ANALYZING BENEFITS AND RISKS IN MEDICINE, TO WHOM AND FOR WHOM?

Abstract

The audience is often not explicitly named as part of a research study, but the framing of the research and the written results tend to be targeted toward particular addressees, without recognition of the impact of the boundaries. As researchers, we often think of this issue as one of “communication.” We acknowledge that if our studies are to be understood more broadly, we must learn to write the results in non-scientific terms for a different audience. We do not often consider that research aimed at our traditional audiences may fail to consider the factors that could be the most crucial for the broader objectives our research is trying to achieve. It is within this context that a case study in benefit / risk illustrates the impact of framing and boundaries on the outcomes included in research. A current public debate in the UK and, to a lesser extent, in the US over the use of mammography screening for breast cancer reveals a great deal of well-intended information but not very much clarity. On its surface, defining the outcome of mammography as a benefit or risk would seem to be a straightforward exercise. However, the relative merits as discussed below would suggest otherwise.