Framing the numerical findings of Cochrane plain language summaries: two randomized controlled trials

Ivan Buljan, Ružica Tokalić, Marija Roguljić, Irena Zakarija-Grković, Davorka Vrdoljak, Petra Milić, Livia Puljak, Ana Marušić, Ivan Buljan, Ružica Tokalić, Marija Roguljić, Irena Zakarija-Grković, Davorka Vrdoljak, Petra Milić, Livia Puljak, Ana Marušić

Abstract

Background: Cochrane systematic review Plain language Summaries (CSR PLSs should serve as a tool for the evidence translation to non-medical population. However, the evidence of optimal type of numerical presentation in CSR PLSs is still scarce. The aim of this study was to investigate readers' comprehension and preferences for different presentation of findings, including framing and numerical data, in Cochrane systematic review Plain Language Summaries (CSR PLSs).

Methods: We conducted a parallel randomized trial and a crossover randomized trial at the School of Medicine and family practice offices in Split, Croatia. The participants were students and consumers. We assessed possible differences in comprehension, measured by four questions on PLS content, of CSR PLSs depending on the positive or negative framing of results (n = 91) (Trial 1) or using percentages or frequencies for the presentation of results (n = 245) (Trial 2). The outcome measures were comprehension of PLS content, perceived effectiveness of the treatment and readiness to use the treatment (all on 1-10 scales).

Results: In Trial 1 we found no difference in readers' perception of the effectiveness of the described treatment, desire that the treatment be offered by their family doctor, readiness to use the treatment, or comprehension when CSR PLS results were presented positively or negatively. In Trial 2 we found no difference in CSR PLS comprehension when results were presented as natural frequencies or percentages (BF10 = 0.62, Bayesian t-test for independent samples).

Conclusions: Numerical presentation and framing direction of results appear to have no significant impact on understanding of messages in CSR PLSs.

Trial registration: The trials were registered in ClinicalTrials.gov. Protocol registration numbers: Trial 1: NCT03442387; Trial 2: NCT03554252.

Keywords: Evidence summaries; Health numeracy; Information translation; Plain language summaries.

Conflict of interest statement

All authors are members of Cochrane Croatia. AM is a Co-chair of Cochrane’s Scientific Committee. Co-author Livia Puljak is a Section Editor of this journal. The authors declare they do not have any other actual or potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participants in both trials

References

    1. Kurtzman ET, Greene J. Effective presentation of health care performance information for consumer decision making: a systematic review. Patient Educ Couns. 2016;99(1):36–43. doi: 10.1016/j.pec.2015.07.030.
    1. Rosenbaum S, Oxman AD, Lewin S, Glenton C, Opiyo N, Sheppard S. User and producer-friendly formatting of Cochrane Reviews. Edinburgh: Cochrane Colloquium Edinburgh; 2018.
    1. Jelicic Kadic A, Fidahic M, Vujcic M, Saric F, Propadalo I, Marelja I, et al. Cochrane plain language summaries are highly heterogeneous with low adherence to the standards. BMC Med Res Methodol. 2016;16(1):61. doi: 10.1186/s12874-016-0162-y.
    1. Reyna VF, Nelson WL, Han PK, Dieckmann NF. How numeracy influences risk comprehension and medical decision making. Psychol Bull. 2009;135(6):943–973. doi: 10.1037/a0017327.
    1. Chen Y, Feeley TH. Numeracy, information seeking, and self-efficacy in managing health: an analysis using the 2007 health information National Trends Survey (HINTS) Health Commun. 2014;29(9):843–853. doi: 10.1080/10410236.2013.807904.
    1. Perneger TV, Agoritsas T. Doctors and patients’ susceptibility to framing Bias: a randomized trial. J Gen Intern Med. 2011;26(12):1411–1417. doi: 10.1007/s11606-011-1810-x.
    1. Cochrane community. Editorial and Publishing Policy Resource: Plain Language Expectations for Authors of Cochrane Summaries (PLEACS). [cited August 2019]. Available from: .
    1. Akl EA, Oxman AD, Herrin J, Vist GE, Terrenato I, Sperati F, et al. Framing of health information messages. Cochrane Database Syst Rev. 2011;12:CD006777.
    1. Derry S, Wiffen PJ, Moore RA, Bendtsen L. Ibuprofen for acute treatment of episodic tension-type headache in adults. Cochrane Database Syst Rev. 2015;7:CD011474.
    1. Richards BL, Whittle SL, Buchbinder R. Muscle relaxants for pain management in rheumatoid arthritis. Cochrane Database Syst Rev. 2012;1:CD008922.
    1. Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, et al. Manual therapy and exercise for adhesive capsulitis (frozen shoulder) Cochrane Database Syst Rev. 2014;8:CD011275.
    1. Santos J, Alarcão J, Fareleira F, Vaz-Carneiro A, Costa J. Tapentadol for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;5:CD009923.
    1. Veys L, Derry S, Moore RA. Ketoprofen for episodic tension-type headache in adults. Cochrane Database Syst Rev. 2016;9:CD012190.
    1. IBM Watson Developer Cloud. Tone Analyzer. (Available at:) (Accessed 30 Aug 2018).
    1. Peng J, Li H, Miao D, Feng X. Five different types of framing effects in medical situation: a preliminary exploration. Iran Red Crescent Med J. 2013;15(2):161–165. doi: 10.5812/ircmj.8469.
    1. Buljan I, Malički M, Wager E, Puljak L, Hren D, Kellie F, et al. No difference in knowledge obtained from infographic or plain language summary of a Cochrane systematic review: three randomized controlled trials. J Clin Epidemiol. 2018;97:86–94. doi: 10.1016/j.jclinepi.2017.12.003.
    1. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97–107. doi: 10.7326/0003-4819-155-2-201107190-00005.
    1. Malloy-Weir LJ, Schwartz L, Yost J, McKibbon KA. Empirical relationships between numeracy and treatment decision making: a scoping review of the literature. Patient Educ Couns. 2016;99(3):310–325. doi: 10.1016/j.pec.2015.10.002.
    1. Dukic N, Blecich AA, Cerovic LJ. Economic implications of insufficient health literacy. The 6th international conference “the changing economic landscape: issues, implications and policy options. May 30th - June 1st 2013; Pula, Croatia.
    1. Magsamen-Conrad K, Dillon JM, Billotte Verhoff C, Faulkner SL. Online health-information seeking among older populations: family influences and the role of the medical professional. Health Commun. 2019;34(8):859–871. doi: 10.1080/10410236.2018.1439265.
    1. Magsamen-Conrad K, Wang F, Tetteh D, Lee Y-I. Using technology adoption theory and a lifespan approach to develop a theoretical framework for eHealth literacy: extending UTAUT. Health Commun. 2019:1–12. .
    1. Mosconi P, Antes G, Barbareschi G, Burls A, Demotes-Mainard J, Chalmers I, et al. A European multi-language initiative to make the general population aware of independent clinical research: the European communication on research awareness need project. Trials. 2016;17(1):19. doi: 10.1186/s13063-015-1146-7.
    1. Goggins KM, Wallston KA, Nwosu S, Schildcrout JS, Castel L, Kripalani S, et al. Health Literacy, Numeracy, and Other Characteristics Associated With Hospitalized Patients' Preferences for Involvement in Decision Making. J Health Commun. 2014;19(sup2):29–43. doi: 10.1080/10810730.2014.938841.
    1. Puljak L. Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health. J Evidence-Based Med. 2016;9(1):4–7. doi: 10.1111/jebm.12175.
    1. Nejašmić D, Miošić I, Vrdoljak D, Permozer Hajdarović S, Tomičić M, Gmajnić R, et al. Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study. Croat Med J. 2017;58(4):300–309. doi: 10.3325/cmj.2017.58.300.

Source: PubMed

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