Article type
Year
Abstract
Background: Patients are increasingly expected to be actively involved in their care. Moreover, making evidence-based decisions with patients to aid healthcare and treatment decisions is well recognised. Few evidence-based communication tools exist that successfully engage and aid consumer understanding in a format that also facilitates evidence-based clinical decisions.
Objectives: To develop a tool that presents the best available evidence for treatment effects that enables both patients and clinicians to make better informed treatment and healthcare decisions.
Methods: Using treatment of hypertension with angiotensin converting enzyme inhibitors (ACEi) as an example, we searched the output of the Cochrane Hypertension Review Group for relevant systematic reviews and found one suitable review. We extracted data into Excel on the mean effect (95% confidence limits (Cl)) of 14 ACEi on systolic blood pressure (SBP) only. These data were used to create a modified bar chart. Each ACEi was displayed in descending order according to the certainty of effects based on 95% Cl. The modified chart was inserted into a table column with the heading 'Blood pressure effect performance'. Other columns included ‘Dose’, ‘Cost’, ‘Sample size’ and ‘Duration’. These columns provide data on the dosage of drug for the observed blood pressure effect, the cost on a daily basis based on the dose, the number of studies and participants for the observed effect and the duration of treatment/follow-up of these studies. Individual sections with the headings ‘Technical Information’, ‘Cost information’, ‘Dose information’, ‘Quality information’ and ‘Usage information’ are placed under the table and provide clarification and further details of the information contained therein.
Results: We present the methods used to derive the first Evidence of Effects Page (EEP) as a new and effective way to present the evidence for treatment effects.
Conclusions: EEPs for treatments of most health conditions can now be developed, and their efficacy in improving informed and shared-decisions can be assessed in suitable trials.
Objectives: To develop a tool that presents the best available evidence for treatment effects that enables both patients and clinicians to make better informed treatment and healthcare decisions.
Methods: Using treatment of hypertension with angiotensin converting enzyme inhibitors (ACEi) as an example, we searched the output of the Cochrane Hypertension Review Group for relevant systematic reviews and found one suitable review. We extracted data into Excel on the mean effect (95% confidence limits (Cl)) of 14 ACEi on systolic blood pressure (SBP) only. These data were used to create a modified bar chart. Each ACEi was displayed in descending order according to the certainty of effects based on 95% Cl. The modified chart was inserted into a table column with the heading 'Blood pressure effect performance'. Other columns included ‘Dose’, ‘Cost’, ‘Sample size’ and ‘Duration’. These columns provide data on the dosage of drug for the observed blood pressure effect, the cost on a daily basis based on the dose, the number of studies and participants for the observed effect and the duration of treatment/follow-up of these studies. Individual sections with the headings ‘Technical Information’, ‘Cost information’, ‘Dose information’, ‘Quality information’ and ‘Usage information’ are placed under the table and provide clarification and further details of the information contained therein.
Results: We present the methods used to derive the first Evidence of Effects Page (EEP) as a new and effective way to present the evidence for treatment effects.
Conclusions: EEPs for treatments of most health conditions can now be developed, and their efficacy in improving informed and shared-decisions can be assessed in suitable trials.