Communicating evidence
One
of the real frustrations about evidence is the disconnect between what the
evidence is, and what the perceptions may be, with the clearest example being
MMR. Each day millions of important decisions are being taken by professionals
and their patients, part of which involves communicating evidence of benefit
and risk, so that informed choices can be made. Do we know the best way of
doing this?
Systematic review
The
simple answer is that we do not, but a systematic review [1] begins helping us
think about it. The review sought studies relating to three questions about
strategies of effective communication. These related to the most effective
decision tools, the most effective formats to represent probabilistic
information, and the most effective way to elicit patient preferences.
Results
Predictably
there is no simple answer to an incredibly complex question, in part because
there is so little research. A few points emerge worth noting:
- Information should be structured or interactive.
- Ideally it should be tailored to the individual as much as possible.
- Natural frequency formats should be used to convey numbers.
- Pictures and graphs can help convey numeric information.
- Written information is helped by pictures or graphs.
Comment
No
surprises here, then, especially for Bandolier readers following our attempts
to find some clarity. It helps to see that others find nothing much more, and
it helps to define research agendas. There are opportunities here for simple,
inexpensive, but important research.
The
review is perhaps most important because it demonstrates an enormous black hole
in the whole business of evidence. If finding trustworthy evidence is hard
enough, knowing how best to tell people about it is a black hole. We struggle
communicating with healthcare professionals, with industry, and with
government. In the absence of evidence about communicating effectively with
patients, because we know so little, we should assume we do it badly.
Communicating
evidence is important in a patient-led service, but there are pitfalls. The
biggest is when the evidence is that what patients want and what we do are
diametrically opposed.
Reference:
- LJ Trevena et al. A systematic review on communicating with patients about evidence. Journal of Evaluation in Clinical Practice 2006 12: 13-23.