Questions to Ask When a Test or Treatment Is Suggested
Four short questions, known in the UK as BRAN, plus a few more for tests and treatments, and how to use them to take part in the decision.
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“We could run a scan.” “I would suggest starting tablets.” Sentences like these often arrive near the end of an appointment, and many people simply nod. A handful of short questions can turn that moment into a conversation, and they are the same questions whatever the test or treatment happens to be.
The aim is not to accept or to refuse. It is to understand what is being offered well enough to take part in the decision.
Four questions that fit on a sticky note
In the UK, the Academy of Medical Royal Colleges promotes four questions through its Choosing Wisely work. Their first letters spell BRAN. NHS bodies use them too: NHS Greater Glasgow and Clyde, a health board in Scotland, builds its “It’s OK to Ask” message around them.
The Academy places these questions inside a wider idea called shared decision making: clinician and patient choose a test, treatment or package of care together, using both the clinical evidence and the patient’s own informed preferences and values. It notes that there is usually more than one way to deal with a problem, and that having no treatment is sometimes one of the options.
How to use each question
Benefits: ask “how likely” and “how much”
A benefit has a size. A useful follow-up is: “Out of 100 people like me, roughly how many are helped?” If the answer comes as a percentage, ask what it is a percentage of. Our explainer on relative and absolute risk shows why that matters. Your clinician may not have an exact figure, and “we do not know precisely” is an honest and useful answer.
Risks: ask about common ones and serious ones
These are different things. Something can be common and mild, or rare and serious. Ask about both, and ask what you should do if a problem appears. For a test, the risks include what follows from the result: more tests, waiting, and sometimes findings that are hard to interpret.
Alternatives: ask what else is reasonable
This is not a challenge to the clinician’s judgement. NHS Greater Glasgow and Clyde says there is no one-size-fits-all approach to healthcare, and asking can bring out options that suit your circumstances better. Alternatives might be a different treatment, a different timing, or watching and reviewing.
Nothing: ask what waiting would mean
Sometimes the answer is “it would probably settle on its own”. Sometimes it is “it would get worse, and here is how quickly”. Either way you learn how urgent the decision is. This question is about understanding the choice in front of you, not about avoiding care.
When it is a test
The NHS in England suggests three practical questions about any test:
- What is the test for?
- How and when will I get the results?
- Who do I contact if I do not get them?
One more is worth adding: “What will we do differently depending on the result?” It shows what the test is meant to decide. If the test is offered to people without symptoms as part of a programme, see what a screening test can and cannot tell you.
When it is a treatment
The NHS list for treatments goes a little further than BRAN. It includes:
- Are there other ways to treat my condition, and what do you recommend?
- What are the side effects or risks?
- How long will I need treatment?
- How will I know if it is working?
- What happens if I do not have it?
- Is there anything I should stop or avoid, and anything I can do to help myself?
If the treatment is a new medicine, the World Health Organization’s “5 Moments for Medication Safety” flyer adds questions for the moment of starting: what the medicine is called and what it is for, what the risks and possible side effects are, whether you have told your health professional about your allergies and other health conditions, and how to store it. A current list of everything you take makes it much easier for a professional to check for interactions.
A worked scenario
Bring what matters to you
Evidence is half of a shared decision. The other half is you. NHS Greater Glasgow and Clyde encourages people to tell their healthcare team what is important to them and their family, so that the care offered fits their goals and preferences. A side effect that is trivial for one person may be a serious problem for someone who drives for a living or cares for a small child. Say these things aloud, because they are not in your records.
If you need time
You can ask: “Does this need deciding today?” Many decisions do not, and you can ask for written information or a reliable website to read at home. Some decisions are urgent. If your clinician says so, ask what makes it urgent, so you understand the reason for the pace.
Sources
- Academy of Medical Royal Colleges (UK) Choosing Wisely
- NHS Greater Glasgow and Clyde (UK (Scotland)) 'It's OK to Ask' questions about your healthcare
- NHS (UK (England)) What to ask your doctor or other healthcare professional
- World Health Organization (International) 5 moments for medication safety: Flyer
How this guide was prepared
Written by Meetis Editorial with AI assistance, using the sources listed above, and checked against them before publication. It has not been reviewed by a doctor or other health professional. It is general information, not personal medical advice — for questions about your own health, speak to a qualified professional.
