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Communicating evidence

Systematic review
Results
Comment

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:

  1. Information should be structured or interactive.
  2. Ideally it should be tailored to the individual as much as possible.
  3. Natural frequency formats should be used to convey numbers.
  4. Pictures and graphs can help convey numeric information.
  5. 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:

  1. LJ Trevena et al. A systematic review on communicating with patients about evidence. Journal of Evaluation in Clinical Practice 2006 12: 13-23.

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