Investigating and improving the understanding of Cochrane diagnostic test accuracy reviews (DTARs)

Article type
Authors
Zhelev Z1, Garside R1, Hyde C1
1Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, UK
Abstract
Background: The understanding and application of test accuracy information for clinical and policy decision making is difficult, and further complicated when primary test evaluations are systematically reviewed and meta-analysed. No research has yet explored health professionals’ understanding and interpretation of such reviews. At the 2010 Colloquium we presented the protocol for the current study, which is now underway.

Objectives: We aim to explore how clinicians and policy makers, who vary in knowledge and experience with test accuracy and systematic reviews, extract and interpret information from Cochrane Diagnostic Test Accuracy Reviews (DTARs). We hope that the findings will help the Cochrane Collaboration to improve the presentation and accessibility of this type of review, and will ultimately result in increased use of test accuracy information in clinical and policy decision making.

Methods: An online survey gathered preliminary information about clinicians' and policy makers' experience with test accuracy information and systematic reviews. Based on this, a purposive sample is being selected to take part in cognitive interviews, using one of the three existing Cochrane DTARs as material. The interviews are video-recorded and transcribed, and qualitative analysis is carried out to identify patterns in participants' 'reading’ and interpretation of the reviews with a particular focus on the difficulties encountered.

Study progress and preliminary findings: Final results will be available by the end of August 2011. Preliminary analysis of the survey and the number of interviews completed so far suggests, however, that there are a number of common difficulties experienced when reading a DTAR including statistical and clinical terminology, the way in which information is structured and presented, and navigating the document. This points to specific ways of improving DTARs' presentation and accessibility. In addition, the study demonstrates the value of this innovative way of using cognitive interviewing and the possibilities of its application in other research.