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Elliott SA, Scott SD, Charide R, Patterson-Stallwood L, Sayfi S, Motilall A, Baba A, Lotfi T, Suvada J, Klugar M, Kredo T, Mathew JL, Richards DP, Butcher NJ, Offringa M, Pottie K, Schünemann HJ, Hartling L. A multimethods randomized trial found that plain language versions improved parents' understanding of health recommendations. J Clin Epidemiol 2023; 161:8-19. [PMID: 37421995 DOI: 10.1016/j.jclinepi.2023.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/02/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES To assess the effectiveness of plain language compared with standard language versions of COVID-19 recommendations specific to child health. STUDY DESIGN AND SETTING Pragmatic, allocation-concealed, blinded, superiority randomized controlled trial with nested qualitative component. Trial was conducted online, internationally. Parents or legal guardians (≥18 years) of a child (<18 years) were eligible. Participants were randomized to receive a plain language recommendation (PLR) or standard (SLV) verison of a COVID-19 recommendation specific to child health. Primary outcome was understanding. Secondary outcomes included: preference, accessibility, usability, satisfaction, and intended behavior. Interviews explored perceptions and preferences for each format. RESULTS Between July and August 2022, 295 parents were randomized; 241 (81.7%) completed the study (intervention n = 121, control n = 120). Mean understanding scores were significantly different between groups (PLR 3.96 [standard deviation (SD) 2.02], SLV 3.33 [SD 1.88], P = 0.014). Overall participants preferred the PLR version: mean rating 5.05/7.00 (95% CI 4.81, 5.29). Interviews (n = 12 parents) highlighted their preference for the PLR and provided insight on elements to enhance future knowledge mobilization of health recommendations. CONCLUSION Compared to SLVs, parents preferred PLRs and better understood the recommendation. Guideline developers should strive to use plain language to increase understanding, uptake, and implementation of evidence by the public.
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rana Charide
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Patterson-Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Shahab Sayfi
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ashley Motilall
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Tamara Lotfi
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Jozef Suvada
- Departments of Science and International Studies, St. Elizabeth University of Public Health and Social Science, Bratislava, Slovak Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno-Bohunice, Czech Republic
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dawn P Richards
- Five02 Labs Inc, Toronto, Ontario, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Holger J Schünemann
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
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Stallwood L, Sammy A, Prebeg M, Relihan J, Baba A, Charide R, Sayfi S, Elliott SA, Hartling L, Munan M, Richards DP, Mathew JL, Kredo T, Mbuagbaw L, Motilall A, Scott SD, Klugar M, Lotfi T, Stevens AL, Pottie K, Schünemann HJ, Butcher NJ, Offringa M. Plain Language vs Standard Format for Youth Understanding of COVID-19 Recommendations: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:956-965. [PMID: 37548983 PMCID: PMC10407760 DOI: 10.1001/jamapediatrics.2023.2686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 08/08/2023]
Abstract
Importance To ensure that youths can make informed decisions about their health, it is important that health recommendations be presented for understanding by youths. Objective To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of youths provided with a digital plain language recommendation (PLR) format vs the original standard language version (SLV) of a health recommendation. Design, Setting, and Participants This pragmatic, allocation-concealed, blinded, superiority randomized clinical trial included individuals from any country who were 15 to 24 years of age, had internet access, and could read and understand English. The trial was conducted from May 27 to July 6, 2022, and included a qualitative component. Interventions An online platform was used to randomize youths in a 1:1 ratio to an optimized digital PLR or SLV format of 1 of 2 health recommendations related to the COVID-19 vaccine; youth-friendly PLRs were developed in collaboration with youth partners and advisors. Main Outcomes and Measures The primary outcome was understanding, measured as the proportion of correct responses to 7 comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior. After completion of the survey, participants indicated their interest in completing a 1-on-1 semistructured interview to reflect on their preferred digital format (PLR or SLV) and their outcome assessment survey response. Results Of the 268 participants included in the final analysis, 137 were in the PLR group (48.4% female) and 131 were in the SLV group (53.4% female). Most participants (233 [86.9%]) were from North and South America. No significant difference was found in understanding scores between the PLR and SLV groups (mean difference, 5.2%; 95% CI, -1.2% to 11.6%; P = .11). Participants found the PLR to be more accessible and usable (mean difference, 0.34; 95% CI, 0.05-0.63) and satisfying (mean difference, 0.39; 95% CI, 0.06-0.73) and had a stronger preference toward the PLR (mean difference, 4.8; 95% CI, 4.5-5.1 [4.0 indicated a neutral response]) compared with the SLV. No significant difference was found in intended behavior (mean difference, 0.22 (95% CI, -0.20 to 0.74). Interviewees (n = 14) agreed that the PLR was easier to understand and generated constructive feedback to further improve the digital PLR. Conclusions and Relevance In this randomized clinical trial, compared with the SLV, the PLR did not produce statistically significant findings in terms of understanding scores. Youths ranked it higher in terms of accessibility, usability, and satisfaction, suggesting that the PLR may be preferred for communicating health recommendations to youths. The interviews provided suggestions for further improving PLR formats. Trial Registration ClinicalTrials.gov Identifier: NCT05358990.
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Affiliation(s)
- Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Adrian Sammy
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shahab Sayfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sarah A. Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dawn P. Richards
- Five02 Labs Inc, Toronto, Ontario, Canada
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Joseph L. Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Ashley Motilall
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Adrienne L. Stevens
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nancy J. Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Taneja S, Panday J, Popoola A, Greyson D, McDonald SD, Patel T, Vanstone M. Making informed choices about cannabis use during pregnancy and lactation: A qualitative study of information use. Birth 2023; 50:504-512. [PMID: 35848512 DOI: 10.1111/birt.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cannabis use during pregnancy and lactation continues to increase as some perceive cannabis to be helpful for symptom management and coping. As such, pregnant and lactating people are faced with challenging decisions, weighing benefits against the potential risks of cannabis use. To help clinicians facilitate informed choices, we explored the self-identified information needs of pregnant and lactating people who are deciding whether or not to use cannabis. We aimed to describe the modes and sources of their information-seeking and their satisfaction with the information they found. METHODS We interviewed 52 people in Canada who made the decision to start, stop, or continue using cannabis during pregnancy and lactation. Participants were recruited from advertisements in prenatal clinics and on social media. We utilized an inductive approach to analysis focused on information used in decision-making about cannabis use, including the process of seeking and evaluating that information. RESULTS Participants were deliberate in their search for information, most commonly seeking information on risks of use. Information sources were mainly online material or people in their social networks. Clinicians were not commonly described as a knowledgeable or supportive source of information. Overwhelmingly, participants described the information they found as insufficient and emphasized the need for more comprehensive and trustworthy sources of information. CONCLUSIONS Participants identified distinct and unmet information needs associated with their decision to use cannabis. They described a desire for clear evidence about the impact of cannabis use, including information about how to balance the benefits they perceived from cannabis use with the risks of harm.
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Affiliation(s)
- Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Janelle Panday
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anuoluwa Popoola
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Radiology and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Tejal Patel
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
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Riera R, de Oliveira Cruz Latorraca C, Padovez RCM, Pacheco RL, Romão DMM, Barreto JOM, Machado MLT, Gomes R, da Silva SF, Martimbianco ALC. Strategies for communicating scientific evidence on healthcare to managers and the population: a scoping review. Health Res Policy Syst 2023; 21:71. [PMID: 37430348 DOI: 10.1186/s12961-023-01017-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Health evidence needs to be communicated and disseminated in a manner that is clearly understood by decision-makers. As an inherent component of health knowledge translation, communicating results of scientific studies, effects of interventions and health risk estimates, in addition to understanding key concepts of clinical epidemiology and interpreting evidence, represent a set of essential instruments to reduce the gap between science and practice. The advancement of digital and social media has reshaped the concept of health communication, introducing new, direct and powerful communication platforms and gateways between researchers and the public. The objective of this scoping review was to identify strategies for communicating scientific evidence in healthcare to managers and/or population. METHODS We searched Cochrane Library, Embase®, MEDLINE® and other six electronic databases, in addition to grey literature, relevant websites from related organizations for studies, documents or reports published from 2000, addressing any strategy for communicating scientific evidence on healthcare to managers and/or population. RESULTS Our search identified 24 598 unique records, of which 80 met the inclusion criteria and addressed 78 strategies. Most strategies focused on risk and benefit communication in health, were presented by textual format and had been implemented and somehow evaluated. Among the strategies evaluated and appearing to yield some benefit are (i) risk/benefit communication: natural frequencies instead of percentages, absolute risk instead relative risk and number needed to treat, numerical instead nominal communication, mortality instead survival; negative or loss content appear to be more effective than positive or gain content; (ii) evidence synthesis: plain languages summaries to communicate the results of Cochrane reviews to the community were perceived as more reliable, easier to find and understand, and better to support decisions than the original summaries; (iii) teaching/learning: the Informed Health Choices resources seem to be effective for improving critical thinking skills. CONCLUSION Our findings contribute to both the knowledge translation process by identifying communication strategies with potential for immediate implementation and to future research by recognizing the need to evaluate the clinical and social impact of other strategies to support evidence-informed policies. Trial registration protocol is prospectively available in MedArxiv (doi.org/10.1101/2021.11.04.21265922).
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Affiliation(s)
- Rachel Riera
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Carolina de Oliveira Cruz Latorraca
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | | | - Rafael Leite Pacheco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil.
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
| | - Davi Mamblona Marques Romão
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Instituto Veredas, São Paulo, Brazil
| | - Jorge Otávio Maia Barreto
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | - Maria Lúcia Teixeira Machado
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Carlos, São Carlos, Brazil
| | - Romeu Gomes
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | | | - Ana Luiza Cabrera Martimbianco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Metropolitna de Santo (Unimes), Santos, Brazil
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Helmer SM, Matthias K, Mergenthal L, Reimer M, De Santis KK. Dissemination of knowledge from Cochrane Public Health reviews: a bibliographic study. Syst Rev 2023; 12:113. [PMID: 37400880 DOI: 10.1186/s13643-023-02272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Appropriate dissemination of public health evidence is of high importance to ensure that scientific knowledge reaches potential stakeholders and relevant population groups. A wide distrust towards science and its findings indicates that communication thereof remains below its potential. Cochrane Public Health provides an important source of high-quality scientific evidence in the field of public health via reviews with systematic methodology. The aims of this study were to identify (1) dissemination strategies and (2) stakeholders of Cochrane Public Health reviews. METHODS This is a bibliographic study with a cross-sectional design. All 68 records (reviews or review protocols) listed on the Cochrane Public Health website ( https://ph.cochrane.org/cph-reviews-and-topics ) up to 8 March 2022 were included. Record characteristics, dissemination strategies, and potential stakeholder details were coded by one author, and 10% of records were checked by another author. Data were analyzed using descriptive statistics or narratively into common themes. RESULTS The 68 records were published between 2010 and 2022 and included 15 review protocols and 53 reviews with systematic methodology (46 systematic, 6 rapid, and 1 scoping review). All 53 reviews were disseminated via open-access plain language summaries (PLS) in English with translations into 3-13 other languages. Other dissemination strategies included information on Cochrane websites (e.g., clinical answers or guidelines) available for 41/53 reviews and Cochrane news or blogs that mentioned 19/53 reviews. Overall, 23/68 records mentioned the actual stakeholder involvement in review production, protocol development, or formulation of dissemination plans. The potential stakeholders included several highly diverse groups, such as the general population or specific communities (e.g., racial minority groups), policy and decision makers, and researchers and professionals in various fields (e.g., nutrition, physical activity, education, or care). CONCLUSIONS This study shows that Cochrane Public Health reviews are disseminated predominantly via PLS in different languages and via review information on Cochrane websites. Planned dissemination strategies were rarely reported although actual stakeholders were involved in the planning and production of some reviews. The relevance of Cochrane Public Health reviews for non-academic stakeholders and the general population highlights the need for the dissemination of evidence from such reviews beyond academia. SYSTEMATIC REVIEW REGISTRATION The study was prospectively registered at the Open Science Framework ( https://osf.io/ga9pt/ ).
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Affiliation(s)
- Stefanie Maria Helmer
- Institute of Public Health and Nursing Research, Faculty 11 Human and Health Sciences, University of Bremen, Grazer Str. 4, 28359, Bremen, Germany.
- Cochrane Public Health Europe (https://ph.cochrane.org/cochrane-public-health-europe), Bremen, Germany.
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Mia Reimer
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Karina Karolina De Santis
- Cochrane Public Health Europe (https://ph.cochrane.org/cochrane-public-health-europe), Bremen, Germany
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
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Morgan RL, Yepes-Nuñez JJ, Ewusie J, Mbuagbaw L, Chang S, Baldeh T, Hempel S, Helfand M, Shekelle P, Wilt TJ, Schünemann HJ. Improving grading of recommendations assessment, development, and evaluation evidence tables part 4: a three-arm noninferiority randomized trial demonstrates improved understanding of content in summary of findings tables with a new format. J Clin Epidemiol 2023; 154:125-135. [PMID: 36503004 DOI: 10.1016/j.jclinepi.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/15/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate alternative formats of summary of findings (SoF) tables for single comparison with multiple outcomes. STUDY DESIGN AND SETTING We conducted a three-arm randomized controlled noninferiority trial (RCT) in the following systematic review (SR) users: researchers, clinical practice guideline developers, health care providers, policymakers, and knowledge transfer organizations to measure understanding, accessibility, satisfaction, and preference across the current grading of recommendations assessment, development, and evaluation (GRADE) SoF, an alternative GRADE SoF, or an adapted evidence-based practice center (EPC) program SoF table. RESULTS One Hundred Seventy-Nine participants were randomized, and 129 participants completed the RCT (n = 47 current GRADE, n = 41 alternative GRADE, n = 41 adapted EPC). Understanding the certainty of evidence and treatment effect was comparable across groups. The adapted EPC SoF table was inferior for quantifying risk and RD compared to the alternatives (<35% correct vs. >85% correct). Participants reported increased satisfaction when SoF tables presented number needed to treat (NNT), anticipated absolute effect differences, and narrative syntheses for evidence that could not be meta-analyzed. Participants reported accessibility to information as significantly better in both GRADE SoF tables, when compared with the adapted EPC SoF table. Participants preferred the alternative GRADE SoF table format. CONCLUSION The alternative GRADE SoF table is a promising format for SR users preferring a comprehensive presentation of SR results for single comparisons.
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Affiliation(s)
- Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Juan José Yepes-Nuñez
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada; School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Joycelyne Ewusie
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Tejan Baldeh
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Susanne Hempel
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Mark Helfand
- VA Portland Health Care System and Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Paul Shekelle
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Timothy J Wilt
- Minneapolis VA, Center for Care Delivery and Outcomes Research, University of Minnesota Schools of Medicine Public Health, Division of Health Policy and Management, Minneapolis, MN, USA
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milano, Italy.
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Charide R, Stallwood L, Munan M, Sayfi S, Hartling L, Butcher NJ, Offringa M, Elliott S, Richards DP, Mathew JL, Akl EA, Kredo T, Mbuagbaw L, Motillal A, Baba A, Prebeg M, Relihan J, Scott SD, Suvada J, Falavigna M, Klugar M, Lotfi T, Stevens A, Pottie K, Schünemann HJ. Knowledge mobilization activities to support decision-making by youth, parents, and adults using a systematic and living map of evidence and recommendations on COVID-19: protocol for three randomized controlled trials and qualitative user-experience studies. Trials 2023; 24:27. [PMID: 36641457 PMCID: PMC9840541 DOI: 10.1186/s13063-023-07067-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic underlined that guidelines and recommendations must be made more accessible and more understandable to the general public to improve health outcomes. The objective of this study is to evaluate, quantify, and compare the public's understanding, usability, satisfaction, intention to implement, and preference for different ways of presenting COVID-19 health recommendations derived from the COVID-19 Living Map of Recommendations and Gateway to Contextualization (RecMap). METHODS AND ANALYSIS This is a protocol for a multi-method study. Through an online survey, we will conduct pragmatic allocation-concealed, blinded superiority randomized controlled trials (RCTs) in three populations to test alternative formats of presenting health recommendations: adults, parents, and youth, with at least 240 participants in each population. Prior to initiating the RCT, our interventions will have been refined with relevant stakeholder input. The intervention arm will receive a plain language recommendation (PLR) format while the control arm will receive the corresponding original recommendation format as originally published by the guideline organizations (standard language version). Our primary outcome is understanding, and our secondary outcomes are accessibility and usability, satisfaction, intended behavior, and preference for the recommendation formats. Each population's results will be analyzed separately. However, we are planning a meta-analysis of the results across populations. At the end of each survey, participants will be invited to participate in an optional one-on-one, virtual semi-structured interview to explore their user experience. All interviews will be transcribed and analyzed using the principles of thematic analysis and a hybrid inductive and deductive approach. ETHICS AND DISSEMINATION Through Clinical Trials Ontario, the Hamilton Integrated Research Ethics Board has reviewed and approved this protocol (Project ID: 3856). The University of Alberta has approved the parent portion of the trial (Project ID:00114894). Findings from this study will be disseminated through open-access publications in peer-reviewed journals and using social media. TRIAL REGISTRATION Clinicaltrials.gov NCT05358990 . Registered on May 3, 2022.
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Affiliation(s)
- Rana Charide
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Lisa Stallwood
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada
| | - Matthew Munan
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada
| | - Shahab Sayfi
- grid.39381.300000 0004 1936 8884Schulich School of Medicine & Dentistry, Western University, London, Ontario Canada
| | - Lisa Hartling
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada ,grid.17089.370000 0001 2190 316XCochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta Canada
| | - Nancy J. Butcher
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Martin Offringa
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada ,grid.42327.300000 0004 0473 9646Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario Canada
| | - Sarah Elliott
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada ,grid.17089.370000 0001 2190 316XCochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta Canada
| | - Dawn P. Richards
- Five02 Labs Inc, Toronto, Ontario Canada ,grid.498672.6Canadian Arthritis Patient Alliance, Toronto, Ontario Canada
| | - Joseph L. Mathew
- grid.415131.30000 0004 1767 2903Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Elie A. Akl
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.22903.3a0000 0004 1936 9801Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Tamara Kredo
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa ,grid.11956.3a0000 0001 2214 904XDivision of Clinical Pharmacology, Department of Medicine and Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.25073.330000 0004 1936 8227Department of Anesthesia, McMaster University, Hamilton, Ontario Canada ,grid.25073.330000 0004 1936 8227Department of Pediatrics, McMaster University, Hamilton, Ontario Canada ,grid.416721.70000 0001 0742 7355Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario Canada ,grid.460723.40000 0004 0647 4688Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon ,grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ashley Motillal
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Ami Baba
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada
| | - Matthew Prebeg
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Jacqueline Relihan
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Shannon D. Scott
- grid.17089.370000 0001 2190 316XFaculty of Nursing, University of Alberta, Edmonton, Alberta Canada
| | - Jozef Suvada
- Departments of Science and International Studies, St. Elizabeth University of Public Health and Social Science, Bratislava, Slovak Republic
| | - Maicon Falavigna
- grid.8532.c0000 0001 2200 7498National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miloslav Klugar
- grid.10267.320000 0001 2194 0956Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Tamara Lotfi
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Adrienne Stevens
- grid.415368.d0000 0001 0805 4386Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Canada
| | - Kevin Pottie
- grid.39381.300000 0004 1936 8884Schulich School of Medicine & Dentistry, Western University, London, Ontario Canada ,grid.39381.300000 0004 1936 8884Department of Family Medicine, Western University, London, Ontario Canada
| | - Holger J. Schünemann
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Milan, Italy
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Sharp MK, Baki DABA, Quigley J, Tyner B, Devane D, Mahtani KR, Smith SM, O'Neill M, Ryan M, Clyne B. The effectiveness and acceptability of evidence synthesis summary formats for clinical guideline development groups: a mixed-methods systematic review. Implement Sci 2022; 17:74. [PMID: 36303142 PMCID: PMC9615384 DOI: 10.1186/s13012-022-01243-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Clinical guideline development often involves a rigorous synthesis of evidence involving multidisciplinary stakeholders with different priorities and knowledge of evidence synthesis; this makes communicating findings complex. Summary formats are typically used to communicate the results of evidence syntheses; however, there is little consensus on which formats are most effective and acceptable for different stakeholders. METHODS This mixed-methods systematic review (MMSR) aimed to evaluate the effectiveness and acceptability (e.g. preferences and attitudes and preferences towards) of evidence synthesis summary formats for GDG members. We followed the PRISMA 2020 guideline and Joanna Briggs Institute Manual for Evidence Synthesis for MMSRs. We searched six databases (inception to April 20, 2021) for randomised controlled trials (RCTs), RCTs with a qualitative component, and qualitative studies. Screening, data extraction, and quality appraisal were performed in duplicate. Qualitative findings were synthesised using meta-aggregation, and quantitative findings are described narratively. RESULTS We identified 17,240 citations and screened 54 full-text articles, resulting in 22 eligible articles (20 unique studies): 4 articles reported the results of 5 RCTs, one of which also had a qualitative component. The other 18 articles discussed the results of 16 qualitative studies. Therefore, we had 5 trials and 17 qualitative studies to extract data from. Studies were geographically heterogeneous and included a variety of stakeholders and summary formats. All 5 RCTs assessed knowledge or understanding with 3 reporting improvement with newer formats. The qualitative analysis identified 6 categories of recommendations: 'presenting information', 'tailoring information' for end users, 'trust in producers and summary', 'knowledge required' to understand findings, 'quality of evidence', and properly 'contextualising information'. Across these categories, the synthesis resulted in 126 recommendations for practice. Nine recommendations were supported by both quantitative and qualitative evidence and 116 by only qualitative. A majority focused on how to present information (n = 64) and tailor content for different end users (n = 24). CONCLUSIONS This MMSR provides guidance on how to improve evidence summary structure and layout. This can be used by synthesis producers to better communicate to GDGs. Study findings will inform the co-creation of evidence summary format prototypes based on GDG member's needs. Trial registration The protocol for this project was previously published, and the project was preregistered on Open Science Framework (Clyne and Sharp, Evidence synthesis and translation of findings for national clinical guideline development: addressing the needs and preferences of guideline development groups, 2021; Sharp and Clyne, Evidence synthesis summary formats for decision-makers and Clinical Guideline Development Groups: A mixed-methods systematic review protocol, 2021).
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Affiliation(s)
- Melissa K Sharp
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland.
| | | | - Joan Quigley
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Barrie Tyner
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, NUI Galway, Galway, Ireland
- Evidence Synthesis Ireland & Cochrane, Galway, Ireland
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Susan M Smith
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland
- Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Michelle O'Neill
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, James Street, Dublin 8, Ireland
| | - Barbara Clyne
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2, Ireland
- Health Information and Quality Authority, George's Court, George's Lane, Dublin 7, Ireland
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9
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Stoll M, Kerwer M, Lieb K, Chasiotis A. Plain language summaries: A systematic review of theory, guidelines and empirical research. PLoS One 2022; 17:e0268789. [PMID: 35666746 PMCID: PMC9170105 DOI: 10.1371/journal.pone.0268789] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Plain language summaries (PLSs) have been introduced to communicate research in an understandable way to a nonexpert audience. Guidelines for writing PLSs have been developed and empirical research on PLSs has been conducted, but terminology and research approaches in this comparatively young field vary considerably. This prompted us to review the current state of the art of the theoretical and empirical literature on PLSs. The two main objectives of this review were to develop a conceptual framework for PLS theory, and to synthesize empirical evidence on PLS criteria. We began by searching Web of Science, PubMed, PsycInfo and PSYNDEX (last search 07/2021). In our review, we included empirical investigations of PLSs, reports on PLS development, PLS guidelines, and theoretical articles referring to PLSs. A conceptual framework was developed through content analysis. Empirical studies investigating effects of PLS criteria on defined outcomes were narratively synthesized. We identified 7,714 records, of which 90 articles met the inclusion criteria. All articles were used to develop a conceptual framework for PLSs which comprises 12 categories: six of PLS aims and six of PLS characteristics. Thirty-three articles empirically investigated effects of PLSs on several outcomes, but study designs were too heterogeneous to identify definite criteria for high-quality PLSs. Few studies identified effects of various criteria on accessibility, understanding, knowledge, communication of research, and empowerment. We did not find empirical evidence to support most of the criteria we identified in the PLS writing guidelines. We conclude that although considerable work on establishing and investigating PLSs is available, empirical evidence on criteria for high-quality PLSs remains scarce. The conceptual framework developed in this review may provide a valuable starting point for future guideline developers and PLS researchers.
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Affiliation(s)
- Marlene Stoll
- Leibniz Institute for Psychology (ZPID), Trier, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Martin Kerwer
- Leibniz Institute for Psychology (ZPID), Trier, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
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10
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Ellermann C, McDowell M, Schirren CO, Lindemann AK, Koch S, Lohmann M, Jenny MA. Identifying content to improve risk assessment communications within the Risk Profile: Literature reviews and focus groups with expert and non-expert stakeholders. PLoS One 2022; 17:e0266800. [PMID: 35404989 PMCID: PMC9000125 DOI: 10.1371/journal.pone.0266800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
Objective
To improve consumer decision making, the results of risk assessments on food, feed, consumer products or chemicals need to be communicated not only to experts but also to non-expert audiences. The present study draws on evidence from literature reviews and focus groups with diverse stakeholders to identify content to integrate into an existing risk assessment communication (Risk Profile).
Methods
A combination of rapid literature reviews and focus groups with experts (risk assessors (n = 15), risk managers (n = 8)), and non-experts (general public (n = 18)) were used to identify content and strategies for including information about risk assessment results in the “Risk Profile” from the German Federal Institute for Risk Assessment. Feedback from initial focus groups was used to develop communication prototypes that informed subsequent feedback rounds in an iterative process. A final prototype was validated in usability tests with experts.
Results
Focus group feedback and suggestions from risk assessors were largely in line with findings from the literature. Risk managers and lay persons offered similar suggestions on how to improve the existing communication of risk assessment results (e.g., including more explanatory detail, reporting probabilities for individual health impairments, and specifying risks for subgroups in additional sections). Risk managers found information about quality of evidence important to communicate, whereas people from the general public found this information less relevant. Participants from lower educational backgrounds had difficulties understanding the purpose of risk assessments. User tests found that the final prototype was appropriate and feasible to implement by risk assessors.
Conclusion
An iterative and evidence-based process was used to develop content to improve the communication of risk assessments to the general public while being feasible to use by risk assessors. Remaining challenges include how to communicate dose-response relationships and standardise quality of evidence ratings across disciplines.
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Affiliation(s)
- C. Ellermann
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
- * E-mail:
| | - M. McDowell
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
| | - C. O. Schirren
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
| | - A.-K. Lindemann
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - S. Koch
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - M. Lohmann
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - M. A. Jenny
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
- Robert Koch Institute, Berlin, Germany
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Kerwer M, Stoll M, Jonas M, Benz G, Chasiotis A. How to Put It Plainly? Findings From Two Randomized Controlled Studies on Writing Plain Language Summaries for Psychological Meta-Analyses. Front Psychol 2021; 12:771399. [PMID: 34975663 PMCID: PMC8717946 DOI: 10.3389/fpsyg.2021.771399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
Plain language summaries (PLS) aim to communicate research findings to laypersons in an easily understandable manner. Despite the societal relevance of making psychological research findings available to the public, our empirical knowledge on how to write PLS of psychology studies is still scarce. In this article, we present two experimental studies investigating six characteristics of PLS for psychological meta-analyses. We specifically focused on approaches for (1) handling technical terms, (2) communicating the quality of evidence by explaining the methodological approach of meta-analyses, (3) explaining how synthesized studies operationalized their research questions, (4) handling statistical terms, (5) structuring PLS, and (6) explaining complex meta-analytic designs. To develop empirically validated guidelines on writing PLS, two randomized controlled studies including large samples stratified for education status, age, and gender (N Study1=2,288 and N Study2=2,211) were conducted. Eight PLS of meta-analyses from different areas of psychology were investigated as study materials. Main outcome variables were user experience (i.e., perceived accessibility, perceived understanding, and perceived empowerment) and knowledge acquisition, as well as understanding and knowledge of the quality of evidence. Overall, our hypotheses were partially confirmed, with our results underlining, among other things, the importance of explaining or replacing content-related technical terms (i.e., theoretical concepts) and indicating the detrimental effects of providing too many details on statistical concepts on user experience. Drawing on these and further findings, we derive five empirically well-founded rules on the lay-friendly communication of meta-analytic research findings in psychology. Implications for PLS authors and future research on PLS are discussed.
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Affiliation(s)
- Martin Kerwer
- Leibniz Institute for Psychology (ZPID), Trier, Germany
| | - Marlene Stoll
- Leibniz Institute for Psychology (ZPID), Trier, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Mark Jonas
- Leibniz Institute for Psychology (ZPID), Trier, Germany
| | - Gesa Benz
- Leibniz Institute for Psychology (ZPID), Trier, Germany
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Schneider CR, Freeman ALJ, Spiegelhalter D, van der Linden S. The effects of quality of evidence communication on perception of public health information about COVID-19: Two randomised controlled trials. PLoS One 2021; 16:e0259048. [PMID: 34788299 PMCID: PMC8598038 DOI: 10.1371/journal.pone.0259048] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/11/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The quality of evidence about the effectiveness of non-pharmaceutical health interventions is often low, but little is known about the effects of communicating indications of evidence quality to the public. METHODS In two blinded, randomised, controlled, online experiments, US participants (total n = 2140) were shown one of several versions of an infographic illustrating the effectiveness of eye protection in reducing COVID-19 transmission. Their trust in the information, understanding, feelings of effectiveness of eye protection, and the likelihood of them adopting it were measured. FINDINGS Compared to those given no quality cues, participants who were told the quality of the evidence on eye protection was 'low', rated the evidence less trustworthy (p = .001, d = 0.25), and rated it as subjectively less effective (p = .018, d = 0.19). The same effects emerged compared to those who were told the quality of the evidence was 'high', and in one of the two studies, those shown 'low' quality of evidence said they were less likely to use eye protection (p = .005, d = 0.18). Participants who were told the quality of the evidence was 'high' showed no statistically significant differences on these measures compared to those given no information about evidence quality. CONCLUSIONS Without quality of evidence cues, participants responded to the evidence about the public health intervention as if it was high quality and this affected their subjective perceptions of its efficacy and trust in the provided information. This raises the ethical dilemma of weighing the importance of transparently stating when the evidence base is actually low quality against evidence that providing such information can decrease trust, perception of intervention efficacy, and likelihood of adopting it.
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Affiliation(s)
- Claudia R. Schneider
- Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Alexandra L. J. Freeman
- Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, United Kingdom
| | - David Spiegelhalter
- Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, United Kingdom
| | - Sander van der Linden
- Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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13
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Santesso N, Wiercioch W, Barbara AM, Dietl H, Schünemann HJ. Focus groups and interviews with the public led to the development of a template for a GRADE Plain Language Recommendation (PLR). J Clin Epidemiol 2021; 141:18-25. [PMID: 34534671 DOI: 10.1016/j.jclinepi.2021.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/24/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Clear communication of health care recommendations to patients and the public is essential. Current work has focused on creating patient versions of guidelines without much attention to single recommendations. In this study, we built on previously conducted research to test a template and explore the public's perceptions of, and attitudes towards plain language guideline recommendations. STUDY DESIGN AND SETTING We conducted four focus groups with people interested in healthy aging to obtain general attitudes, perceptions, and understanding of recommendations. We then conducted nine user-tests of Plain Language Recommendations developed from GRADE guidelines. We performed a directed content analysis, and finalized a template for a Plain Language Recommendation. RESULTS We identified themes related to personalized information; strength of recommendations; support with health care and appointments; amount and credibility of information; and formatting. When recommendations were conditional, participants wanted more information about why and what to consider. The template for a Plain Language Recommendation is available in the GRADEpro software to facilitate automation. CONCLUSION We created a Plain Language Recommendation template to communicate specific information from guidelines to patients and the public. Broad application of the template is warranted and future research could measure the impact on understanding and behavior change.
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Affiliation(s)
- Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4L8, Canada.
| | - Wojtek Wiercioch
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4L8, Canada.
| | - Angela M Barbara
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4L8, Canada.
| | | | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4L8, Canada.
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Zadro J, Jones C, Harris I, Buchbinder R, O'Connor DA, McCaffery K, Thompson RE, Karunaratne S, Teng MJ, Maher C, Hoffmann T. Development of a patient decision aid on subacromial decompression surgery and rotator cuff repair surgery: an international mixed-methods study. BMJ Open 2021; 11:e054032. [PMID: 34462283 PMCID: PMC8407224 DOI: 10.1136/bmjopen-2021-054032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To develop and user test a patient decision aid for people with subacromial pain syndrome that presents evidence-based information on the benefits and harms of subacromial decompression surgery and rotator cuff repair surgery. DESIGN Mixed-methods study outlining the development of a patient decision aid. SETTING We assembled a multidisciplinary steering group, and used existing decision aids and decision science to draft the decision aid. Participants were recruited through social media (not restricted by country nor setting), local hospitals and the authors' collaboration network. PARTICIPANTS People with shoulder pain and health professionals who manage people with shoulder pain. PRIMARY AND SECONDARY OUTCOMES We interviewed participants to gather feedback on the decision aid, assessed useability and acceptability (using qualitative and quantitative methods) and performed iterative cycles of redrafting the decision aid and reinterviewing participants as necessary. Interview data were analysed using thematic analysis. Quantitative data were summarised descriptively. RESULTS We interviewed 26 health professionals (11 physiotherapists, 7 orthopaedic surgeons, 4 general practitioners, 3 chiropractors and 1 osteopath) and 14 people with shoulder pain. Most health professionals and people with shoulder pain rated all aspects of decision aid acceptability as adequate-to-excellent (eg, length, presentation, comprehensibility). Interviews highlighted agreement among health professionals and people with shoulder pain on most aspects of the decision aid (eg, treatment options, summary of benefits, harms and practical issues, questions to ask a health professional, graphics, formatting). However, some aspects of the decision aid elicited divergent views among health professionals (eg, causes and symptoms of shoulder pain, evidence on benefits and harms). CONCLUSION This decision aid could be an acceptable and valuable tool for helping people with subacromial pain syndrome make informed treatment choices. A randomised controlled trial evaluating whether this decision aid reduces people's intentions to undergo shoulder surgery and facilitates informed treatment choices is underway.Trial registration number ACTRN12621000992808.
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Affiliation(s)
- Joshua Zadro
- Institute for Musculoskeletal Health, Sydney School of Public Health, University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Caitlin Jones
- Institute for Musculoskeletal Health, Sydney School of Public Health, University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Ian Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia
| | - Rachelle Buchbinder
- Dept of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Denise A O'Connor
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Sascha Karunaratne
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Min Jiat Teng
- Institute for Musculoskeletal Health, Sydney School of Public Health, University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Christopher Maher
- Institute for Musculoskeletal Health, Sydney School of Public Health, University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Tammy Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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15
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Maurer M, Siegel JE, Firminger KB, Lowers J, Dutta T, Chang JS. Lessons Learned from Developing Plain Language Summaries of Research Studies. Health Lit Res Pract 2021; 5:e155-e161. [PMID: 34213994 PMCID: PMC8241231 DOI: 10.3928/24748307-20210524-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Plain language translation may facilitate the public's ability to understand and use results of scientific research. Brief description of activity: This article describes the Patient-Centered Outcomes Research Institute's (PCORI) approach to and lessons learned from developing plain language summaries of PCORI-funded research for the lay public. Implementation: We developed and tested a standard template for the summaries, incorporating feedback in the template design from focus groups with members of the public. Between February 2017 and March 2020, we completed translation of 272 plain language summaries of PCORI-funded studies, covering topics including cardiovascular disease, obesity, cancer, mental health, asthma, HIV/AIDS, and comparative effectiveness research methods. Results: Templates use a question-and-answer format, with sections on the rationale, methods, results, limitations, and how the research will help inform decisions. In addition to feedback on template heading wording and order, focus group participants stressed the importance of establishing relevance and conveying credibility and limitations. Lessons learned: Lessons learned relate to supporting consistency across individual summaries, carefully prioritizing content to include in the summaries, and balancing plain language and reading level with precision. These lessons learned from template development and implementation may be useful to other organizations or publishers contemplating similar efforts to make scientific research results more accessible. [HLRP: Health Literacy Research and Practice. 2021;5(2):e155–e161.] Plain Language Summary: The Patient-Centered Outcomes Research Institute (PCORI) funds comparative effectiveness research. This research compares the benefits and harms of two or more health care choices. In this article, we describe lessons learned from PCORI's efforts to develop plain language summaries of results from the research it funds. These lessons may help other organizations that want to share research results in plain language.
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Affiliation(s)
- Maureen Maurer
- Address correspondence to Maureen Maurer, MPH, 100 Europa Drive, Suite 315, Chapel Hill, NC 27514;
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16
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Oxman M, Larun L, Pérez Gaxiola G, Alsaid D, Qasim A, Rose CJ, Bischoff K, Oxman AD. Quality of information in news media reports about the effects of health interventions: Systematic review and meta-analyses. F1000Res 2021; 10:433. [PMID: 35083033 PMCID: PMC8756300 DOI: 10.12688/f1000research.52894.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 12/21/2022] Open
Abstract
Background Many studies have assessed the quality of news reports about the effects of health interventions, but there has been no systematic review of such studies or meta-analysis of their results. We aimed to fill this gap (PROSPERO ID: CRD42018095032). Methods We included studies that used at least one explicit, prespecified and generic criterion to assess the quality of news reports in print, broadcast, or online news media, and specified the sampling frame, and the selection criteria and technique. We assessed criteria individually for inclusion in the meta-analyses, excluding ineligible criteria and criteria with inadequately reported results. We mapped and grouped criteria to facilitate evidence synthesis. Where possible, we extracted the proportion of news reports meeting the included criterion. We performed meta-analyses using a random effects model to estimate such proportions for individual criteria and some criteria groups, and to characterise heterogeneity across studies. Results We included 44 primary studies in the review, and 18 studies and 108 quality criteria in the meta-analyses. Many news reports gave an unbalanced and oversimplified picture of the potential consequences of interventions. A limited number mention or adequately address conflicts of interest (22%; 95% CI 7%-49%) (low certainty), alternative interventions (36%; 95% CI 26%-47%) (moderate certainty), potential harms (40%; 95% CI 23%-61%) (low certainty), or costs (18%; 95% CI 12%-28%) (moderate certainty), or quantify effects (53%; 95% CI 36%-69%) (low certainty) or report absolute effects (17%; 95% CI 4%-49%) (low certainty). Discussion There is room for improving health news, but it is logically more important to improve the public's ability to critically appraise health information and make judgements for themselves.
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Affiliation(s)
- Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lillebeth Larun
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Giordano Pérez Gaxiola
- Cochrane Associated Centre and Evidence‐based Medicine Department, Sinaloa's Pediatric Hospital, Culiacan, Mexico
| | - Dima Alsaid
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Anila Qasim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Karin Bischoff
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Andrew David Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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17
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Oxman M, Larun L, Pérez Gaxiola G, Alsaid D, Qasim A, Rose CJ, Bischoff K, Oxman AD. Quality of information in news media reports about the effects of health interventions: Systematic review and meta-analyses. F1000Res 2021; 10:433. [PMID: 35083033 PMCID: PMC8756300 DOI: 10.12688/f1000research.52894.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 09/23/2023] Open
Abstract
Background Many studies have assessed the quality of news reports about the effects of health interventions, but there has been no systematic review of such studies or meta-analysis of their results. We aimed to fill this gap (PROSPERO ID: CRD42018095032). Methods We included studies that used at least one explicit, prespecified and generic criterion to assess the quality of news reports in print, broadcast, or online news media, and specified the sampling frame, and the selection criteria and technique. We assessed criteria individually for inclusion in the meta-analyses, excluding inappropriate criteria and criteria with inadequately reported results. We mapped and grouped criteria to facilitate evidence synthesis. Where possible, we extracted the proportion of news reports meeting the included criterion. We performed meta-analyses using a random effects model to estimate such proportions for individual criteria and some criteria groups, and to characterise heterogeneity across studies. Results We included 44 primary studies in the qualitative summary, and 18 studies and 108 quality criteria in the meta-analyses. Many news reports gave an unbalanced and oversimplified picture of the potential consequences of interventions. A limited number mention or adequately address conflicts of interest (22%; 95% CI 7%-49%) (low certainty), alternative interventions (36%; 95% CI 26%-47%) (moderate certainty), potential harms (40%; 95% CI 23%-61%) (low certainty), or costs (18%; 95% CI 12%-28%) (moderate certainty), or quantify effects (53%; 95% CI 36%-69%) (low certainty) or report absolute effects (17%; 95% CI 4%-49%) (low certainty). Discussion There is room for improving health news, but it is logically more important to improve the public's ability to critically appraise health information and make judgements for themselves.
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Affiliation(s)
- Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lillebeth Larun
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Giordano Pérez Gaxiola
- Cochrane Associated Centre and Evidence‐based Medicine Department, Sinaloa's Pediatric Hospital, Culiacan, Mexico
| | - Dima Alsaid
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Anila Qasim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Karin Bischoff
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Andrew David Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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18
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Metcalfe D, Aldalooj E, Thakur M, Clements L. Framing superbugs - testing whether advocacy frames change attitudes, intention or behaviour using an online randomised control experiment. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16723.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Antimicrobial resistance (AMR) presents a significant threat to global health, requiring multifaceted action by individuals and policymakers. Advocates must persuade others to act. Making communication about AMR more effective could plausibly increase support for action. The Wellcome Trust-funded ‘Reframing Resistance’ project used communications research to develop framing recommendations for the language practitioners use to describe AMR. The aim of this study was to explore how this language influenced attitudes and behaviours towards AMR. Methods: This study was a randomised trial to evaluate the effects of different styles of AMR framing language upon attitudinal and behavioural measures. Participants (n=1,934) were recruited in October 2019 using an on-line tool called “Prolific” and randomly assigned to review five variations of AMR narratives: four experimental frames which incorporated different combinations of language recommended by the framing guidelines, or a control frame without these features, taken from UN AMR communications. Participants were then asked a series of attitudinal and behavioural questions in relation to the AMR narrative they reviewed. Attitudes were measured using five-point Likert-type scales and behaviours were measured using binary variables. Descriptive analysis was used to explore respondents’ characteristics and multivariable logistic regression models were used to establish independent associations between AMR frames and respondents’ attitudes and behaviours. Results: Participants who reviewed narratives that followed framing language guidelines were more likely to donate money or sign a petition, and rated narratives as more usable and important than participants who reviewed the control framing. Conclusions: While larger trials with more diverse participants are needed to confirm generalisability, these results suggest that applying framing to communications could help advocates of AMR to drive action. Furthermore, the study reinforces the value of randomised studies to empirically test the impact of frames upon behaviour and indicates the potential for a more extensive programme of research.
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Büchter RB, Betsch C, Ehrlich M, Fechtelpeter D, Grouven U, Keller S, Meuer R, Rossmann C, Waltering A. Communicating Uncertainty in Written Consumer Health Information to the Public: Parallel-Group, Web-Based Randomized Controlled Trial. J Med Internet Res 2020; 22:e15899. [PMID: 32773375 PMCID: PMC7445603 DOI: 10.2196/15899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/14/2020] [Accepted: 06/21/2020] [Indexed: 12/02/2022] Open
Abstract
Background Uncertainty is integral to evidence-informed decision making and is of particular importance for preference-sensitive decisions. Communicating uncertainty to patients and the public has long been identified as a goal in the informed and shared decision-making movement. Despite this, there is little quantitative research on how uncertainty in health information is perceived by readers. Objective The aim of this study was to examine the impact of different uncertainty descriptions regarding the evidence for a treatment effect in a written research summary for the public. Methods We developed 8 versions of a research summary on a fictitious drug for tinnitus with varying degrees (Q1), sources (Q2), and magnitudes of uncertainty (Q3). We recruited 2099 members of the German public from a web-based research panel. Of these, 1727 fulfilled the inclusion criteria and were randomly presented with one of these research summaries. Randomization was conducted by using a centralized computer with a random number generator. Web-based recruitment and data collection were fully automated. Participants were not aware of the purpose of the study and alternative presentations. We measured the following outcomes: perception of the treatment effectiveness (primary), certainty in the judgement of treatment effectiveness, perception of the body of evidence, text quality, and intended decision. The outcomes were self-assessed. Results For the primary outcome, we did not find a global effect for Q1 and Q2 (P=.25 and P=.73), but we found a global effect for Q3 (P=.048). Pairwise comparisons showed a weaker perception of treatment effectiveness for the research summary with 3 sources of uncertainty compared to the version with 2 sources of uncertainty (P=.04). Specifically, the proportion of the participants in the group with 3 sources of uncertainty that perceived the drug as possibly beneficial was 9% lower than that of the participants in the group with 2 sources of uncertainty (92/195, 47.2% vs 111/197, 56.3%, respectively). The proportion of the participants in the group with 3 sources of uncertainty that considered the drug to be of unclear benefit was 8% higher than that of the participants in the group with 2 sources of uncertainty (72/195, 36.9% vs 57/197, 28.9%, respectively). However, there was no significant difference compared to the version with 1 source of uncertainty (P=.31). We did not find any meaningful differences between the research summaries for the secondary outcomes. Conclusions Communicating even a large magnitude of uncertainty for a treatment effect had little impact on the perceived effectiveness. Efforts to improve public understanding of research are needed to improve the understanding of evidence-based health information. Trial Registration German Clinical Trials Register DRKS00015911, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015911 International Registered Report Identifier (IRRID) RR2-10.2196/13425
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Affiliation(s)
- Roland B Büchter
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Martina Ehrlich
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Dennis Fechtelpeter
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Ulrich Grouven
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Sabine Keller
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Regina Meuer
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | | | - Andreas Waltering
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
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20
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Colombo C, Confalonieri P, Rovaris M, La Mantia L, Galeazzi P, Silena Trevisan, Pariani A, Gerevini S, De Stefano N, Guglielmino R, Caserta C, Mosconi P, Filippini G. The IN-DEEP project "INtegrating and Deriving Evidence, Experiences, Preferences": a web information model on magnetic resonance imaging for people with multiple sclerosis. J Neurol 2020; 267:2421-2431. [PMID: 32361839 DOI: 10.1007/s00415-020-09864-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The IN-DEEP project aims to provide people with multiple sclerosis (PwMS) with evidence-based information on magnetic resonance imaging (MRI) in diagnosis and monitoring the disease through a website, and to collect their opinions on the clarity of the website's contents and its usefulness. METHODS AND ANALYSIS A multidisciplinary advisory board committee was set up. We investigated the experience, attitude and information needs on MRI through three meetings with 24 PwMS, facilitated by an expert researcher and an observer. We developed the website on the basis of input from PwMS and systematic reviews and guidelines, assessed with AMSTAR and AGREE II. We sought feedback from nine PwMS who pilot-tested the beta-version of the website, during a meeting and through phone interviews and judged whether the contents were clear, understandable and useful, and the website was easily navigable. The website is in Italian. RESULTS The website ( https://www.istituto-besta.it/in-deep-risonanza-magnetica2 ) provides two levels of information, different layouts and visualization of data covering MRI diagnostic accuracy, sensitivity and specificity, contents on how MRI can monitor PwMS over time to determine changes in the condition and evaluate treatment effects, practical information on how to prepare for the exam, educational tools and a glossary. The website was judged clear and useful by a sample of PwMS. CONCLUSIONS The website is a tool to address PwMS information needs on the role of MRI. It could be used by neurologists to facilitate communication with PwMS.
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Affiliation(s)
- Cinzia Colombo
- Laboratory of Research and Consumer Involvement, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy.
| | - Paolo Confalonieri
- Multiple Sclerosis Centre, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS, Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy
| | - Marco Rovaris
- IRCCS Don C. Gnocchi Foundation ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - Loredana La Mantia
- IRCCS Don C. Gnocchi Foundation ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | | | | | | | - Simonetta Gerevini
- Unit of Neuroradiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Roberta Guglielmino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149, Genoa, Italy
| | - Cinzia Caserta
- Multiple Sclerosis Center, Policlinico G. Rodolico, University of Catania, Catania, Italy
| | - Paola Mosconi
- Laboratory of Research and Consumer Involvement, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Graziella Filippini
- Scientific Direction, Carlo Besta Foundation and Neurological Institute, via Celoria 11, 20133, Milan, Italy
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21
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Oral A, Arienti C, Lazzarini SG, Grubišić F, Kiekens C, Negrini S. The Cochrane Corners by Cochrane Rehabilitation. Eur J Phys Rehabil Med 2020; 56:529-534. [PMID: 32235822 DOI: 10.23736/s1973-9087.20.06258-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cochrane Rehabilitation (CR) is pursuing the goal of disseminating Cochrane evidence, in line with the Cochrane Knowledge Translation (KT) strategy theme 2: "Packaging, push, and support implementation", through several projects: the CR eBook project, blogshots, and Cochrane Corners. A Cochrane Corner is a KT vehicle in which the contents of the Cochrane Library are summarized and presented by a rehabilitation professional, using the qualitative statements proposed by Cochrane Norway to communicate the magnitude of rehabilitation intervention effects on specific outcomes, based on the certainty of evidence, and followed by a section on "clinical implication for rehabilitation professionals" (both for clinical and research practice). Our Cochrane Corners aim to inform about evidence produced by Cochrane in the field of rehabilitation from a rehabilitation professional perspective. After setting internal rules for Cochrane Corners, designing a template and preparing a guide for authors, the production of Cochrane Corners started. As of December 2019, CR signed Publication Agreements with 13 rehabilitation relevant Journals, contributed to Editorials as introductory articles for the launch of Cochrane Corners in some of these Journals and published 34 Cochrane Corners, in print or ahead of print, whereas 7 additional Cochrane Corners have been submitted to the Journals and will be published soon. This initiative provided a significant opportunity for CR to communicate with members of other groups within Cochrane as well as with journal editors. The impact of Cochrane Corners on the readers will need to be evaluated in the future: unfortunately, we have no instruments to measure it at present.
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Affiliation(s)
- Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | - Frane Grubišić
- Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy.,University Hospitals Leuven - KU Leuven, Leuven, Belgium
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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22
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Utrankar A, Mayo-Gamble TL, Allen W, Novak L, Kassim AA, Bonnet K, Schlundt D, Murry VM, Jackson GP, DeBaun M, Cronin RM. Technology use and preferences to support clinical practice guideline awareness and adherence in individuals with sickle cell disease. J Am Med Inform Assoc 2019; 25:976-988. [PMID: 29741695 DOI: 10.1093/jamia/ocy036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/22/2018] [Indexed: 11/14/2022] Open
Abstract
Objective Sickle cell disease (SCD) is a chronic condition affecting over 100 000 individuals in the United States, predominantly from vulnerable populations. Clinical practice guidelines, written for providers, have low adherence. This study explored knowledge about guidelines; desire for guidelines; and how technology could support guideline awareness and adherence, examining current technology uses, and user preferences to inform design of a patient-centered guidelines application in a chronic disease. Methods This cross-sectional mixed-methods study involved semi-structured interviews, surveys, and focus groups of adolescents and adults with SCD. We evaluated interest, preferences, and anticipated benefits or barriers of a patient-centered adaptation of SCD practice guidelines; prospective technology uses for health; and barriers to technology utilization. Results Forty-seven individuals completed surveys and interviews, and 39 participated in three separate focus groups. Most participants (91%) were unaware of SCD guidelines, but almost all (96%) expressed interest in a guidelines application, identifying benefits (knowledge, activation, individualization, and rewards), and barriers (poor information, low motivation, and resource limitations). Current technology health uses included information access, care coordination, and reminders about health-related actions. Prospective technology uses included informational messaging and timely alerts. Barriers to technology use included lack of interest, lack of utility, and preference for direct communication. Conclusions This study's findings can inform the design of clinical practice guideline applications, suggesting a promising role for technology to engage patients, facilitate care decisions and actions, and improve outcomes.
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Affiliation(s)
- Amol Utrankar
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Whitney Allen
- School of Medicine, Meharry Medical College, Nashville, TN, USA
| | - Laurie Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adetola A Kassim
- Department of Medicine, Division of Hematology/Oncology, for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Velma M Murry
- Department of Human & Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - Gretchen Purcell Jackson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael DeBaun
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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23
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Fontaine G, Maheu-Cadotte MA, Lavallée A, Mailhot T, Rouleau G, Bouix-Picasso J, Bourbonnais A. Communicating Science in the Digital and Social Media Ecosystem: Scoping Review and Typology of Strategies Used by Health Scientists. JMIR Public Health Surveill 2019; 5:e14447. [PMID: 31482854 PMCID: PMC6751098 DOI: 10.2196/14447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/06/2019] [Accepted: 07/29/2019] [Indexed: 01/23/2023] Open
Abstract
Background The public’s understanding of science can be influential in a wide range of areas related to public health, including policy making and self-care. Through the digital and social media ecosystem, health scientists play a growing role in public science communication (SC). Objective This review aimed to (1) synthesize the literature on SC initiated by health scientists targeting the public in the digital and social media ecosystem and (2) describe the SC strategies and communication channels used. Methods This scoping review was based on the Joanna Briggs Institute Methodological Framework. A systematic search was performed in 6 databases (January 2000 to April 2018). Title and abstract screening, full-text review, data charting, and critical appraisal were performed independently by two review authors. Data regarding included studies and communication channels were synthesized descriptively. A typology of SC strategies was developed using a qualitative and inductive method of data synthesis. Results Among 960 unique publications identified, 18 met inclusion criteria. A third of publications scored good quality (6/18, 33%), half scored moderate quality (9/18, 50%), and less than a fifth scored low quality (3/18, 16%). Overall, 75 SC strategies used by health scientists were identified. These were grouped into 9 types: content, credibility, engagement, intention, linguistics, planification, presentation, social exchange, and statistics. A total of 5 types of communication channels were identified: social networking platforms (eg, Twitter), content-sharing platforms (eg, YouTube), digital research communities (eg, ResearchGate), personal blogs and websites (eg, WordPress), and social news aggregation and discussion platforms (eg, Reddit). Conclusions Evidence suggests that multiple types of SC strategies and communication channels are used by health scientists concurrently. Few empirical studies have been conducted on SC by health scientists in the digital and social media ecosystem. Future studies should examine the appropriateness and effectiveness of SC strategies for improving public health–related outcomes and identify the barriers, facilitators, and ethical considerations inherent to the involvement of health scientists in the digital and social media ecosystem.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, CHU Sainte-Justine, Montréal, QC, Canada
| | - Tanya Mailhot
- Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Geneviève Rouleau
- Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada.,Faculty of Nursing, Université Laval, Québec City, QC, Canada
| | - Julien Bouix-Picasso
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Health Education and Practice Laboratory, The Faculty of Health, Medicine and Human Biology, Université Paris 13 Nord, Paris, France.,French Military Health Service Academy, Department for Non-Medical Personnel Education, École du Val-de-Grâce, Paris, France
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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24
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Cassa Macedo A, Oliveira Vilela de Faria A, Ghezzi P. Boosting the Immune System, From Science to Myth: Analysis the Infosphere With Google. Front Med (Lausanne) 2019; 6:165. [PMID: 31403046 PMCID: PMC6673706 DOI: 10.3389/fmed.2019.00165] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/03/2019] [Indexed: 11/30/2022] Open
Abstract
Background: The concept that one can “boost” immunity is a popular one. Although the only evidence-based approach to this is vaccination, the lay public is exposed to a wide range of information on how to boost immunity. The aim of this study was to analyze such information available on the Internet. Methods and findings: We visited 185 webpages returned from a Google search on “boost immunity” and classified them by typology (blogs, commercial, government, no-profit, news, professional, scientific journals) and by using standard indicators of health information quality (JAMA score, HONCode). We then analyzed their content in terms of disease and “boosters” mentioned. Commercial and news websites represented one third of the results each. Of the 37 approaches to boost immunity recorded, the top ones were diet (77% of webpages), fruit (69%), vitamins (67%), antioxidants (52%), probiotics (51%), minerals (50%), and vitamin C (49%). Interestingly, vaccines ranked 27th, with only 12% of webpages mentioning them. Conclusions: Commercial websites are an important component of the information available to the public on the topic, and thus contribute providing biased information.
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Affiliation(s)
- Arthur Cassa Macedo
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Pietro Ghezzi
- Brighton & Sussex Medical School, Brighton, United Kingdom
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Oxman AD, Paulsen EJ. Who can you trust? A review of free online sources of "trustworthy" information about treatment effects for patients and the public. BMC Med Inform Decis Mak 2019; 19:35. [PMID: 30786889 PMCID: PMC6381637 DOI: 10.1186/s12911-019-0772-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 02/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Information about effects of treatments based on unsystematic reviews of research evidence may be misleading. However, finding trustworthy information about the effects of treatments based on systematic reviews, which is accessible to patients and the public can be difficult. The objectives of this study were to identify and evaluate free sources of health information for patients and the public that provide information about effects of treatments based on systematic reviews. METHODS We reviewed websites that we and our colleagues knew of, searched for government sponsored health information websites, and searched for online sources of health information that provide evidence-based information. To be included in our review, a website had to be available in English, freely accessible, and intended for patients and the public. In addition, it had to have a broad scope, not limited to specific conditions or types of treatments. It had to include a description of how the information is prepared and the description had to include a statement about using systematic reviews. We compared the included websites by searching for information about the effects of eight treatments. RESULTS Three websites met our inclusion criteria: Cochrane Evidence, Informed Health, and PubMed Health. The first two websites produce content, whereas PubMed Health aggregated content. A fourth website that met our inclusion criteria, CureFacts, was under development. Cochrane Evidence provides plain language summaries of Cochrane Reviews (i.e. summaries that are intended for patients and the public). They are translated to several other languages. No information besides treatment effects is provided. Informed Health provides information about treatment effects together with other information for a wide range of topics. PubMed Health was discontinued in October 2018. It included a large number of systematic reviews of treatment effects with plain language summaries for Cochrane Reviews and some other reviews. None of the three websites included links to ongoing trials, and information about treatment effects was not reported consistently on any of the websites. CONCLUSION It is possible for patients and the public to access trustworthy information about the effects of treatments using the two of the websites included in this review.
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Affiliation(s)
- Andrew D Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway. .,University of Oslo, Oslo, Norway.
| | - Elizabeth J Paulsen
- Centre for Informed Health Choices, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
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Medley N, Vogel JP, Care A, Alfirevic Z. Interventions during pregnancy to prevent preterm birth: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2018; 11:CD012505. [PMID: 30480756 PMCID: PMC6516886 DOI: 10.1002/14651858.cd012505.pub2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Preterm birth (PTB) is a major factor contributing to global rates of neonatal death and to longer-term health problems for surviving infants. Both the World Health Organization and the United Nations consider prevention of PTB as central to improving health care for pregnant women and newborn babies. Current preventative clinical strategies show varied efficacy in different populations of pregnant women, frustrating women and health providers alike, while researchers call for better understanding of the underlying mechanisms that lead to PTB. OBJECTIVES We aimed to summarise all evidence for interventions relevant to the prevention of PTB as reported in Cochrane systematic reviews (SRs). We intended to highlight promising interventions and to identify SRs in need of an update. METHODS We searched the Cochrane Database of Systematic Reviews (2 November 2017) with key words to capture any Cochrane SR that prespecified or reported a PTB outcome. Inclusion criteria focused on pregnant women without signs of preterm labour or ruptured amniotic membranes. We included reviews of interventions for pregnant women irrespective of their risk status. We followed standard Cochrane methods.We applied GRADE criteria to evaluate the quality of SR evidence. We assigned graphic icons to classify the effectiveness of interventions as: clear evidence of benefit; clear evidence of harm; clear evidence of no effect or equivalence; possible benefit; possible harm; or unknown benefit or harm. We defined clear evidence of benefit and clear evidence of harm to be GRADE moderate- or high-quality evidence with a confidence interval (CI) that does not cross the line of no effect. Clear evidence of no effect or equivalence is GRADE moderate- or high-quality evidence with a narrow CI crossing the line of no effect. Possible benefit and possible harm refer to GRADE low-quality evidence with a clear effect (CI does not cross the line of no effect) or GRADE moderate- or high-quality evidence with a wide CI. Unknown harm or benefit refers to GRADE low- or very low-quality evidence with a wide CI. MAIN RESULTS We included 83 SRs; 70 had outcome data. Below we highlight key results from a subset of 36 SRs of interventions intended to prevent PTB. OUTCOME preterm birthClear evidence of benefitFour SRs reported clear evidence of benefit to prevent specific populations of pregnant women from giving birth early, including midwife-led continuity models of care versus other models of care for all women; screening for lower genital tract infections for pregnant women less than 37 weeks' gestation and without signs of labour, bleeding or infection; and zinc supplementation for pregnant women without systemic illness. Cervical cerclage showed clear benefit for women with singleton pregnancy and high risk of PTB only.Clear evidence of harmNo included SR reported clear evidence of harm.No effect or equivalenceFor pregnant women at high risk of PTB, bedrest for women with singleton pregnancy and antibiotic prophylaxis during the second and third trimester were of no effect or equivalent to a comparator.Possible benefitFour SRs found possible benefit in: group antenatal care for all pregnant women; antibiotics for pregnant women with asymptomatic bacteriuria; pharmacological interventions for smoking cessation for pregnant women who smoke; and vitamin D supplements alone for women without pre-existing conditions such as diabetes.Possible harmOne SR reported possible harm (increased risk of PTB) with intramuscular progesterone, but this finding is only relevant to women with multiple pregnancy and high risk of PTB. Another review found possible harm with vitamin D, calcium and other minerals for pregnant women without pre-existing conditions. OUTCOME perinatal deathClear evidence of benefitTwo SRs reported clear evidence of benefit to reduce pregnant women's risk of perinatal death: midwife-led continuity models of care for all pregnant women; and fetal and umbilical Doppler for high-risk pregnant women.Clear evidence of harmNo included SR reported clear evidence of harm.No effect or equivalenceFor pregnant women at high risk of PTB, antibiotic prophylaxis during the second and third trimester was of no effect or equivalent to a comparator.Possible benefitOne SR reported possible benefit with cervical cerclage for women with singleton pregnancy and high risk of PTB.Possible harmOne SR reported possible harm associated with a reduced schedule of antenatal visits for pregnant women at low risk of pregnancy complications; importantly, these women already received antenatal care in settings with limited resources. OUTCOMES preterm birth and perinatal deathUnknown benefit or harmFor pregnant women at high risk of PTB for any reason including multiple pregnancy, home uterine monitoring was of unknown benefit or harm. For pregnant women at high risk due to multiple pregnancy: bedrest, prophylactic oral betamimetics, vaginal progesterone and cervical cerclage were all of unknown benefit or harm. AUTHORS' CONCLUSIONS Implications for practiceThe overview serves as a map and guide to all current evidence relevant to PTB prevention published in the Cochrane Library. Of 70 SRs with outcome data, we identified 36 reviews of interventions with the aim of preventing PTB. Just four of these SRs had evidence of clear benefit to women, with an additional four SRs reporting possible benefit. No SR reported clear harm, which is an important finding for women and health providers alike.The overview summarises no evidence for the clinically important interventions of cervical pessary, cervical length assessment and vaginal progesterone because these Cochrane Reviews were not current. These are active areas for PTB research.The graphic icons we assigned to SR effect estimates do not constitute clinical guidance or an endorsement of specific interventions for pregnant women. It remains critical for pregnant women and their healthcare providers to carefully consider whether specific strategies to prevent PTB will be of benefit for individual women, or for specific populations of women.Implications for researchFormal consensus work is needed to establish standard language for overviews of reviews and to define the limits of their interpretation.Clinicians, researchers and funders must address the lack of evidence for interventions relevant to women at high risk of PTB due to multiple pregnancy.
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Affiliation(s)
- Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | - Joshua P Vogel
- Burnet InstituteMaternal and Child Health85 Commercial RoadMelbourneAustralia
| | - Angharad Care
- The University of LiverpoolDepartment of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | - Zarko Alfirevic
- The University of LiverpoolDepartment of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Boyko JA, Riley BL, Willis CD, Stockton L, Zummach D, Kerner J, Robinson K, Chia M. Knowledge translation for realist reviews: a participatory approach for a review on scaling up complex interventions. Health Res Policy Syst 2018; 16:101. [PMID: 30348180 PMCID: PMC6198505 DOI: 10.1186/s12961-018-0374-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/24/2018] [Indexed: 11/11/2022] Open
Abstract
Background Knowledge syntheses that use a realist methodology are gaining popularity. Yet, there are few reports in the literature that describe how results are summarised, shared and used. This paper aims to inform knowledge translation (KT) for realist reviews by describing the process of developing a KT strategy for a review on pathways for scaling up complex public health interventions. Methods The participatory approach used for the realist review was also used to develop the KT strategy. The approach included three main steps, namely (1) an international meeting focused on interpreting preliminary findings from the realist review and seeking input on KT activities; (2) a targeted literature review on KT for realist reviews; and (3) consultations with primary knowledge users of the review. Results The international meeting identified a general preference among knowledge users for findings from the review that are action oriented. A need was also identified for understanding how to tailor findings for specific knowledge user groups in relation to their needs. The literature review identified four papers that included brief descriptions of planned or actual KT activities for specific research studies; however, information was minimal on what KT activities or products work for whom, under what conditions and why. The consultations revealed that KT for realist reviews should consider the following: (1) activities closely aligned with the preferences of specific knowledge user groups; (2) key findings that are sensitive to factors within the knowledge user’s context; and (3) actionable statements that can advance KT goals, activities or products. The KT strategy derived from the three activities includes a planning framework and tailored KT activities that address preferences of knowledge users for findings that are action oriented and context relevant. Conclusions This paper provides an example of a KT strategy for realist reviews that blends theoretical and practical insights. Evaluation of the strategy’s implementation will provide useful insights on its effectiveness and potential for broader application. Electronic supplementary material The online version of this article (10.1186/s12961-018-0374-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer A Boyko
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.
| | - Barbara L Riley
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Cameron D Willis
- Movember Foundation, P.O. Box 60, East Melbourne, VIC, 8002, Australia.,Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
| | - Lisa Stockton
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Dana Zummach
- Propel Centre for Population Health Impact, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Jon Kerner
- Canadian Partnership Against Cancer, 145 King Street West Suite 900, Toronto, ON, M5H 1J8, Canada
| | - Kerry Robinson
- Public Health Agency of Canada, 130 Colonnade Road A.L. 6501H, Ottawa, ON, K1A 0K9, Canada
| | - Marie Chia
- Public Health Agency of Canada, 130 Colonnade Road A.L. 6501H, Ottawa, ON, K1A 0K9, Canada
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Moretti A, Gimigliano F, Arienti C, Pollet J, Kiekens C, Negrini S. The Cochrane Rehabilitation eBook: a knowledge translation tool to transfer evidence to different rehabilitation audiences. Eur J Phys Rehabil Med 2018; 54:808-810. [PMID: 30220116 DOI: 10.23736/s1973-9087.18.05406-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Systematic reviews are a powerful method for summarizing and synthesizing evidence and create a methodological opportunity for preparing data integration tables to enable review-level synthesis of the evidence. One of the main tasks of Cochrane Rehabilitation is to make it possible to improve the application of evidence-based clinical practice by all rehabilitation professionals, and to facilitate policy-makers in decision-making according to the best evidence. In this context arises the need to diffuse the high-quality information of Cochrane Systematic Reviews (CSR), through synthetic and easy-to-use messages for the different rehabilitation audiences. Cochrane Rehabilitation has recently launched the production of an eBook including all the evidence coming from the CSR tagged by its Review Committee as of rehabilitation interest with the final aim to enhance the application of evidence in clinical practice, medical education, health system policies, and in the community. This will be a powerful tool for the dissemination of evidence-based practice, education and knowledge, as well as to support political decisions for both effective organization and resource allocation in rehabilitation field.
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Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Joel Pollet
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy -
| | - Carlotte Kiekens
- KU Leuven, PRM, Leuven, Belgium
- University Hospitals Leuven, Physical and Rehabilitation Medicine, Leuven, Belgium
| | - Stefano Negrini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Petkovic J, Welch V, Jacob MH, Yoganathan M, Ayala AP, Cunningham H, Tugwell P. Do evidence summaries increase health policy-makers' use of evidence from systematic reviews? A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-52. [PMID: 37131376 PMCID: PMC8428003 DOI: 10.4073/csr.2018.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This review summarizes the evidence from six randomized controlled trials that judged the effectiveness of systematic review summaries on policymakers' decision making, or the most effective ways to present evidence summaries to increase policymakers' use of the evidence. This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one. The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary. None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?" Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews. Plain language summary Policy briefs make systematic reviews easier to understand but little evidence of impact on use of study findings: It is likely that evidence summaries are easier to understand than complete systematic reviews. Whether these summaries increase the use of evidence from systematic reviews in policymaking is not clear.What is this review about?: Systematic reviews are long and technical documents that may be hard for policymakers to use when making decisions. Evidence summaries are short documents that describe research findings in systematic reviews. These summaries may simplify the use of systematic reviews.Other names for evidence reviews are policy briefs, evidence briefs, summaries of findings, or plain language summaries. The goal of this review was to learn whether evidence summaries help policymakers use evidence from systematic reviews. This review also aimed to identify the best ways to present the evidence summary to increase the use of evidence.What are the main findings of this review?: This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one.The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary.None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?"Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read.. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews.What do the findings of this review mean?: Our review suggests that evidence summaries help policymakers to better understand the findings presented in systematic reviews. In short, evidence summaries should be developed to make it easier for policymakers to understand the evidence presented in systematic reviews. However, right now there is very little evidence on the best way to present systematic review evidence to policymakers.How up to date is this review?: The authors of this review searched for studies through June 2016. Executive summary/Abstract Background: Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. Strategies to promote the use of evidence to decision makers are required, and evidence summaries have been suggested as a facilitator. Evidence summaries include policy briefs, briefing papers, briefing notes, evidence briefs, abstracts, summary of findings tables, and plain language summaries. There are many organizations developing and disseminating systematic review evidence summaries for different populations or subsets of decision makers. However, evidence on the usefulness and effectiveness of systematic review summaries is lacking. We present an overview of the available evidence on systematic review evidence summaries.Objectives: This systematic review aimed to 1) assess the effectiveness of evidence summaries on policy-makers' use of the evidence and 2) identify the most effective summary components for increasing policy-makers' use of the evidence.Search methods: We searched several online databases (Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Global Health Library, Popline, Africa-wide, Public Affairs Information Services, Worldwide Political Science Abstracts, Web of Science, and DfiD), websites of research groups and organizations which produce evidence summaries, and reference lists of included summaries and related systematic reviews. These databases were searched in March-April, 2016.Selection criteria: Eligible studies included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary", "policy brief", or other product derived from systematic reviews that presented evidence in a summarized form. These interventions could be compared to active comparators (e.g. other summary formats) or no intervention.The primary outcomes were: 1) use of systematic review summaries decision-making (e.g. self-reported use of the evidence in policy-making, decision-making) and 2) policymaker understanding, knowledge, and/or beliefs (e.g. changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g. format) of the summaries.Results: Our database search combined with our grey literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text and we included 6 studies (reported in 7 papers, 1661 participants) as well as protocols from 2 ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (4 studies) and perceived usefulness or usability (3 studies). Summary of Findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for Summary of Findings tables, certain elements, such as reporting study event rates and absolute differences were preferred as well as avoiding the use of footnotes. No studies assessed adverse effects. The risks of bias in these studies were mainly assessed as unclear or low however, two studies were assessed as high risk of bias for incomplete outcome data due to very high rates of attrition.Authors' conclusions: Evidence summaries may be easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear.
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Whiting P, Leeflang M, de Salis I, Mustafa RA, Santesso N, Gopalakrishna G, Cooney G, Jesper E, Thomas J, Davenport C. Guidance was developed on how to write a plain language summary for diagnostic test accuracy reviews. J Clin Epidemiol 2018; 103:112-119. [PMID: 30036677 DOI: 10.1016/j.jclinepi.2018.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To develop guidance for authors of diagnostic test accuracy (DTA) reviews to help them write a plain language summary of the results of their review. STUDY DESIGN AND SETTING We used a combination of focus groups, user testing, and a web-based survey. Participants included patient representatives, media representatives, and health professionals. RESULTS We present step-by-step guidance for authors of DTA reviews for writing a plain language summary. This guidance is illustrated with examples of reader-tested sentences, explanations, and a figure. CONCLUSION We hope this guidance will allow reviewers to present the findings of DTA reviews so that it is easier for readers to understand the results and conclusions. This will increase the accessibility of these reviews for various audiences.
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Affiliation(s)
- Penny Whiting
- Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK; NIHR CHLARC West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
| | - Mariska Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Isabel de Salis
- Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, and Director, Outcomes and Implementation Research, University of Kansas Medical Center, Kansas City, KS, USA; Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
| | - Nancy Santesso
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
| | - Gowri Gopalakrishna
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Geraldine Cooney
- NIHR CHLARC West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Emily Jesper
- Sense about Science, 14a Clerkenwell Green, London, United Kingdom
| | - Joanne Thomas
- Sense about Science, 14a Clerkenwell Green, London, United Kingdom
| | - Clare Davenport
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Preparing Parents to Make An Informed Choice About Antibiotic Use for Common Acute Respiratory Infections in Children: A Randomised Trial of Brief Decision Aids in a Hypothetical Scenario. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 10:463-474. [PMID: 28258505 DOI: 10.1007/s40271-017-0223-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process. OBJECTIVE The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children. METHODS Adult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability. RESULTS After reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95% CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95% CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95% CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features. CONCLUSION The decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.
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Cusack L, Del Mar CB, Chalmers I, Gibson E, Hoffmann TC. Educational interventions to improve people's understanding of key concepts in assessing the effects of health interventions: a systematic review. Syst Rev 2018; 7:68. [PMID: 29716639 PMCID: PMC5930693 DOI: 10.1186/s13643-018-0719-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/23/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Health information is readily accessible but is of variable quality. General knowledge about how to assess whether claims about health interventions are trustworthy is not common, so people's health decisions can be ill-informed, unnecessarily costly and even unsafe. This review aims to identify and evaluate studies of educational interventions designed to improve people's understanding of key concepts for evaluating claims about the effects of health interventions. METHODS/DESIGN We searched multiple electronic databases and sources of grey literature. Inclusion criteria included all study types that included a comparison, any participants (except health professionals or health professional students) and educational interventions aimed at improving people's understanding of one or more of the key concepts considered necessary for assessing health intervention claims. Knowledge and/or understanding of concepts or skills relevant to evaluating health information were our primary outcome measures. Secondary outcomes included behaviour, confidence, attitude and satisfaction with the educational interventions. Two authors independently screened search results, assessed study eligibility and risk of bias and extracted data. Results were summarised using descriptive synthesis. RESULTS Among 24 eligible studies, 14 were randomised trials and 10 used other study designs. There was heterogeneity across study participants, settings and educational intervention type, content and delivery. The risk of bias was high in at least one domain for all randomised studies. Most studies measured outcomes immediately after the educational intervention, with few measuring later. In most of the comparisons, measures of knowledge and skills were better among those who had received educational interventions than among controls, and some of these differences were statistically significant. The effects on secondary outcomes were inconsistent. CONCLUSIONS Educational interventions to improve people's understanding of key concepts for evaluating health intervention claims can improve people's knowledge and skills, at least in the short term. Effects on confidence, attitude and behaviour are uncertain. Many of the studies were at moderate or greater risk of bias. Improvements in study quality, consistency of outcome measures and measures of longer-term effects are needed to improve confidence in estimates of the effects of educational interventions to improve people's understanding of key concepts for evaluating health intervention claims. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016033103.
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Affiliation(s)
- Leila Cusack
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia.
| | - Chris B Del Mar
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
| | | | - Elizabeth Gibson
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
| | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
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Riva N, Puljak L, Moja L, Ageno W, Schünemann H, Magrini N, Squizzato A. Multiple overlapping systematic reviews facilitate the origin of disputes: the case of thrombolytic therapy for pulmonary embolism. J Clin Epidemiol 2018; 97:1-13. [DOI: 10.1016/j.jclinepi.2017.11.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/25/2017] [Accepted: 11/13/2017] [Indexed: 01/08/2023]
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Buljan I, Malički M, Wager E, Puljak L, Hren D, Kellie F, West H, Alfirević Ž, Marušić A. No difference in knowledge obtained from infographic or plain language summary of a Cochrane systematic review: three randomized controlled trials. J Clin Epidemiol 2018; 97:86-94. [PMID: 29269021 DOI: 10.1016/j.jclinepi.2017.12.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 11/14/2017] [Accepted: 12/11/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to test the usefulness of an infographic in the translation of knowledge about health information from a Cochrane systematic review to lay and professional populations in comparison to a plain language summary (PLS) and scientific abstract (SA). STUDY DESIGN AND SETTING We conducted three parallel randomized trials with university students (n = 171), consumers (n = 99), and doctors (n = 64), to examine the effect of different summary formats of a Cochrane systematic review on the knowledge about health information presented in the review, reading experience, and perceived user-friendliness. In the trials involving students and doctors, an infographic was compared to a PLS and a SA, while in those with consumers, an infographic was compared to a PLS. RESULTS We found no difference in knowledge between the infographic and the text-based PLS in any of the trials or in the whole participant sample. All three participant groups preferred the infographic and gave it higher ratings for reading experience (d = 0.48 in the overall sample) and user-friendliness (d = 0.46 in the overall sample). CONCLUSION Although the infographic format was perceived as more enjoyable for reading, it was not better than a traditional, text-based PLS in the translation of knowledge about findings from a Cochrane systematic review.
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Affiliation(s)
- Ivan Buljan
- Cochrane Croatia, Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2 21000, Split, Croatia.
| | - Mario Malički
- Cochrane Croatia, Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2 21000, Split, Croatia
| | - Elizabeth Wager
- Sideview, Princes Risborough, UK; University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Cochrane Croatia, University of Split School of Medicine, Split, Croatia
| | - Darko Hren
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split Croatia
| | - Frances Kellie
- Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Helen West
- Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Žarko Alfirević
- Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Ana Marušić
- Cochrane Croatia, Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2 21000, Split, Croatia
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M Barbara A, Dobbins M, Haynes RB, Iorio A, Lavis JN, Levinson AJ. User Experiences of the McMaster Optimal Aging Portal's Evidence Summaries and Blog Posts: Usability Study. JMIR Hum Factors 2016; 3:e22. [PMID: 27542995 PMCID: PMC5010647 DOI: 10.2196/humanfactors.6208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence summaries and blogs can support evidence-informed healthy aging, by presenting high-quality health research evidence in plain language for a nonprofessional (citizen) audience. OBJECTIVE Our objective was to explore citizens' perceptions about the usability of evidence summaries and blog posts on the Web-based McMaster Optimal Aging Portal. METHODS Twenty-two citizens (aged 50 years and older) and informal caregivers participated in a qualitative study using a think-aloud method and semistructured interviews. Eleven interviews were conducted in person, 7 over the telephone, and 4 by Skype. RESULTS We identified themes that fell under 4 user-experience categories: (1) desirability: personal relevance, (2) understandability: language comprehension, grasping the message, dealing with uncertainty, (3) usability: volume of information, use of numbers, and (4) usefulness: intention to use, facility for sharing. CONCLUSIONS Participants recognized that high-quality evidence on aging was valuable. Their intended use of the information was influenced by how much it applied to their own health circumstances or those of a loved one. Some specific formatting features that were preferred included consistent layout, content organized by subheadings, catchy titles, numerical information summarized in a table, and inclusion of a glossary.
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Affiliation(s)
- Angela M Barbara
- Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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Carrasco-Labra A, Brignardello-Petersen R, Santesso N, Neumann I, Mustafa RA, Mbuagbaw L, Etxeandia Ikobaltzeta I, De Stio C, McCullagh LJ, Alonso-Coello P, Meerpohl JJ, Vandvik PO, Brozek JL, Akl EA, Bossuyt P, Churchill R, Glenton C, Rosenbaum S, Tugwell P, Welch V, Garner P, Guyatt G, Schünemann HJ. Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format. J Clin Epidemiol 2016; 74:7-18. [DOI: 10.1016/j.jclinepi.2015.12.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 10/25/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
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Jelicic Kadic A, Fidahic M, Vujcic M, Saric F, Propadalo I, Marelja I, Dosenovic S, Puljak L. Cochrane plain language summaries are highly heterogeneous with low adherence to the standards. BMC Med Res Methodol 2016; 16:61. [PMID: 27216616 PMCID: PMC4877986 DOI: 10.1186/s12874-016-0162-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 05/13/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze whether Cochrane plain language summaries (PLSs) adhere to the Standards for the reporting of Plain Language Summaries in new Cochrane Intervention Reviews (PLEACS). METHODS A systematic analysis of adherence to the measurable PLEACS items was performed for Cochrane PLSs published from March 2013 to the end of January 2015. Duplicate independent data extraction was performed. An adherence score was calculated for each PLS and for the Cochrane Review Groups (CRGs) that published them. RESULTS Of the 1738 analyzed PLSs, not a single one adhered fully to the measured PLEACS items. The highest adherence was found for absence of details of the search strategy (99 % adherence), and the lowest adherence for an item mandating to address quality according to the GRADE system (0.7 % adherence). Overall adherence percentage of PLSs reporting reviews with included studies was 57 %. Different CRGs had a wide range of adherence scores. CONCLUSIONS Cochrane plain language summaries are highly heterogeneous with a low adherence to the PLEACS standards. Therefore, there is much room for improving the content and consistency of the PLS. A standardization of PLSs is necessary to ensure delivery of proper and consistent information for consumers.
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Affiliation(s)
- Antonia Jelicic Kadic
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Mahir Fidahic
- Faculty of Medicine, University of Tuzla, Univerzitetska 1, 75000, Tuzla, Bosnia and Herzegovina
| | - Milan Vujcic
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Frano Saric
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Ivana Propadalo
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Ivana Marelja
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Svjetlana Dosenovic
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Livia Puljak
- Cochrane Croatia, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia.
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Vernooij RWM, Willson M, Gagliardi AR. Characterizing patient-oriented tools that could be packaged with guidelines to promote self-management and guideline adoption: a meta-review. Implement Sci 2016; 11:52. [PMID: 27079375 PMCID: PMC4832541 DOI: 10.1186/s13012-016-0419-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 04/02/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Self-management is an important component of care for patients or consumers (henceforth termed patients) with chronic conditions. Research shows that patients view guidelines as potential sources of self-management support. However, few guidelines provide such support. The primary purpose of this study was to characterize effective types of self-management interventions that could be packaged as resources in (i.e., appendices) or with guidelines (i.e., accompanying products). METHODS We conducted a meta-review of systematic reviews that evaluated self-management interventions. MEDLINE, EMBASE, and the Cochrane Library were searched from 2005 to 2014 for English language systematic reviews. Data were extracted on study characteristics, intervention (content, delivery, duration, personnel, single or multifaceted), and outcomes. Interventions were characterized by the type of component for different domains (inform, activate, collaborate). Summary statistics were used to report the characteristics, frequency, and impact of the types of self-management components. A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used to assess the methodological quality of included reviews. RESULTS Seventy-seven studies were included (14 low, 44 moderate, 18 high risk of bias). Reviews addressed numerous clinical topics, most frequently diabetes (23, 30 %). Fifty-four focused on single (38 educational, 16 self-directed) and 21 on multifaceted interventions. Support for collaboration with providers was the least frequently used form of self-management. Most conditions featured multiple types of self-management components. The most frequently occurring type of self-management component across all studies was lifestyle advice (72 %), followed by psychological strategies (69 %), and information about the condition (49 %). In most reviews, the intervention both informed and activated patients (57, 76 %). Among the reviews that achieved positive results, 83 % of interventions involved activation alone, 94 % in combination with information, and 95 % in combination with information and collaboration. No trends in the characteristics and impact of self-management by condition were observed. CONCLUSIONS This study revealed numerous opportunities for enhancing guidelines with resources for both patients and providers to support self-management. This includes single resources that provide information and/or prompt activation. Further research is needed to more firmly establish the statistical association between the characteristics of self-management support and outcomes; and to and optimize the design of self-management resources that are included in or with guidelines, in particular, resources that prompt collaboration with providers.
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Affiliation(s)
- Robin W M Vernooij
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Melina Willson
- Systematic Reviews and Health Technology Assessments, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
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Alderdice F, McNeill J, Lasserson T, Beller E, Carroll M, Hundley V, Sunderland J, Devane D, Noyes J, Key S, Norris S, Wyn-Davies J, Clarke M. Do Cochrane summaries help student midwives understand the findings of Cochrane systematic reviews: the BRIEF randomised trial. Syst Rev 2016; 5:40. [PMID: 26932724 PMCID: PMC4774039 DOI: 10.1186/s13643-016-0214-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Abstracts and plain language summaries (PLS) are often the first, and sometimes the only, point of contact between readers and systematic reviews. It is important to identify how these summaries are used and to know the impact of different elements, including the authors' conclusions. The trial aims to assess whether (a) the abstract or the PLS of a Cochrane Review is a better aid for midwifery students in assessing the evidence, (b) inclusion of authors' conclusions helps them and (c) there is an interaction between the type of summary and the presence or absence of the conclusions. METHODS Eight hundred thirteen midwifery students from nine universities in the UK and Ireland were recruited to this 2 × 2 factorial trial (abstract versus PLS, conclusions versus no conclusions). They were randomly allocated to one of four groups and asked to recall knowledge after reading one of four summary formats of two Cochrane Reviews, one with clear findings and one with uncertain findings. The primary outcome was the proportion of students who identified the appropriate statement to describe the main findings of the two reviews as assessed by an expert panel. RESULTS There was no statistically significant difference in correct response between the abstract and PLS groups in the clear finding example (abstract, 59.6 %; PLS, 64.2 %; risk difference 4.6 %; CI -0.2 to 11.3) or the uncertain finding example (42.7 %, 39.3 %, -3.4 %, -10.1 to 3.4). There was no significant difference between the conclusion and no conclusion groups in the example with clear findings (conclusions, 63.3 %; no conclusions, 60.5 %; 2.8 %; -3.9 to 9.5), but there was a significant difference in the example with uncertain findings (44.7 %; 37.3 %; 7.3 %; 0.6 to 14.1, p = 0.03). PLS without conclusions in the uncertain finding review had the lowest proportion of correct responses (32.5 %). Prior knowledge and belief predicted student response to the clear finding review, while years of midwifery education predicted response to the uncertain finding review. CONCLUSIONS Abstracts with and without conclusions generated similar student responses. PLS with conclusions gave similar results to abstracts with and without conclusions. Removing the conclusions from a PLS with uncertain findings led to more problems with interpretation.
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Affiliation(s)
- Fiona Alderdice
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK.
| | - Jenny McNeill
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK.
| | - Toby Lasserson
- Cochrane Editorial Unit, St Albans House, 57-59 Haymarket, London, SW1Y 4QX, UK.
| | - Elaine Beller
- Bond University Queensland, Robina, QLD, 4229, Australia.
| | - Margaret Carroll
- School of Nursing, Trinity College Dublin, 24 D`Olier Street, Dublin, Ireland.
| | - Vanora Hundley
- School of Health and Social Care, Bournemouth University, Royal London House R118, Christchurch Road, Bournemouth, BH1 3LT, UK.
| | - Judith Sunderland
- School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK.
| | - Declan Devane
- Nursing & Midwifery Studies, Aras Moyola, National University of Ireland Galway, Galway, Ireland.
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, LL57 2DG, Gwynedd, UK.
| | - Susan Key
- School of Nursing and Midwifery and Social Care, Faculty of Health Sciences and Medicine, Edinburgh Napier University, Sighthill Court, Edinburgh, EH11 4BN, UK.
| | - Sarah Norris
- Department of Interprofessional Health Studies, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Janine Wyn-Davies
- Faculty of Health Sport and Science, University of South Wales, Pontypridd, South Wales, CF3 71DL, UK.
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.
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Gagliardi AR, Légaré F, Brouwers MC, Webster F, Badley E, Straus S. Patient-mediated knowledge translation (PKT) interventions for clinical encounters: a systematic review. Implement Sci 2016; 11:26. [PMID: 26923462 PMCID: PMC4770686 DOI: 10.1186/s13012-016-0389-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-mediated knowledge translation (PKT) interventions engage patients in their own health care. Insight on which PKT interventions are effective is lacking. We sought to describe the type and impact of PKT interventions. METHODS We performed a systematic review of PKT interventions, defined as strategies that inform, educate and engage patients in their own health care. We searched MEDLINE, EMBASE and the Cochrane Library from 2005 to 2014 for English language studies that evaluated PKT interventions delivered immediately before, during or upon conclusion of clinical encounters to individual patients with arthritis or cancer. Data were extracted on study characteristics, PKT intervention (theory, content, delivery, duration, personnel, timing) and outcomes. Interventions were characterized by type of patient engagement (inform, activate, collaborate). We performed content analysis and reported summary statistics. RESULTS Of 694 retrieved studies, 16 were deemed eligible (5 arthritis, 11 cancer; 12 RCTs, 4 cohort studies; 7 low, 3 uncertain, 6 high risk of bias). PKT interventions included print material in 10 studies (brochures, booklets, variety of print material, list of websites), electronic material in 10 studies (video, computer program, website) and counselling in 2 studies. They were offered before, during and after consultation in 4, 1 and 4 studies, respectively; as single or multifaceted interventions in 10 and 6 studies, respectively; and by clinicians, health educators, researchers or volunteers in 4, 3, 5 and 1 study, respectively. Most interventions informed or activated patients. All studies achieved positive impact in one or more measures of patient knowledge, decision-making, communication and behaviour. This was true regardless of condition, PKT intervention, timing, personnel, type of engagement or delivery (single or multifaceted). No studies assessed patient harms, or interventions for providers to support PKT intervention delivery. Two studies evaluated the impact on providers of PKT interventions aimed at patients. CONCLUSIONS Single interventions involving print material achieved beneficial outcomes as did more complex interventions. Few studies were eligible, and no studies evaluated patient harms, or provider outcomes. Further research is warranted to evaluate these PKT interventions in more patients, or patients with different conditions; different types of PKT interventions for patients and for providers; and potential harms associated with interventions.
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Fearns N, Graham K, Johnston G, Service D. Improving the user experience of patient versions of clinical guidelines: user testing of a Scottish Intercollegiate Guideline Network (SIGN) patient version. BMC Health Serv Res 2016; 16:37. [PMID: 26837683 PMCID: PMC4736267 DOI: 10.1186/s12913-016-1287-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/22/2016] [Indexed: 11/15/2022] Open
Abstract
Background Guideline producers are increasingly producing versions of guidelines for the public, and knowledge of what the public want from them is also increasing. The aim of this study was to user test a patient version of a SIGN clinical guideline that was designed based on preliminary work for the DECIDE project. SIGN is the leading national guideline producer in Scotland. Methods People with a diagnosis of glaucoma and non-professional carers were recruited from across Scotland. User testing was conducted using a think-aloud protocol method. Each session was conducted by one interviewer and one observer. All sessions were recorded and transcribed. The data was analysed, problems with the guideline were identified and resolved and key findings were themed using a user experience model. Results Thirteen user testing sessions with people with glaucoma and one with a carer were conducted. Key facilitators of desirability and usability identified include clear branding as a patient version and a clearly described purpose, audience and contents page. Other facilitators include a “friendly” tone which is achieved by the use of colour, quotes, icons, simple language and charts, and brief chunked text. The value and usefulness of the patient guideline was influenced by its ability to: inform the public, link information to actions, and empower people in their interaction with healthcare professionals. Participants were disappointed by the lack of information on treatment in the patient version, which was outside its scope. Information on the evidence based guideline production process and the involvement of appropriately skilled professionals was key to the credibility of the guideline. Lack of awareness of guidelines and guideline producing bodies, is a potentially serious threat to findability/accessibility. Conclusions It is important for guideline producers to maximise the user experience of the public when they access patient versions of guidelines, particularly given the current low level of access and awareness. One size does not fit all and guideline producers need to strike a balance between keeping the patient version simple and providing sufficient information to facilitate shared decision making and empower the public. Guideline producers may find the results of this study useful in designing their own patient versions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1287-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naomi Fearns
- Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Karen Graham
- Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Gordon Johnston
- Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Duncan Service
- Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
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Jamtvedt G, Klemp M, Mørland B, Nylenna M. Responsibility and accountability for well informed health-care decisions: a global challenge. Lancet 2015; 386:826-8. [PMID: 26085031 DOI: 10.1016/s0140-6736(15)60855-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gro Jamtvedt
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
| | - Marianne Klemp
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Berit Mørland
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Magne Nylenna
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
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Phillips K, Taylor A, Mease PJ, Simon LS, Conaghan PG, Choy EH, Singh JA, Strand V, Gossec L, Kaiser U, de Wit M, Ostelo R, Maxwell L, Tugwell PS. Harmonizing Pain Outcome Measures: Results of the Pre-OMERACT Meeting on Partnerships for Consensus on Patient-important Pain Outcome Domains Between the Cochrane Musculoskeletal Group and OMERACT. J Rheumatol 2015; 42:1943-1946. [DOI: 10.3899/jrheum.141386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective.A variety of authorities in pain measurement and outcome methodology met prior to the Outcome Measures in Rheumatology (OMERACT) 12 meeting in May 2014 to develop partnerships for consensus on pain outcomes.Methods.Following overview presentations, discussion centered on pain-specific and global constructs in the domain of chronic pain. Practical issues for clinical trial implementation were also discussed. Breakout sessions were completed regarding additional details of domain constructs. A nominal group process involving all workshop participants confirmed that chronic pain outcome measures encompass a broad range of constructs and that existing scales may be inadequate for assessment in clinical trials.Results.Participants endorsed that both pain intensity and pain interference are important constructs to be measured in clinical trials of chronic pain as it pertains to rheumatologic diagnoses.Conclusion.Further work is needed on inclusion of the patient perspective in the development of pain domains as well as Cochrane Collaboration summary of findings tables.
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Treweek S, Altman DG, Bower P, Campbell M, Chalmers I, Cotton S, Craig P, Crosby D, Davidson P, Devane D, Duley L, Dunn J, Elbourne D, Farrell B, Gamble C, Gillies K, Hood K, Lang T, Littleford R, Loudon K, McDonald A, McPherson G, Nelson A, Norrie J, Ramsay C, Sandercock P, Shanahan DR, Summerskill W, Sydes M, Williamson P, Clarke M. Making randomised trials more efficient: report of the first meeting to discuss the Trial Forge platform. Trials 2015; 16:261. [PMID: 26044814 PMCID: PMC4475334 DOI: 10.1186/s13063-015-0776-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/21/2015] [Indexed: 11/17/2022] Open
Abstract
Randomised trials are at the heart of evidence-based healthcare, but the methods and infrastructure for conducting these sometimes complex studies are largely evidence free. Trial Forge ( www.trialforge.org ) is an initiative that aims to increase the evidence base for trial decision making and, in doing so, to improve trial efficiency.This paper summarises a one-day workshop held in Edinburgh on 10 July 2014 to discuss Trial Forge and how to advance this initiative. We first outline the problem of inefficiency in randomised trials and go on to describe Trial Forge. We present participants' views on the processes in the life of a randomised trial that should be covered by Trial Forge.General support existed at the workshop for the Trial Forge approach to increase the evidence base for making randomised trial decisions and for improving trial efficiency. Agreed upon key processes included choosing the right research question; logistical planning for delivery, training of staff, recruitment, and retention; data management and dissemination; and close down. The process of linking to existing initiatives where possible was considered crucial. Trial Forge will not be a guideline or a checklist but a 'go to' website for research on randomised trials methods, with a linked programme of applied methodology research, coupled to an effective evidence-dissemination process. Moreover, it will support an informal network of interested trialists who meet virtually (online) and occasionally in person to build capacity and knowledge in the design and conduct of efficient randomised trials.Some of the resources invested in randomised trials are wasted because of limited evidence upon which to base many aspects of design, conduct, analysis, and reporting of clinical trials. Trial Forge will help to address this lack of evidence.
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Affiliation(s)
- Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Doug G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Nuffield Orthopaedics Centre, Windmill Road, Oxford, OX3 7LD, UK.
| | - Peter Bower
- Medical Research Council North West Hub for Trials Methodology Research, Manchester Academic Health Science Centre, Centre for Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Marion Campbell
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | | | - Seonaidh Cotton
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - David Crosby
- Medical Research Council, Methodology Research Programme (MRC MRP), London, UK.
| | - Peter Davidson
- Consultant in Public Health and Head of Health Technology Assessment, National Institute for Health Research, Evaluation, Trials, and Studies Coordinating Centre, University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK.
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Lelia Duley
- Nottingham Clinical Trials Unit (NCTU), Nottingham Health Science Partners, C Floor, South Block, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH, UK.
| | - Janet Dunn
- Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, UK.
| | - Diana Elbourne
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Barbara Farrell
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
| | - Carrol Gamble
- North West Hub for Trials Methodology Research, University of Liverpool, 1st floor Duncan Building, Daulby Street, Liverpool, L69 3GA, UK.
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Kerry Hood
- South East Wales Trials Unit (SEWTU), School of Medicine, Cardiff University, Cardiff, UK.
| | - Trudie Lang
- The Global Health Network, Oxford University Centre for Tropical Medicine, University of Oxford, Oxford, UK.
| | | | - Kirsty Loudon
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Alison McDonald
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Gladys McPherson
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Annmarie Nelson
- Marie Curie Palliative Care Research Centre, Cardiff University School of Medicine, Heath Park, Cardiff, Wales, CF14 4YS, UK.
| | - John Norrie
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Peter Sandercock
- Division of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
| | | | | | - Matt Sydes
- Medical Research Council, Clinical Trials Unit (MRC CTU), London, UK.
| | - Paula Williamson
- North West Hub for Trials Methodology Research and Department of Biostatistics, University of Liverpool, 1st floor Duncan Building Daulby Street, Liverpool, L69 3GA, UK.
| | - Mike Clarke
- Institute of Clinical Sciences, Block B, Queens University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK.
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Liira H, Saarelma O, Callaghan M, Harbour R, Jousimaa J, Kunnamo I, Loudon K, Mcfarlane E, Treweek S. Patients, health information, and guidelines: A focus-group study. Scand J Prim Health Care 2015. [PMID: 26205344 PMCID: PMC4750726 DOI: 10.3109/02813432.2015.1067517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Evidence-based clinical guidelines could support shared decision-making and help patients to participate actively in their care. However, it is not well known how patients view guidelines as a source of health information. This qualitative study aimed to assess what patients know about guidelines, and what they think of their presentation formats. RESEARCH QUESTION What is the role of guidelines as health information for patients and how could the implementation of evidence-based information for patients be improved? METHODS A qualitative study with focus groups that were built around a semi-structured topic guide. Focus groups were audiotaped and transcribed and analysed using a phenomenographic approach. RESULTS Five focus groups were carried out in 2012 with a total of 23 participants. Patients searched for health information from the Internet or consulted health professionals or their personal networks. The concepts of guidelines included instructions or standards for health professionals, information given by a health professional to the patient, and material to protect and promote the interests of patients. Some patients did not have a concept for guidelines. Patients felt that health information was abundant and its quality sometimes difficult to assess. They respected conciseness, clarity, clear structure, and specialists or well-known organizations as authors of health information. Patients would like health professionals to deliver and clarify written materials to them or point out to them the relevant Internet sites. CONCLUSIONS The concept of guidelines was not well known among our interviewees; however, they expressed an interest in having more communication on health information, both written information and clarifications with their health professionals.
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Affiliation(s)
- Helena Liira
- Correspondence: Helena Liira, 15 Atkinson Road, Subiaco 6008 WA, Australia.
| | - Osmo Saarelma
- Duodecim Medical Publications Ltd, Helsinki, Finland
| | - Margaret Callaghan
- Scottish Intercollegiate Guidelines Network, NHS Healthcare Improvement Scotland, Glasgow, Scotland
| | - Robin Harbour
- Scottish Intercollegiate Guidelines Network, NHS Healthcare Improvement Scotland, Glasgow, Scotland
| | | | | | - Kirsty Loudon
- Division of Population Health Sciences, University of Dundee, UK
| | - Emma Mcfarlane
- National Institute for Health and Care Excellence, Manchester, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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