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Barreto JOM, de Melo RC, da Silva LALB, de Araújo BC, de Freitas Oliveira C, Toma TS, de Bortoli MC, Demaio PN, Kuchenmüller T. Research evidence communication for policy-makers: a rapid scoping review on frameworks, guidance and tools, and barriers and facilitators. Health Res Policy Syst 2024; 22:99. [PMID: 39118156 PMCID: PMC11312384 DOI: 10.1186/s12961-024-01169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/23/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.
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Affiliation(s)
| | | | | | | | | | | | | | - Peter Nichols Demaio
- McMaster Health Forum, Hamilton, Canada
- Department of Health, Aging and Society, McMaster University, Hamilton, Canada
| | - Tanja Kuchenmüller
- Evidence to Policy and Impact, Research for Health, Science Division, World Health Organization, Geneva, Switzerland
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Osti T, Valz Gris A, Corona VF, Villani L, D'Ambrosio F, Lomazzi M, Favaretti C, Cascini F, Gualano MR, Ricciardi W. Public health leadership in the COVID-19 era: how does it fit? A scoping review. BMJ LEADER 2024; 8:174-182. [PMID: 37709494 DOI: 10.1136/leader-2022-000653] [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: 06/28/2022] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
The COVID-19 pandemic has put a lot of pressure on all the world's health systems and public health leaders who have often found themselves unprepared to handle an emergency of this magnitude. This study aims to bring together published evidence on the qualities required to leaders to deal with a public health issue like the COVID-19 pandemic. This scoping literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A search of relevant articles was performed in the PubMed, Scopus and Web of Science databases. A total of 2499 records were screened, and 45 articles were included, from which 93 characteristics of effective leadership were extrapolated and grouped into 6 clusters. The qualities most frequently reported in the articles were human traits and emotional intelligence (46.7%) and communication skills such as transparency and reliability (48.9%). Responsiveness and preparedness (40%), management skills (33.3%) and team working (35.6%) are considered by a significant percentage of the articles as necessary for the construction of rapid and effective measures in response to the emergency. A considerable proportion of articles also highlighted the need for leaders capable of making evidence-based decisions and driving innovation (31.1%). Although identifying leaders who possess all the skills described in this study appears complex, determining the key characteristics of effective public health leadership in a crisis, such as the COVID-19 pandemic, is useful not only in selecting future leaders but also in implementing training and education programmes for the public health workforce.
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Affiliation(s)
- Tommaso Osti
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Angelica Valz Gris
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Valerio Flavio Corona
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Marta Lomazzi
- World Federation of Public Health Association, Geneva, Switzerland
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Carlo Favaretti
- Leadership Research Center, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Fidelia Cascini
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
| | - Maria Rosaria Gualano
- Leadership Research Center, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
- UniCamillus - Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
- Leadership Research Center, Università Cattolica del Sacro Cuore-Campus di Roma, Rome, Italy
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Büchter RB, Albrecht M, Grimm M, Seelig M, Steckelberg A, Rahn AC. [Advancing standards for the development of evidence-based health information for consumers: Needs and priorities among members of the Network for Evidence-based Medicine]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 187:42-52. [PMID: 38744602 DOI: 10.1016/j.zefq.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/27/2024] [Accepted: 03/31/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development. METHODS In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively. RESULTS Among the 41 participants, only 23% considered the standards to be sufficient, and only 55% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n=46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, "presenting benefits and harms" and "content beyond treatments (in particular, diagnostics and prognosis)" were considered to be the most important (n=36). DISCUSSION Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability - for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a limited response rate. CONCLUSIONS The needs assessment showed that the currently established standards and recommendations for the development of evidence-based health information in the German-speaking regions represent important cornerstones but need to be expanded to answer more practice-oriented questions. The challenges and proposed solutions stated by the participants can help further develop the standards. The prioritization can be used to set priorities for the development of the standards, guide the order of possible work packages and allocate resources.
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Affiliation(s)
- Roland Brian Büchter
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln, Deutschland; für den Fachbereich Patienteninformation und -beteiligung des EbM-Netzwerks.
| | - Martina Albrecht
- SHARE TO CARE, Patientenzentrierte Versorgung GmbH, Köln, Deutschland
| | | | | | - Anke Steckelberg
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Anne Christin Rahn
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Deutschland; für den Fachbereich Patienteninformation und -beteiligung des EbM-Netzwerks
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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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L'Heureux J, McTaggart-Cowan H, Johns G, Chen L, Steiner T, Tocher P, Sun H, Zhang W. How to present work productivity loss results from clinical trials for patients and caregivers? A mixed methods approach. Soc Sci Med 2023; 328:115999. [PMID: 37276772 DOI: 10.1016/j.socscimed.2023.115999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES From the perspectives of patients and caregivers, the objectives were: identifying which result presentations, describing work productivity loss (WPL) outcomes, are most understandable; measuring which presentations are important to report; and investigating which WPL outcomes are viewed as important alongside clinical trials results. METHODS We used a four phased, sequential mixed methods design, guided by patient-oriented research engaging one patient partner. We conducted think-aloud interviews, in British Columbia/Canada, to review WPL results and our survey measuring the understandability and importance of the results, and importance of each WPL outcome. We surveyed a sample representing working Canadians. The findings were summarized and analyzed using linear and logistic regression. We conducted sub-group analyses; one was gender based. All regressions were conducted using generalized estimating equations. RESULTS In our qualitative phases, 20 patients and caregivers were interviewed. Participants recommended for the results to be brief, simple, and represented visually. Then, 118 patients and 120 caregivers were surveyed. The results presented in days or cost yielded the highest understandability and importance to report. All WPL outcomes were identified as important to somewhat important to report by most. The associations indicated that the more understandable the result presentation was, the more likely it was to be rated as important. Age was the only factor significantly associated with selecting days or cost as the most important result. CONCLUSION Presenting WPL results in days and cost, using lay terms and visual supports, were viewed as easiest to understand and most important to report in clinical trials by patients and caregivers. Our findings are supportive of clinical trials standardizing the measurement of WPL to include all of its outcomes (absenteeism, presenteeism, employment status changes and total work productivity loss), in addition to tools assessing the comprehensiveness of WPL results to be provided to patients and caregivers.
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Affiliation(s)
- Jacynthe L'Heureux
- School of Population and Public Health, University of British Columbia; 2206 E Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
| | - Helen McTaggart-Cowan
- Faculty of Health Sciences, Simon Fraser University; Blusson Hall, Room, 11300, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada; British Columbia Cancer Research Centre, 675 W 10th Avenue; Vancouver, British Columbia, V5Z 1L3, Canada.
| | - Gary Johns
- Sauder School of Business, University of British Columbia; 2053 Main Mall, Vancouver, British Columbia, V6T 1Z2, Canada; John Molson School of Business, Concordia University, 1450 Guy Street, Montreal, Quebec, H3H 0A1, Canada.
| | - Lin Chen
- Patient Voices Network, 201-750 Pender Street, Vancouver, British Columbia, V6C 2T8, Canada
| | - Theodore Steiner
- Division of Infectious Diseases, Vancouver General Hospital, 2733 Heather Street, Rm C328 HP East, Vancouver, British Columbia, V5Z 3J5, Canada.
| | - Paige Tocher
- Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
| | - Wei Zhang
- School of Population and Public Health, University of British Columbia; 2206 E Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia; 2405 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
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Davis C, Wagner AK, Salcher-Konrad M, Scowcroft H, Mintzes B, Pokorny AMJ, Lew J, Naci H. Communication of anticancer drug benefits and related uncertainties to patients and clinicians: document analysis of regulated information on prescription drugs in Europe. BMJ 2023; 380:e073711. [PMID: 36990506 PMCID: PMC10053600 DOI: 10.1136/bmj-2022-073711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe. DESIGN Document content analysis. SETTING European Medicines Agency. PARTICIPANTS Anticancer drugs granted a first marketing authorisation by the European Medicines Agency, 2017-19. MAIN OUTCOME MEASURES Whether written information on a product addressed patients' commonly asked questions about: who and what the drug is used for; how the drug was studied; types of drug benefit expected; and the extent of weak, uncertain, or missing evidence for drug benefits. Information on drug benefits in written sources for clinicians (summaries of product characteristics), patients (patient information leaflets), and the public (public summaries) was compared with information reported in regulatory assessment documents (European public assessment reports). RESULTS 29 anticancer drugs that received a first marketing authorisation for 32 separate cancer indications in 2017-19 were included. General information about the drug (including information on approved indications and how the drug works) was frequently reported across regulated information sources aimed at both clinicians and patients. Nearly all summaries of product characteristics communicated full information to clinicians about the number and design of the main studies, the control arm (if any), study sample size, and primary measures of drug benefit. None of the patient information leaflets communicated information to patients about how drugs were studied. 31 (97%) summaries of product characteristics and 25 (78%) public summaries contained information about drug benefits that was accurate and consistent with information in regulatory assessment documents. The presence or absence of evidence that a drug extended survival was reported in 23 (72%) summaries of product characteristics and four (13%) public summaries. None of the patient information leaflets communicated information about the drug benefits that patients might expect based on study findings. Scientific concerns about the reliability of evidence on drug benefits, which were raised by European regulatory assessors for almost all drugs in the study sample, were rarely communicated to clinicians, patients, or the public. CONCLUSIONS The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
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Affiliation(s)
- Courtney Davis
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Anita K Wagner
- Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Henry Scowcroft
- Alzheimer's Research UK, Cambridge, UK
- National Cancer Research Institute Bladder and Renal Research Group, London, UK
| | - Barbara Mintzes
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian M J Pokorny
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
- Alice Springs Hospital, Northern Territory, Australia
| | - Jianhui Lew
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Huseyin Naci
- Department of Health Policy, London School of Economics and Political Science, London, UK
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Schladitz K, Weitzel EC, Löbner M, Soltmann B, Jessen F, Schmitt J, Pfennig A, Riedel-Heller SG, Gühne U. Demands on Health Information and Clinical Practice Guidelines for Patients from the Perspective of Adults with Mental Illness and Family Members: A Qualitative Study with In-Depth Interviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114262. [PMID: 36361142 PMCID: PMC9659184 DOI: 10.3390/ijerph192114262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 05/21/2023]
Abstract
(1) Background: "Patient health information" promote health literacy. "Patient guidelines" as a sub group reflect the current evidence about illnesses and treatment options adapted to the needs of laypersons. Little is known about factors promoting and hindering their use by people affected by mental illness and their relatives. (2) Methods: Telephone interviews (N = 15; n = 4 adults affected by mental illness, n = 5 relatives, n = 6 both applicable) were conducted according to the Sørensen model of health literacy. Data were recorded, transcribed and content-analyzed following Mayring. (3) Results: Health information is used regularly by individuals affected by mental illness and their relatives, but "patient guidelines" are largely unknown. Yet, there is a great willingness to use them. Main barriers are a lack of statistical knowledge, the complexity of health-related topics and cognitive impairment sometimes accompanying mental illnesses. Target group-oriented adaptation as well as transparent and even-handed presentation of (dis-)advantages of treatment options can increase trust. (4) Conclusions: Health information and guidelines can help affected persons and relatives to make treatment decisions by conveying unbiased, up-to-date knowledge. Target group-specific adaptations should be made for psychiatric illnesses and features specific to mental illnesses compared to physical illnesses should be included. Clinical practice guidelines must be distributed more widely to increase their impact.
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Affiliation(s)
- Katja Schladitz
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
- Correspondence: ; Tel.: +49-341-97-15481
| | - Elena C. Weitzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Bettina Soltmann
- Institute of Clinical Psychology and Psychotherapy, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01062 Dresden, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937 Köln, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01069 Dresden, Germany
| | - Andrea Pfennig
- Institute of Clinical Psychology and Psychotherapy, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01062 Dresden, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
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Coon JT, Orr N, Shaw L, Hunt H, Garside R, Nunns M, Gröppel-Wegener A, Whear B. Bursting out of our bubble: using creative techniques to communicate within the systematic review process and beyond. Syst Rev 2022; 11:56. [PMID: 35379331 PMCID: PMC8977563 DOI: 10.1186/s13643-022-01935-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Increasing pressure to publicise research findings and generate impact, alongside an expectation from funding bodies to go beyond publication within academic journals, has generated interest in alternative methods of science communication. Our aim is to describe our experience of using a variety of creative communication tools, reflect on their use in different situations, enhance learning and generate discussion within the systematic review community. METHODS Over the last 5 years, we have explored several creative communication tools within the systematic review process and beyond to extend dissemination beyond traditional academic mechanisms. Central to our approach is the co-production of a communication plan with potential evidence users which facilitates (i) the identification of key messages for different audiences, (ii) discussion of appropriate tools to communicate key messages and (iii) exploration of avenues to share them. We aim to involve evidence users in the production of a variety of outputs for each research project cognisant of the many ways in which individuals engage with information. RESULTS Our experience has allowed us to develop an understanding of the benefits and challenges of a wide range of creative communication tools. For example, board games can be a fun way of learning, may flatten power hierarchies between researchers and research users and enable sharing of large amounts of complex information in a thought provoking way, but they are time and resource intensive both to produce and to engage with. Conversely, social media shareable content can be quick and easy to produce and to engage with but limited in the depth and complexity of shareable information. DISCUSSION It is widely recognised that most stakeholders do not have time to invest in reading large, complex documents; creative communication tools can be a used to improve accessibility of key messages. Furthermore, our experience has highlighted a range of additional benefits of embedding these techniques within our project processes e.g. opening up two-way conversations with end-users of research to discuss the implications of findings.
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Affiliation(s)
- Jo Thompson Coon
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK.
| | - Noreen Orr
- University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
| | - Liz Shaw
- University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
| | - Harriet Hunt
- University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
| | - Ruth Garside
- University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
| | - Michael Nunns
- University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
| | | | - Becky Whear
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU, UK
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Oxman AD, Fretheim A, Lewin S, Flottorp S, Glenton C, Helleve A, Vestrheim DF, Iversen BG, Rosenbaum SE. Health communication in and out of public health emergencies: to persuade or to inform? Health Res Policy Syst 2022; 20:28. [PMID: 35248064 PMCID: PMC8897761 DOI: 10.1186/s12961-022-00828-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/11/2022] [Indexed: 01/28/2023] Open
Abstract
Much health communication during the COVID-19 pandemic has been designed to persuade people more than to inform them. For example, messages like "masks save lives" are intended to compel people to wear face masks, not to enable them to make an informed decision about whether to wear a face mask or to understand the justification for a mask mandate. Both persuading people and informing them are reasonable goals for health communication. However, those goals can sometimes be in conflict. In this article, we discuss potential conflicts between seeking to persuade or to inform people, the use of spin to persuade people, the ethics of persuasion, and implications for health communication in the context of the pandemic and generally. Decisions to persuade people rather than enable them to make an informed choice may be justified, but the basis for those decisions should be transparent and the evidence should not be distorted. We suggest nine principles to guide decisions by health authorities about whether to try to persuade people.
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Affiliation(s)
- Andrew D Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway.
| | - Atle Fretheim
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Simon Lewin
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Claire Glenton
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
| | - Arnfinn Helleve
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Didrik Frimann Vestrheim
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
| | - Bjørn Gunnar Iversen
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
| | - Sarah E Rosenbaum
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Skøyen, Postboks 222, 0213, Oslo, Norway
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Chapman E, Pantoja T, Kuchenmüller T, Sharma T, Terry RF. Assessing the impact of knowledge communication and dissemination strategies targeted at health policy-makers and managers: an overview of systematic reviews. Health Res Policy Syst 2021; 19:140. [PMID: 34865640 PMCID: PMC8645346 DOI: 10.1186/s12961-021-00780-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background The use of research evidence as an input for health decision-making is a need for most health systems. There are a number of approaches for promoting evidence use at different levels of the health system, but knowledge of their effectiveness is still scarce. The objective of this overview was to evaluate the effectiveness of knowledge communication and dissemination interventions, strategies or approaches targeting policy-makers and health managers. Methods This overview of systematic reviews used systematic review methods and was conducted according to a predefined and published protocol. A comprehensive electronic search of 13 databases and a manual search in four websites were conducted. Both published and unpublished reviews in English, Spanish or Portuguese were included. A narrative synthesis was undertaken, and effectiveness statements were developed, informed by the evidence identified. Results We included 27 systematic reviews. Three studies included only a communication strategy, while eight only included dissemination strategies, and the remaining 16 included both. None of the selected reviews provided “sufficient evidence” for any of the strategies, while four provided some evidence for three communication and four dissemination strategies. Regarding communication strategies, the use of tailored and targeted messages seemed to successfully lead to changes in the decision-making practices of the target audience. Regarding dissemination strategies, interventions that aimed at improving only the reach of evidence did not have an impact on its use in decisions, while interventions aimed at enhancing users’ ability to use and apply evidence had a positive effect on decision-making processes. Multifaceted dissemination strategies also demonstrated the potential for changing knowledge about evidence but not its implementation in decision-making. Conclusions There is limited evidence regarding the effectiveness of interventions targeting health managers and policy-makers, as well as the mechanisms required for achieving impact. More studies are needed that are informed by theoretical frameworks or specific tools and using robust methods, standardized outcome measures and clear descriptions of the interventions. We found that passive communication increased access to evidence but had no effect on uptake. Some evidence indicated that the use of targeted messages, knowledge-brokering and user training was effective in promoting evidence use by managers and policy-makers. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00780-4.
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Affiliation(s)
| | - Tomas Pantoja
- Family Medicine Department, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Tanja Kuchenmüller
- Evidence to Policy and Impact, Research for Health - Science Division - World Health Organization, Geneva, Switzerland
| | | | - Robert F Terry
- Manager Research Policy, The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
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11
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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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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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13
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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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14
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Wang X, Chen Y, Akl EA, Tokalić R, Marušić A, Qaseem A, Falck-Ytter Y, Lee MS, Siedler M, Barber SL, Zhang M, Chan ESY, Estill J, Kwong JSW, Okumura A, Zhou Q, Yang K, Norris SL. The reporting checklist for public versions of guidelines: RIGHT-PVG. Implement Sci 2021; 16:10. [PMID: 33430911 PMCID: PMC7798200 DOI: 10.1186/s13012-020-01066-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/29/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Public or patient versions of guidelines (PVGs) are derivative documents that "translate" recommendations and their rationale from clinical guidelines for health professionals into a more easily understandable and usable format for patients and the public. PVGs from different groups and organizations vary considerably in terms of quality of their reporting. In order to address this issue, we aimed to develop a reporting checklist for developers of PVGs and other potential users. METHODS First, we collected a list of potential items through reviewing a sample of PVGs, existing guidance for developing and reporting PVGs or other similar evidence-based patient tools, as well as qualitative studies on original studies of patients' needs about the content and/or reporting of information in PVGs or similar evidence-based patient tools. Second, we conducted a two-round Delphi consultation to determine the level of consensus on the items to be included in the final reporting checklist. Third, we invited two external reviewers to provide comments on the checklist. RESULTS We generated the initial list of 45 reporting items based on a review of a sample of 30 PVGs, four PVG guidance documents, and 46 relevant studies. After the two-round Delphi consultation, we formed a checklist of 17 items grouped under 12 topics for reporting PVGs. CONCLUSION The RIGHT-PVG reporting checklist provides an international consensus on the important criteria for reporting PVGs.
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Affiliation(s)
- Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, L8S 4 K1, Canada
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Ružica Tokalić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Amir Qaseem
- American College of Physicians, Philadelphia, PA, USA
| | - Yngve Falck-Ytter
- Division of Internal Medicine, Louis Stokes Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Madelin Siedler
- Division of Physical Education and Exercise Science, University of South Florida, Tampa, FL, USA
| | - Sarah L Barber
- World Health Organization Centre for Health Development, Kobe, 651-0073, Japan
| | - Mingming Zhang
- Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Edwin S Y Chan
- Cochrane Singapore, Singapore Clinical Research Institute, Consortium for Clinical Research & Innovation Singapore, Singapore, Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Joey S W Kwong
- United Nations Population Fund Asia and the Pacific Regional Office, Bangkok, Thailand
| | - Akiko Okumura
- Medical Information Network Distribution Service (MINDS) Guideline Centre, Tokyo, Japan
| | - Qi Zhou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China.
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15
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A systematic review of risk communication in clinical trials: How does it influence decisions to participate and what are the best methods to improve understanding in a trial context? PLoS One 2020; 15:e0242239. [PMID: 33196663 PMCID: PMC7668608 DOI: 10.1371/journal.pone.0242239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background Effective risk communication is challenging. Ensuring potential trial participants’ understand ‘risk’ information presented to them is a key aspect of the informed consent process within clinical trials, yet minimal research has looked specifically at how to communicate probabilities to support decisions about trial participation. This study reports a systematic review of the literature focusing on presentation of probabilistic information or understanding of risk by potential trial participants. Methods A search strategy for risk communication in clinical trials was designed and informed by systematic reviews of risk communication in treatment and screening contexts and supplemented with trial participation terms. Extracted data included study characteristics and the main interventions/findings of each study. Explanatory studies that investigated the methods for presenting probabilistic information within participant information leaflets for a clinical trial were included, as were interventions that focused on optimising understanding of probabilistic information within the context of a clinical trial. Results The search strategy identified a total of 4931 studies. Nineteen papers were selected for full text screening, and seven studies included. All reported results from risk communication studies that aimed to support potential trial participants’ decision making set within hypothetical trials. Five of these were randomised comparisons of risk communication interventions, and two were prospectively designed, non-randomised studies. Study interventions focused on probability presentation, risk framing and risk interpretation with a wide variety of interventions being evaluated and considerable heterogeneity in terms of outcomes assessed. Studies show conflicting findings when it comes to how best to present information, although numerical, particularly frequency formats and some visual aids appear to have promise. Conclusions The evidence base surrounding risk communication in clinical trials indicates that there is as yet no clear optimal method for improving participant understanding, or clear consensus on how it affects their willingness to participate. Further research into risk communication within trials is needed to help illuminate the mechanisms underlying risk perception and understanding and provide appropriate ways to present and communicate risk in a trial context so as to further promote informed choices about participation. A key focus for future research should be to investigate the potential for learning in the evidence on risk communication from treatment and screening decisions when applied to decisions about trial participation.
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