Improving the user experience of evidence.
A design approach to evidence-informed heath care
Sarah E.Rosenbaum
Norwegian Knowledge Centre for the Health Services,
Available online at: http://bit.ly/icI4ua
“……Evidence about the benefits and harms of health care interventions has the potential to improve quality of care. Syntheses of the best available evidence - systematic reviews - can provide valuable information for health care clinicians and policy makers, but these publications are often too lengthy to be useful for decision makers in time-pressed contexts. Condensed summaries of reviews may help, but there is little research about how to design such summaries (what content to include and how to present it), how they will be experienced by users, and their effect. Earlier research to create summaries of Cochrane Reviews has also shown that condensing complex data can be challenging and lead to misrepresentation
This thesis builds on a series of studies examining these issues from several perspectives, with the designed artifact as the main focal point. An underlying assumption for all of this work is that the design of artifacts in which evidence is embedded may shape or influence users’ experiences of this evidence. Given that these artifacts are, in effect, mediating between the domains of evidence production and evidence use (by policymakers, clinicians or the public), they warrant far more attention that they appear to have received to date.
Multiple methods are employed, including a framework from design practice domain.
· The first study is a set of user tests, examining health professionals’user experience of the Cochrane Library (where Cochrane Reviews are published).
The second study involves exploring user and stakeholder feedback to inform iterations of a Summary of Findings Table for Cochrane Reviews.
· The third study is an evaluation of the effect of including a Summary of Findings Table in a Cochrane Review (compared to a Review with no table) on user satisfaction, understanding and time spent to find key messages.
· The fourth study explores user and stakeholder feedback to inform the development of a template for short summaries of systematic reviews that are tailored for health policy makers in low and middle-income countries……”
Evidence summaries tailored to health policy-makers in low- and middle-income countries
Sarah E Rosenbaum,a Claire Glenton,b Charles Shey Wiysonge,c Edgardo Abalos,d Luciano Mignini,d Taryn Young,e Fernando Althabe,f AgustÃn Ciapponi,f Sebastian Garcia Marti,f Qingyue Meng,g Jian Wang,g Ana Maria De la Hoz Bradford,h Suzanne N Kiwanuka,i Elizeus Rutebemberwa,i George W Pariyo,i Signe Flottorp a & Andrew D Oxman a
a Norwegian Knowledge Centre for the Health Services,
b Sintef,
c School of Child and Adolescent Health,
d Centro Rosarino de Estudios Perinatales,
e South African Cochrane Centre,
f Institute for Clinical Effectiveness and Health Policy,
g Centre for Health Management and Policy,
h Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana,
I Health Policy Planning and Management,
Bulletin of the World Health Organization (BLT) -Volume 89, Number 1, January 2011
Available online at: http://bit.ly/gpNl8I
“…..Policy-makers liked a graded entry format (i.e. short summary with key messages up front). They particularly valued the section on the relevance of the summaries for LMICs, which compensated for the lack of locally-relevant detail in the original review. Some struggled to understand the text and numbers. Three issues made redesigning the summaries particularly challenging:
(i) participants had a poor understanding of what a systematic review was;
(ii) they expected information not found in the systematic reviews and
(iii) they wanted shorter, clearer summaries. Solutions included adding information to help understand the nature of a systematic review, adding more references and making the content clearer and the document quicker to scan….”
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