblad AJ,
    2. McCormack J,
    3. Korownyk CS,
    4. Kolber MR,
    5. Ton J,
    6. Perry D,
    7. et al
    . PEER simplified decision aid: osteoarthritis treatment options in primary care. Can Fam Physician 2020;66:191-3. (Eng), e86–8 (Fr).
    OpenUrlFREE Full Text
PreviousNext
Back to top

In this issue

Canadian Family Physician: 66 (6)
Canadian Family Physician
Vol. 66, Issue 6
1 Jun 2020
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Misleading communication aid
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Misleading communication aid
Roger Suss
Canadian Family Physician Jun 2020, 66 (6) 393;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Misleading communication aid
Roger Suss
Canadian Family Physician Jun 2020, 66 (6) 393;
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • We are humans first
  • Truth about grief
  • Today’s residents are ready to lead
Show more Letters

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire