Abstract
BackgroundSystematic reviews provide evidence for clinical questions, however the literature suggests they are not used regularly by physicians for decision-making. A shortened systematic review format is proposed as one possible solution to address barriers, such as lack of time, experienced by busy clinicians. The purpose of this paper is to describe the development process of two shortened formats for a systematic review intended for use by primary care physicians as an information tool for clinical decision-making.MethodsWe developed prototypes for two formats (case-based and evidence-expertise) that represent a summary of a full-length systematic review before seeking input from end-users. The process was composed of the following four phases: 1) selection of a systematic review and creation of initial prototypes that represent a shortened version of the systematic review; 2) a mapping exercise to identify obstacles described by clinicians in using clinical evidence in decision-making; 3) a heuristic evaluation (a usability inspection method); and 4) a review of the clinical content in the prototypes.ResultsAfter the initial prototypes were created (Phase 1), the mapping exercise (Phase 2) identified components that prompted modifications. Similarly, the heuristic evaluation and the clinical content review (Phase 3 and Phase 4) uncovered necessary changes. Revisions were made to the prototypes based on the results.ConclusionsDocumentation of the processes for developing products or tools provides essential information about how they are tailored for the intended user. One step has been described that we hope will increase usability and uptake of these documents to end-users.
Highlights
Systematic reviews provide evidence for clinical questions, the literature suggests they are not used regularly by physicians for decision-making
To describe the development process of two shortened formats for a systematic review intended for use by primary care physicians as an information tool for clinical decision-making
Phase 1: selecting a systematic review and creation of initial prototypes We chose a full-length systematic review to be used for developing prototypes by having four generalist clinicians select from a list of systematic reviews that were drawn from 120 medical journals published in the last five years on topics relevant to primary care [14]
Summary
Systematic reviews provide evidence for clinical questions, the literature suggests they are not used regularly by physicians for decision-making. We located two trials using GRADE (Grading of Recommendations Assessment, Development and Evaluation) by Rosenbaum and colleagues [11,12] who examined a ‘summary of findings’ table added to Cochrane systematic reviews They reported that participants found it easier to locate results for important outcomes, were more likely to correctly answer questions regarding results, and spent less time finding key information. It is necessary to be thoughtful in interpreting these results, as small samples were used and participants were drawn from a convenience sample, including those who had an affiliation with the Cochrane Collaboration Aside from these two trials that demonstrate considerable limitations related to study quality, the studies screened and reviewed revealed no literature in either guiding the creation of different formats or rigorously evaluating the impact on end-users
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