Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Physician Wording Role in Seeking AK Treatment

JAMA Dermatol; ePub 2017 Jan 18; Berry, Butt, et al

Patients’ decisions on whether to receive treatment for actinic keratosis (AK) is significantly affected by physician wording, especially with alterations in the presentation of risk of malignant transformation, a recent study found. A prospective survey study was performed from June 1 to July 31, 2016, in participants who were recruited through the Penn State Milton S. Hershey Dermatology Clinic and an online survey site. A total of 571 individuals were recruited; 539 (94.4%) returned completed surveys. The mean (SD) age of respondents was 42.9 (17.8) years; 306 (56.8%) were women. Researchers found:

  • The decision to receive treatment for AK varied from 57.7% (n=311) to 92.2% (n=497) for the 5 scenarios presented in the questions.
  • The question that presented AK as a “precancer” had the highest proportion of participants who preferred treatment (497 [92.2%]).
  • 2 questions that presented the risk of AK as not progressing to cancer had the lowest proportion of individuals who chose treatment (311 [57.7%] and 328 [60.9%]).


Berry K, Butt M, Kirby JS. Influence of information framing on patient decisions to treat actinic keratosis. [Published online ahead of print January 18, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2016.5245.