Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format

Alonso Carrasco-Labra; Romina Brignardello-Petersen; Nancy Santesso; Ignacio Neumann; Reem A Mustafa; Lawrence Mbuagbaw; Itziar Etxeandia Ikobaltzeta; Catherine De Stio; Lauren J McCullagh; Pablo Alonso-Coello; Joerg J Meerpohl; Per Olav Vandvik; Jan L Brozek; Elie A Akl; Patrick Bossuyt; Rachel Churchill; Claire Glenton; Sarah Rosenbaum; Peter Tugwell; Vivian Welch; Paul Garner; Gordon Guyatt; Holger J Schünemann

doi:10.1016/j.jclinepi.2015.12.007

Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format

J Clin Epidemiol. 2016 Jun:74:7-18. doi: 10.1016/j.jclinepi.2015.12.007. Epub 2016 Jan 11.

Authors

Alonso Carrasco-Labra¹, Romina Brignardello-Petersen², Nancy Santesso³, Ignacio Neumann⁴, Reem A Mustafa⁵, Lawrence Mbuagbaw⁶, Itziar Etxeandia Ikobaltzeta⁷, Catherine De Stio⁸, Lauren J McCullagh⁸, Pablo Alonso-Coello⁹, Joerg J Meerpohl¹⁰, Per Olav Vandvik¹¹, Jan L Brozek¹², Elie A Akl¹³, Patrick Bossuyt¹⁴, Rachel Churchill¹⁵, Claire Glenton¹⁶, Sarah Rosenbaum¹⁶, Peter Tugwell¹⁷, Vivian Welch¹⁸, Paul Garner¹⁹, Gordon Guyatt¹², Holger J Schünemann²⁰

Affiliations

¹ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile.
² Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada.
³ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Cochrane GRADEing (Applicability and Recommendations) Methods Group, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; McMaster GRADE Center, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
⁴ Pontificia Universidad Católica de Chile, Alameda 340, Santiago, Región Metropolitana, Chile.
⁵ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine/Nephrology, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108-2792, USA; Department of Biomedical & Health Informatics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108-2792, USA.
⁶ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, 50 Charlton Avenue East, 3rd Floor Martha Wing, Room H321, Hamilton, Ontario L8N 4A6, Canada.
⁷ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
⁸ Hofstra North Shore LIJ School of Medicine, Department of Medicine, 300 Community Drive, Manhasset, NY 11030, USA.
⁹ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau-CIBER of Epidemiology and Public Health (CIBERESP-IIB Sant Pau), C/ Sant Antoni Maria Claret 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
¹⁰ German Cochrane Centre, Medical Center-University of Freiburg, Berliner Allee 29, 79110 Freiburg, Germany.
¹¹ Department of Medicine, Division Gjøvik, Innlandet Hospital Trust, Kyrre Greppsgt 11, 2819 Gjøvik, Norway; Norwegian Knowledge Centre for the Health Services, Pilestredet Park 7, 0130 Oslo, Norway.
¹² Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Cochrane GRADEing (Applicability and Recommendations) Methods Group, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; McMaster GRADE Center, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
¹³ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut, Riad-El-Solh Beirut 1107 2020, P.O. Box: 11-0236, Beirut, Lebanon.
¹⁴ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Room J2-127, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
¹⁵ Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Office Barley House, Room BF11, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK.
¹⁶ Norwegian Branch of the Nordic Cochrane Centre, Postboks 7004 Street Olavs plass, 0130 Oslo, Norway; Norwegian Knowledge Centre for the Health Services, P.O. Box 7004 Street Olavs plass, N-0130 Oslo, Norway.
¹⁷ Department of Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.
¹⁸ Bruyère Research Institute, University of Ottawa, 304b-85 Primrose Avenue, Ottawa, Ontario, Canada.
¹⁹ Evidence Synthesis for Global Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
²⁰ Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Cochrane GRADEing (Applicability and Recommendations) Methods Group, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; McMaster GRADE Center, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada. Electronic address: schuneh@mcmaster.ca.

PMID: 26791430
DOI: 10.1016/j.jclinepi.2015.12.007

Abstract

Objectives: The current format of summary of findings (SoFs) tables for presenting effect estimates and associated quality of evidence improve understanding and assist users finding key information in systematic reviews. Users of SoF tables have demanded alternative formats to express findings from systematic reviews.

Study design and setting: We conducted a randomized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding understanding, accessibility of information, satisfaction, and preference. Our primary goal was to show that the new format is not inferior to the current format.

Results: Of 390 potentially eligible subjects, 290 were randomized. Of seven items testing understanding, three showed similar results, two showed small differences favoring the new format, and two (understanding risk difference and quality of the evidence associated with a treatment effect) showed large differences favoring the new format [63% (95% confidence interval {CI}: 55, 71) and 62% (95% CI: 52, 71) more correct answers, respectively]. Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format.

Conclusions: While providing at least similar levels of understanding for some items and increased understanding for others, users prefer the new format of SoF tables.

Trial registration: ClinicalTrials.gov NCT02022631.

Keywords: Evidence summaries; Evidence tables; Formatting; GRADE; GRADEpro; Guidelines; Summary of findings table; Systematic reviews; Understanding.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Comprehension*
Consumer Behavior / statistics & numerical data*
Evidence-Based Medicine
Female
Humans
Information Dissemination / methods*
Male
Middle Aged
Research Report / standards*
Review Literature as Topic*
Young Adult

Associated data

ClinicalTrials.gov/NCT02022631