Information Derived from Cochrane Reviews -A Health Consumer's View

Article type
Authors
Wale J
Abstract
Objective: Cochrane Reviews reliably provide good clinical evidence. This poster encourages efforts by Cochrane Review Groups to involve their consumers in considering ways of presenting their information in useful and accessible ways for a wide audience. A 'Consumer Meta Review of Osteoarthritis' is appended as an example of such an effort.

Methods: Examination of the present 'state of the art' reveals shortcomings in the manner in which information from Cochrane Reviews is currently disseminated to consumers. Reviews and their abstracts are presented in language indecipherable to many; it is not possible to find all the information pertinent to a particular condition in one document; less than useful conclusions of insufficient clinical evidence are frequently drawn from reviews. Some of these limitations have been noted in the media (Melissa Sweet, Bulletin) and may result in a failure to reference Cochrane (MyDr). Attempts to address these issues - consumer summaries for Canadian Arthritis Society WebPages, Cochrane consumer Synopses and Hot Topics - go only some of the way towards more adequately meeting the needs of consumers.

Results: A consumer-focussed meta review on osteoarthritis was prepared from Musculoskeletal Review Groups' reviews andprotocols. The brief was to provide a comprehensive cover of the health condition, including the various treatment options, time factors where available, and adverse events in the context of the various stages of progression of the disease.
The meta review is essentially an exercise in education that is responsive to the consumer's needs. It is empathic to a patient's perspective, offering respectful knowledge transference. Consumers do not wish to be addressed in a manner that might be considered patronising or insulting to their intelligence, common sense and sense of self-worth. The present approach encourages collaborative decision making in partnership with health professionals. The consumer typically contributes a very different perspective on the process of a disease, on quality of life issues, on the extent and effect of medical procedures in the short and long term, and on the value of treatment weighted against possible and probable adverse events or consequences. Decisions made in partnership may differ substantially from a treatment regimen determined solely by a health professional. At the heart of this approach is the conviction that consumers have a right to know the reality of a situation and have the freedom to move away from a 'let's try this' approach to a more systematic education and treatment plan that is sensitive to their individual needs.

Conclusions: Consumers who have experienced disease have their own perspective on disease. Priorities in terms of the information they desire, treatment plans and options, may differ from the perspective of those who generally prepare information or WebPages, the health professionals governing their health care, and researchers. There is a need to provide information from Cochrane Reviews in a form that is easily readable by lay people; presented with empathy and sensitivity to the subject; and provides a comprehensive cover of the topic. This transference of information has further potential impact through consumer involvement in policy-making bodies.