Finding a common language to communicate test accuracy evidence: public, clinician and media perspectives

Article type
Authors
Davenport C1, Whiting P2, Leeflang M3, Clooney G2, Gopalakrishna G3
1University Birmingham
2University of Bristol
3University of Amsterdam
Abstract
Background:
There is widespread recognition of the difficulties associated with communicating the relevance of evidence about test accuracy to patients and clinicians. The concept of a 'lay' audience for diagnostic test accuracy (DTA) reviews is likely to be broad, which has implications for effective communication of results in plain language.

Objectives:
Drawing on the perspectives of potential users of plain language summaries (PLS) for DTA reviews to:

- explore views concerning the structure and content of a DTA review PLS;
- explore the possibility of agreeing terminology that might result in a shared understanding about DTA review methods and results for all potential stakeholders.

Methods:
In the context of developing guidance for writing PLS for DTA reviews, we used a mixed methods approach (focus groups, user testing using individual interviews and two web-based surveys) with members of the public, patients, clinicians and journalists. We used a thematic qualitative process to identify emerging themes that we discussed iteratively within the project team to achieve consensus regarding amendments to the emerging PLS guidance.

Results:
We presented three successive versions of the PLS to participants. Emerging themes included: structure (order of information presented, length, textual versus graphic presentation of results and paper versus online format); content (use and wording of subheadings, provision of contextual information); and reading and understanding (communicating the impact of study quality on review findings, translating technical to lay terminology, meeting the needs of different users, communicating the potential impact of a test's accuracy for patients).

Conclusions:
Development of PLS guidance for DTA reviews generated examples of structure and terminology that were accessible across different users. The guidance is therefore likely to be useful when writing summary sections of DTA reviews such as the Abstract and 'Summary of findings' table. Reconciling the needs of a multiple types of consumer in a standalone document has proved difficult.

Patient or healthcare consumer involvement:
The general public, patients, professionals and journalists contributed to the findings of this research. Participant quotes will be used as part of the presentation to illustrate the basis of the themes that emerged.