Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
Department of Clinical Chemistry, Reinier Medical Diagnostic Center, Delft, Netherlands.
J Med Internet Res. 2024 Aug 12;26:e53993. doi: 10.2196/53993.
Direct access of patients to their web-based patient portal, including laboratory test results, has become increasingly common. Numeric laboratory results can be challenging to interpret for patients, which may lead to anxiety, confusion, and unnecessary doctor consultations. Laboratory results can be presented in different formats, but there is limited evidence regarding how these presentation formats impact patients' processing of the information.
This study aims to synthesize the evidence on effective formats for presenting numeric laboratory test results with a focus on outcomes related to patients' information processing, including affective perception, perceived magnitude, cognitive perception, perception of communication, decision, action, and memory.
The search was conducted in 3 databases (PubMed, Web of Science, and Embase) from inception until May 31, 2023. We included quantitative, qualitative, and mixed methods articles describing or comparing formats for presenting diagnostic laboratory test results to patients. Two reviewers independently extracted and synthesized the characteristics of the articles and presentation formats used. The quality of the included articles was assessed by 2 independent reviewers using the Mixed Methods Appraisal Tool.
A total of 18 studies were included, which were heterogeneous in terms of study design and primary outcomes used. The quality of the articles ranged from poor to excellent. Most studies (n=16, 89%) used mock test results. The most frequently used presentation formats were numerical values with reference ranges (n=12), horizontal line bars with colored blocks (n=12), or a combination of horizontal line bars with numerical values (n=8). All studies examined perception as an outcome, while action and memory were studied in 1 and 3 articles, respectively. In general, participants' satisfaction and usability were the highest when test results were presented using horizontal line bars with colored blocks. Adding reference ranges or personalized information (eg, goal ranges) further increased participants' perception. Additionally, horizontal line bars significantly decreased participants' tendency to search for information or to contact their physician, compared with numerical values with reference ranges.
In this review, we synthesized available evidence on effective presentation formats for laboratory test results. The use of horizontal line bars with reference ranges or personalized goal ranges increased participants' cognitive perception and perception of communication while decreasing participants' tendency to contact their physicians. Action and memory were less frequently studied, so no conclusion could be drawn about a single preferred format regarding these outcomes. Therefore, the use of horizontal line bars with reference ranges or personalized goal ranges is recommended to enhance patients' information processing of laboratory test results. Further research should focus on real-life settings and diverse presentation formats in combination with outcomes related to patients' information processing.
患者直接访问他们的基于网络的患者门户，包括实验室测试结果，已经变得越来越普遍。对于患者来说，数值实验室结果可能难以解释，这可能导致焦虑、困惑和不必要的医生咨询。实验室结果可以以不同的格式呈现，但关于这些呈现格式如何影响患者对信息的处理，证据有限。
本研究旨在综合有效呈现数值实验室测试结果的格式证据，重点关注与患者信息处理相关的结果，包括情感感知、感知大小、认知感知、沟通感知、决策、行动和记忆。
该搜索在 3 个数据库（PubMed、Web of Science 和 Embase）中进行，从成立到 2023 年 5 月 31 日。我们纳入了描述或比较向患者呈现诊断实验室测试结果的格式的定量、定性和混合方法文章。两位审查员独立提取和综合了文章和使用的呈现格式的特征。使用混合方法评估工具对纳入文章的质量进行了两位独立审查员的评估。
共有 18 项研究纳入，研究设计和主要结果使用方面存在异质性。文章的质量从差到优不等。大多数研究（n=16，89%）使用模拟测试结果。最常用的呈现格式是带有参考范围的数值（n=12）、带有彩色块的水平条形图（n=12）或水平条形图与数值的组合（n=8）。所有研究都将感知作为一个结果进行了检验，而行动和记忆分别在 1 项和 3 项研究中进行了检验。一般来说，当使用带有彩色块的水平条形图呈现测试结果时，参与者的满意度和可用性最高。添加参考范围或个性化信息（例如，目标范围）进一步增加了参与者的感知。此外，与带有参考范围的数值相比，水平条形图显著降低了参与者寻找信息或联系医生的倾向。
在本综述中，我们综合了关于实验室测试结果有效呈现格式的现有证据。使用带有参考范围或个性化目标范围的水平条形图增加了参与者的认知感知和沟通感知，同时降低了参与者联系医生的倾向。关于这些结果，行动和记忆的研究较少，因此无法得出单一首选格式的结论。因此，建议使用带有参考范围或个性化目标范围的水平条形图来增强患者对实验室测试结果的信息处理。未来的研究应侧重于现实生活环境和多种呈现格式与与患者信息处理相关的结果相结合。
