Weighing up the risks and benefits

Weighing up the risks and benefits of treatments can be tricky. There are lots of different things to consider. Follow the example below to learn what some of these things are and how you might use them to make a decision about treatment.

Imagine that you are 65 and have just had a mild stroke. An artery that supplies your brain with blood and oxygen is blocked. Your doctor has searched through the medical research and tells you that you could have an operation or take an aspirin every day to get rid of the blockage.

There is a type of research study called a randomised controlled trial. This type of study compares different ways of treating people with the same condition. For example, it might compare how well surgery and aspirin work for people who have had a stroke.

(For more information about the different types of studies, see How to pick the best research studies).

In your case, research shows that five years after having surgery 5 percent of people had another stroke. But it also found that five years after taking aspirin, 5 percent of people had another stroke.[1] When there is no clear-cut answer, it can be difficult to make a decision.

So you need to consider other things as well. Your doctor says that you also need to think about the risk of complications from surgery. About 2 percent of people who have surgery die from the procedure. The risk varies according to the surgeon's skill. Some surgeons have better results than others.

What should you do? What extra information do you need?

  • You need to consider how healthy you are. If you have other serious medical problems, the risks from an operation may be greater.

  • You need to find out how many of this type of operation your surgeon has done and what the results of the surgery have been. Have the operations been successful? Have the people having them made a full recovery?The surgeon's results are sometimes tricky to understand because they may depend on the health of the people who were operated on. People who are healthier are more likely to make a full recovery.

  • You will probably also want to know whether the research studies that your doctor looked at included people like you. Studies often include people who are young and physically fit.

  • You also need to think about what is important to you. If what matters most is that your father died during surgery and you've always been afraid of having an operation, then maybe you should choose aspirin.

It can be difficult to think about all the different things that can affect your decision about treatment. But it is the only way to work out which treatment is best for you.

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