Trevena LJ, Davey HM, Barratt A, Butow P, Caldwell P, et al.
Journal of evaluation in clinical practice. Date of publication 2006 Feb 1;volume 12(1):13-23.
1. J Eval Clin Pract. 2006 Feb;12(1):13-23.
A systematic review on communicating with patients about evidence.
Trevena LJ(1), Davey HM, Barratt A, Butow P, Caldwell P.
Author information:
(1)Screening & Test Evaluation Program, School of Public Health, University of
Sydney, Sydney, NSW, Australia. lyndalt@health.usyd.edu.au
OBJECTIVE: To conduct a systematic search for (1) the effectiveness of
evidence-based communication tools to increase patient understanding of evidence,
(2) effective formats for representing probabilistic information and (3)
effective strategies for eliciting patient preferences about evidence. A case
scenario is used to illustrate some of the difficulties of putting these results
into practice.
DATA SOURCES: Systematic search of The Cochrane Library, Medline, Psychinfo,
Embase and Cancerlit.
REVIEW METHODS: Systematic reviews of randomized controlled trials (RCTs) and
high quality RCTs were included. Studies were excluded if they did not address
the question, were focused on behavioural outcomes without attempting to increase
understanding, were concerned with counselling as a therapeutic intervention, or
were specific to communication regarding clinical trial participation.
RESULTS: We found 10 systematic reviews of RCTs and 30 additional RCTs addressing
our questions. Communication tools in most formats (verbal, written, video,
provider-delivered, computer-based) will increase patients' understanding but are
more likely to do so if structured, tailored and/or interactive. Probabilistic
information is best represented as event rates (natural frequencies) in relevant
groups of people, rather than words, probabilities or summarized as effect
measures such as relative risk reduction. Illustrations such as cartoons, or
graphs (vertical bar charts) appear to aid understanding. Values clarification
exercises may be better than standard utility techniques for eliciting
preferences in individual decision making. Looking for effective evidence-based
communication tools for prostatic specific antigen testing highlighted the
challenges for clinicians and consumers in accessing tools that are
evidence-based in design as well as content.
CONCLUSION: There is an increasing body of evidence supporting the design of
effective evidence-based communication tools but variable access to such tools in
practice.
DOI: 10.1111/j.1365-2753.2005.00596.x
PMID: 16422776 [Indexed for MEDLINE]
