Multilayered and digitally structured presentation formats of trustworthy recommendations : A combined survey and randomised trial
Brandt, Linn (University of Oslo)
Vandvik, Per Olav (University of Oslo)
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Akl, Elie A. (American University of Beirut)
Thornton, Judith (National Institute for Health and Care Excellence)
Rigau, David (Institut d'Investigació Biomèdica Sant Pau)
Adams, Katie (National Institute for Health and Care Excellence)
O'connor, Paul (National Institute for Health and Care Excellence)
Guyatt, Gordon (McMaster University (Canadà))
Kristiansen, Anette (University of Oslo)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format - compared to a standard format - as well as conceptual understanding of trustworthy guideline concepts. Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts. Mandatory educational lectures in 7 non-academic and academic hospitals, and 2 settings involving primary care in Lebanon, Norway, Spain and the UK. 181 practicing physicians in internal medicine (156) and general practice (25). A new digitally structured, multilayered guideline presentation format and a standard narrative presentation format currently in widespread use. Our primary outcome was preference for presentation format. Understanding, perceived usefulness and perception of absolute effects were secondary outcomes. 72% (95% CI 65 to 79) of participants preferred the multilayered format and 16% (95% CI 10 to 22) preferred the standard format. A majority agreed that recommendations (multilayered 86% vs standard 91%, p value=0. 31) and evidence summaries (79% vs 77%, p value=0. 76) were useful in the context of the clinical scenario. 72% of participants randomised to the multilayered format vs 58% for standard formats reported correct understanding of the recommendations (p value=0. 06). Most participants elected an appropriate clinical action after viewing the recommendations (98% vs 92%, p value=0. 10). 82% of the participants considered absolute effect estimates in evidence summaries helpful or crucial. Clinicians clearly preferred a novel multilayered presentation format to the standard format. Whether the preferred format improves decision-making and has an impact on patient important outcomes merits further investigation.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Ressenya ; recerca ; Versió publicada
Matèria:	EPIDEMIOLOGY
Publicat a:	BMJ open, Vol. 7 Núm. 2 (january 2017) , p. e011569, ISSN 2044-6055

DOI: 10.1136/bmjopen-2016-011569
PMID: 28188149

9 p, 1.6 MB

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