Assessing the optimal presentation of how patients value health outcomes (values and preferences): A qualitative user testing

Article type
Authors
Zhang Y1, Li S2, Yepes-Nunez JJ3, Alonso Coello P4, Pardo-Hernandez H5, Morgan R3, Guyatt G3, Schünemann H3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
2University of Toronto
3Department of Health Research Methods, Evidence, and Impact, McMaster University
4Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain
5Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona
Abstract
Background: We conceptualise patient values and preferences as how patients value the relative importance of health outcomes. A transparent and structured approach to communicate this type of evidence remains unavailable.

Objectives: To develop and evaluate the use of the current summary of findings table formats for the presentation of outcome importance (values and preferences) evidence.

Methods: We developed a tabulated presentation of findings and certainty of evidence, based on the existing GRADE Summary of findings table. Following development, the new-SoF table for presenting the outcome importance evidence, was piloted through brainstorming sessions, and presented to a purposeful sample of systematic review authors and guideline developers using a semi-structured interview format. We analysed the data using an inductive content analysis strategy and Morville's Honeycomb model.

Results: The findings from the user testing interviews were largely related to usability and usefulness of the table. Although the table is in general easy to use, some users misunderstood evidence regarding utilities and variability within studies (as opposed to inconsistency about typical values). To address the former we added a visual analogue scale to clarify the evidence presentation. The settings on which users focused were most often the guideline development process, although the participants felt that the table could be used to summarise and/or present evidence, or for clinicians to initiate a conversation with patients about what is most important to them.

Conclusions: Using rigorous methods we developed a user-friendly summary of findings table to present the evidence regarding outcome importance. Subsequent work will explore the additional value of the summary of finding table and possible alternative formats.