Most internal medicine residents and attending physicians overestimate the benefits and harms of common interventions, according to a new survey. Physicians and residents overestimated a treatment’s benefits 79% of the time and the harms 66% of the time, according to a survey of clinicians working in primary care, hospital medicine and specialty care at two academic medical centers.

In addition to inaccurate benefit/risk estimations, the authors found the respondents were not very confident in their responses. Most (67.5%) chose 4 on a scale from 1 to 10, where 10 was very confident. Physicians also underestimate how often most treatments have no effect, either harmful or beneficial, the researchers found.

In an invited commentary, Anna L. Parks, MD, from the Department of Medicine, University of California, San Francisco, and Patrick G. O’Malley, MD, MPH, from the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, write that communication with patients about risks and benefits is particularly important with low-value care, as health systems struggle to rein in costs. “More attention to numeracy and shared decision-making communication skills will complement system interventions like deployment of effective [electronic medical record]-based decision support tools at the point of care,” they write. “Physicians at all levels of training must take on the additional professional obligation of communicating risk and benefits clearly to achieve care that is both high-value and in line with patients’ goals.”

You can see the survey, published online in JAMA Internal Medicine, here.