Development of two shortened systematic review formats for clinicians

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.

Using a systematic review in clinical decision making: a pilot parallel, randomized controlled trial

“…Two alternate systematic review formats were developed focusing on making traditional systematic reviews shorter in length, while at the same time maintaining essential information for clinical decision-making. This process is described in previous publications [ 16 – 18 ]. Briefly, prototypes for two formats of a shortened systematic review were developed in collaboration with a human factors engineer based on principles of user-centered design and included a mapping exercise to identify obstacles described by clinicians in using clinical evidence in decision-making, a heuristic evaluation of the prototypes, and a clinical content review of the re-formatted reviews [ 16 ].…”

“…We developed two shortened systematic review formats to enhance their use in clinical decision-making that could be offered as a companion product to a full-length systematic review. The prototypes were developed using a rigorous process including a mapping exercise, a heuristic evaluation, and a clinical content review which was followed by focus groups and usability testing with clinicians [ 16 – 18 ]. In order to assess these shortened formats, an online randomized controlled trial is planned to make comparisons to a full-length systematic review where the purpose of the full-scale randomized controlled trial will be to determine the impact of two distinct shortened systematic review formats compared with a traditional full-length presentation of a systematic review on generalist physicians’ understanding of evidence and their ability to apply it to a patient in a clinical scenario.…”

A usability study of two formats of a shortened systematic review for clinicians

“…The approach to developing two alternate formats of a shortened systematic review to modify the presentation of information has been described in previous publications. 14 15 In brief, prototypes for two formats of a shortened systematic review were developed using an explicit, rigorous process including a mapping exercise, an initial heuristic evaluation and a clinical content review. 14 Following this, a series of focus groups were conducted with primary care physicians to further refine and determine the optimal format for the presentation of information.…”

“… 14 15 In brief, prototypes for two formats of a shortened systematic review were developed using an explicit, rigorous process including a mapping exercise, an initial heuristic evaluation and a clinical content review. 14 Following this, a series of focus groups were conducted with primary care physicians to further refine and determine the optimal format for the presentation of information. 15 The focus groups provided a forum for clinicians to identify the essential components of a format for a shortened systematic review, including key features and content to aid in clinical decision-making.…”

“…In an effort to address this, two shortened systematic review formats were developed to enhance their use by clinicians. 14 15 The next step in the development process is to conduct a usability study with the prototypes so that they can be further refined and the design can be finalised.…”