How should uncertainty about upcoming painful procedures be communicated? An experimental study into highly uncertain pain predictions

Objective: Uncertainty is unavoidable in medical settings. Finding an optimal way to communicate uncertainty may improve doctor-patient communication and, consequently, patients’ health outcomes. Methods: In our exploratory study, healthy participants (n=30) were repeatedly presented with three highly uncertain pain predictions communicated by a hypothetical doctor. A direct statement of high uncertainty (“I don’t know”) was compared to more indirect predictions (social prediction: “It varies widely among people”; range prediction: “… not painful at all to very highly painful”). These were followed by individually calibrated electrical stimuli of non-, moderately, or very highly painful intensity.Results: The direct expression of uncertainty led to the most intense pain sensation (for moderately painful stimuli only), lowest and most certain pain expectations, lowest trust in the hypothetical doctor, and lowest feeling of being well-informed, especially as compared to the social prediction. No differential effects on anxiety were observed.Conclusions: Expressing high uncertainty indirectly, with reference to the common experiences of others, may be beneficial for optimizing pain experiences and enhancing patients’ trust in a medical professional when dealing with uncertainty. Practice Implications: Our findings inform on how high uncertainty could be best communicated in clinical practice, pointing to advantages of indirect communication.