Biomedical subjects

Claire Glenton

Publications and source records attributed to Claire Glenton.

7 recordsLinked to original sources

PubMed2006

Summaries of findings, descriptions of interventions, and information about adverse effects would make reviews more informative.

BACKGROUND AND OBJECTIVE: To describe challenges when extracting and presenting relevant, consistent, and accessible information from systematic reviews. MATERIALS AND METHODS: We systematically selected comparisons and outcomes from 18 Cochrane reviews, evaluated the quality of evidence for each outcome using the GRADE system, and developed standardized patient information. We evaluated the information using patient, review author, researcher, and clinician feedback. RESULTS: Challenges included large numbers of comparisons and outcomes; missing information about treatments and adverse effects; and variations in how effect was measured and presented. By selecting comparisons and outcomes based on patient-relevance, quality, and nonredundancy, we halved the number of outcomes. We prepared information about treatments and adverse effects using other sources. We framed outcomes consistently and standardized the presentation of magnitude of effect. CONCLUSIONS: The incorporation of summary of findings tables in reviews could address these challenges. Problems could also be reduced if review groups agreed upon standard outcomes; excluded less relevant outcomes; incorporated more information about interventions and adverse effects; and implemented clearer guidelines for the presentation of results.

Clinical Trials as Topic↗

PubMed2006

Lay perceptions of evidence-based information--a qualitative evaluation of a website for back pain sufferers.

BACKGROUND: In an evidence-informed patient choice the patient has access to research-based information about the effectiveness of health care options and is encouraged to use this information in treatment decisions. This concept has seen growing popularity in recent years. However, we still know relatively little about users' attitudes to the use of research-based information, possibly because people have been unexposed to this type of information. After developing the BackInfo website where the results of Cochrane systematic reviews on the effects of low back pain were adapted and presented to lay users we evaluated how users responded to this information. METHODS: Focus group meetings were held with 18 chronic back pain sufferers, after they had been sent a link to the website before the meetings. RESULTS: The focus groups suggest that the most important challenges to the use of BackInfo's research-based information are not primarily tied to the comprehension or presentation of the information, but are mainly associated with participants' attitudes towards the credibility of research and researchers, and the applicability of research results to themselves as individuals. Possible explanations for participants' lack of trust in research and their apparent difficulties in applying this research to their own situations include aspects that may be typical for the general public including the media's presentation of research, and a lack of familiarity with and feelings of distance to research evidence. Other aspects may be typical for patient groups with chronic and unclear medical conditions, such as a lack of trust in the health care establishment in general. CONCLUSION: In order to enhance the credibility and applicability of research evidence, providers of research-based information could explore a number of possibilities including the use of including personal stories to illustrate the research outcomes.

Adult↗

PubMed2005

Portals to Wonderland: health portals lead to confusing information about the effects of health care.

BACKGROUND: The Internet offers a seemingly endless amount of health information of varying quality. Health portals, which provide entry points to quality-controlled collections of websites, have been hailed as a solution to this problem. The objective of this study is to assess the extent to which government-run health portals provide access to relevant, valid and understandable information about the effects of health care. METHODS: We selected eight clinically relevant questions for which there was a systematic review, searched four portals for answers, and compared the answers we found to the results of the systematic reviews. RESULTS: Our searches resulted in 3400 hits, 155 of which mentioned both the condition and the intervention in one of the eight questions. Sixty-three of the 155 web pages did not give any information about the effect of the intervention. Seventy-seven qualitatively described the effects of the intervention. Twenty-six of these had information that was too unclear to be categorised; 15 were not consistent with the systematic review; and 36 were consistent with the review, but usually did not mention what happens without the intervention, what outcomes have been measured or when they were measured. Fifteen web pages quantitatively described effects. Four of these were abstracts from the systematic review, nine had information that was incomplete and potentially misleading because of a lack of information about people not receiving the intervention and the length of follow-up; one had information that was consistent with the review, but only referred to three trials whereas the review included six; and one was consistent with the review. CONCLUSION: Information accessible through health portals is unlikely to be based on systematic reviews and is often unclear, incomplete and misleading. Portals are only as good as the websites they lead to. Investments in national health portals are unlikely to benefit consumers without investments in the production and maintenance of relevant, valid and understandable information to which the portals lead.

Delivery of Health Care↗

PubMed2003

Chronic back pain sufferers--striving for the sick role.

The paper draws on data from a Norwegian online discussion list for back pain sufferers and from open, in-depth interviews with Norwegian back pain sufferers. In both sources, back pain sufferers express a fear that the reality of their pain is being questioned. The paper discusses how these experiences of delegitimation can be understood as a result of the back pain sufferers' inability to achieve the sick role. Many of these individuals strive and frequently fail to achieve clinical and social characteristics that make up appropriate sickness behaviour. A lack of proof that they are sick, including a lack of medical diagnosis, appropriate health care treatment, and visible disabilities, can lead to accusations, both felt and enacted, of malingering, hypochondria and/or mental illness. This in turn can lead to problems in the achievement and/or legitimisation of sick role benefits such as sick leave and medication. The sick role concept has been criticised as being inappropriate for describing the experiences of the chronically ill. The paper argues that the sick role concept still appears to reflect the expectations of health professionals, the public and the patient himself. The study does not support the view that chronic illness is related to a decreased dependency on the medical profession. Instead, doctors' inability to offer chronic back pain sufferers a clear diagnosis, explanation, and/or a course of treatment or cure appears not to liberate the patient but rather prolongs his or her dependence on the doctor.

Adaptation, Psychological↗

PubMed2002

Developing patient-centred information for back pain sufferers.

OBJECTIVE: To identify information needs among a group of back pain sufferers as well as the barriers that may prevent them from accessing this information. DESIGN: Data were collected through the use of open, in-depth interviews, through contributions to the Norwegian Back Pain Association's online discussion list, and through a search of the literature. PARTICIPANTS: Norwegian back pain sufferers and their carers. MAIN VARIABLES STUDIED: Information needs and barriers. RESULTS: The informants described information needs that covered a wide range of topics, clinical, financial, emotional and social. Informants wanted to understand the cause of their pain and wanted information about existing diagnoses and diagnostic procedures. Informants asked for information about treatment alternatives, both within and outside the established health-care system, the effects of these treatment alternatives, their procedures, side-effects and costs. In addition, informants wanted information about the social and emotional effects of long-term pain; coping with everyday life; other people's experiences; and about welfare benefits and patient rights. Barriers to this information included the use of medical, legal and other jargon, doctors' lack of time, lack of communication skills, lack of knowledge about back pain and attitudes to back pain patients. CONCLUSIONS: To successfully address the questions and concerns of users, there should be an attempt to present information on as many of these topics as possible. Information should be presented in the user's own language, at several levels of understanding, and should include both evidence- and experienced-based knowledge.

Adaptation, Psychological↗

PubMed1998

The use of evidence by health care user organizations.

OBJECTIVES: To explore the use of research evidence by consumer and patient organizations and the extent to which their goals and activities are consistent with evidence-based health care and patient-centred care. DESIGN: A mailed survey, telephone and face-to-face interviews of leaders of organizations representing health care users. SETTING: Norway. PARTICIPANTS: Sixty-nine of 109 questionnaires that were mailed were included in our analysis and approximately 20 interviews were conducted with representatives of general consumer and patient advocacy groups and interest groups that focus on particular diseases or disabilities. MEASUREMENTS: Information was collected on the goals of the organizations, the nature of their everyday work, the extent to which research information is required in this work and how research information is accessed and appraised. RESULTS: An important focus of many user groups is peer support. They tend to emphasize experience-based knowledge. A total of 82% of the respondents said that they often or sometimes had use for research results in their work. Research-based information is most often obtained indirectly through physicians or researchers. CONCLUSIONS: Norwegian health care user organizations do not appear to promote evidence-based health care. To the extent that they help to disseminate scientific information, they appear to do so uncritically, relying on few sources and traditional authorities.

Journal Article↗

PubMedDate not supplied

Computer-generated patient education materials: do they affect professional practice? A systematic review.

A systematic search of seven electronic databases was done to identify randomized controlled trials that assessed the effect of computer-generated patient education material (PEM) on professional practice. Three studies met the authors' criteria. All three studies involved preventive care. All used a complex intervention of which computer-generated PEM was a major component. Improvements in practice were seen in all studies, although these gains were generally modest. One study showed improvement in patient outcomes. Mann-Whitney statistics calculated for the studies' outcome measures ranged from 0.48 to 0.66, equivalent to risk differences of -4 to 32 percent. Computer-generated PEM seems to have a small, positive effect on professional practice. The small number of included studies and the complex nature of the interventions makes it difficult to draw conclusions about the ability of computer-generated PEM to change professional practice. Future work should involve well-defined interventions that can be clearly evaluated in terms of effect and cost.

Humans↗