Zikmund-Fisher Brian J, Scherer Aaron M, Witteman Holly O, Solomon Jacob B, Exe Nicole L, Tarini Beth A, Fagerlin Angela
Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.
Department of Internal Medicine, University of Michigan.
J Am Med Inform Assoc. 2017 May 1;24(3):520-528. doi: 10.1093/jamia/ocw169.
Most electronic health record systems provide laboratory test results to patients in table format. We tested whether presenting such results in visual displays (number lines) could improve understanding.
We presented 1620 adults recruited from a demographically diverse Internet panel with hypothetical results from several common laboratory tests, first showing near-normal results and then more extreme values. Participants viewed results in either table format (with a "standard range" provided) or one of 3 number line formats: a simple 2-color format, a format with diagnostic categories such as "borderline high" indicated by colored blocks, and a gradient format that used color gradients to smoothly represent increasing risk as values deviated from standard ranges. We measured respondents' subjective sense of urgency about each test result, their behavioral intentions, and their perceptions of the display format.
Visual displays reduced respondents' perceived urgency and desire to contact health care providers immediately for near-normal test results compared to tables but did not affect their perceptions of extreme values. In regression analyses controlling for respondent health literacy, numeracy, and graphical literacy, gradient line displays resulted in the greatest sensitivity to changes in test results.
Unlike tables, which only tell patients whether test results are normal or not, visual displays can increase the meaningfulness of test results by clearly defining possible values and leveraging color cues and evaluative labels.
Patient-facing displays of laboratory test results should use visual displays rather than tables to increase people's sensitivity to variations in their results.
大多数电子健康记录系统以表格形式向患者提供实验室检查结果。我们测试了以视觉显示（数轴）呈现这些结果是否能提高理解度。
我们向从具有人口统计学多样性的互联网小组招募的1620名成年人展示了几种常见实验室检查的假设结果，先展示接近正常的结果，然后是更极端的值。参与者以表格形式（提供“标准范围”）或三种数轴形式之一查看结果：一种简单的双色形式、一种带有诊断类别（如用彩色块表示“临界高值”）的形式，以及一种渐变形式，该形式使用颜色渐变来随着值偏离标准范围而平滑地表示风险增加。我们测量了受访者对每个检查结果的主观紧迫感、他们的行为意图以及他们对显示形式的看法。
与表格相比，视觉显示降低了受访者对接近正常检查结果的紧迫感以及立即联系医疗服务提供者的意愿，但并未影响他们对极端值的看法。在控制受访者健康素养、算术能力和图形素养的回归分析中，渐变线显示对检查结果变化的敏感度最高。
与仅告知患者检查结果是否正常的表格不同，视觉显示可以通过清晰定义可能的值并利用颜色提示和评估标签来提高检查结果的意义。
面向患者的实验室检查结果显示应使用视觉显示而非表格，以提高人们对其结果变化的敏感度。
