Kristiansen Annette, Brandt Linn, Alonso-Coello Pablo, Agoritsas Thomas, Akl Elie A, Conboy Tara, Elbarbary Mahmoud, Ferwana Mazen, Medani Wedad, Murad Mohammad Hassan, Rigau David, Rosenbaum Sarah, Spencer Frederick A, Treweek Shaun, Guyatt Gordon, Vandvik Per Olav
Department of Internal Medicine, Institute for Health and Society, Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway.
Iberoamerican Cochrane Centre, Clinical Epidemiology and Public Health Department, Institute of Biomedical Research, Sant Pau, Spain.
Chest. 2015 Mar;147(3):754-763. doi: 10.1378/chest.14-1366.
Bridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs).
We carried out multiple cycles of brainstorming and sketching, developing a prototype. Physicians participating in the user testing viewed CPG formats linked to clinical scenarios and engaged in semistructured interviews applying a think-aloud method for exploring important aspects of user experience.
We developed a multilayered presentation format that allows clinicians to successively view more in-depth information. Starting with the recommendations, clinicians can, on demand, access a rationale and a key information section containing statements on quality of the evidence, balance between desirable and undesirable consequences, values and preferences, and resource considerations. We collected feedback from 27 stakeholders and performed user testing with 47 practicing physicians from six countries. Advisory group feedback and user testing of the first version revealed problems with conceptual understanding of underlying CPG methodology, as well as difficulties with the complexity of the layout and content. Extensive revisions made before the second round of user testing resulted in most participants expressing overall satisfaction with the final presentation format.
We have developed an electronic, multilayered, CPG format that enhances the usability of CPGs for frontline clinicians. We have implemented the format in electronic guideline tools that guideline organizations can now use when authoring and publishing their guidelines.
弥合临床研究与日常医疗实践之间的差距需要有效的沟通策略。为解决当前在传达实践建议和支持证据方面的不足，我们正在创建并测试临床实践指南（CPG）的呈现形式。
我们进行了多个轮次的头脑风暴和草图设计，开发出一个原型。参与用户测试的医生查看了与临床场景相关联的CPG形式，并采用出声思考法进行半结构化访谈，以探索用户体验的重要方面。
我们开发了一种多层呈现形式，使临床医生能够依次查看更深入的信息。从建议开始，临床医生可以根据需要访问一个理论依据和一个关键信息部分，其中包含关于证据质量、期望与不期望后果之间的平衡、价值观和偏好以及资源考量的陈述。我们收集了27位利益相关者的反馈，并对来自六个国家的47名执业医生进行了用户测试。第一轮版本的咨询小组反馈和用户测试揭示了对CPG基本方法的概念理解存在问题，以及布局和内容复杂性方面的困难。在第二轮用户测试之前进行的广泛修订使大多数参与者对最终呈现形式总体表示满意。
我们开发了一种电子多层CPG形式，提高了CPG对一线临床医生的可用性。我们已将该形式应用于电子指南工具中，指南组织在编写和发布指南时现在可以使用。
