Helping patients access high quality health information.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D Charnock.
Explore the source record for details and available documents.
OBJECTIVE: To develop a short instrument, called DISCERN, which will enable patients and information providers to judge the quality of written information about treatment choices. DISCERN will also facilitate the production of new, high quality, evidence-based consumer health information. DESIGN: An expert panel, representing a range of expertise in consumer health information, generated criteria from a random sample of information for three medical conditions with varying degrees of evidence: myocardial infarction, endometriosis, and chronic fatigue syndrome. A graft instrument, based on this analysis, was tested by the panel on a random sample of new material for the same three conditions. The panel re-drafted the instrument to take account of the results of the test. The DISCERN instrument was finally tested by a national sample of 15 information providers and 13 self help group members on a random sample of leaflets from 19 major national self help organisations. Participants also completed an 8 item questionnaire concerning the face and content validity of the instrument. RESULTS: Chance corrected agreement (weighted kappa) for the overall quality rating was kappa = 0.53 (95% CI kappa = 0.48 to kappa = 0.59) among the expert panel, kappa = 0.40 (95% CI kappa = 0.36 to kappa = 0.43) among information providers, and kappa = 0.23 (95% CI kappa = 0.19 to kappa = 0.27) among self help group members. Higher agreement levels were associated with experience of using the instrument and with professional knowledge of consumer health information. Levels of agreement varied across individual items on the instrument, reflecting the need for subjectivity in rating certain criteria. The trends in levels of agreement were similar among all groups. The final instrument consisted of 15 questions plus an overall quality rating. Responses to the questionnaire after the final testing revealed the instrument to have good face and content validity and to be generally applicable. CONCLUSIONS: DISCERN is a reliable and valid instrument for judging the quality of written consumer health information. While some subjectivity is required for rating certain criteria, the findings demonstrate that the instrument can be applied by experienced users and providers of health information to discriminate between publications of high and low quality. The instrument will also be of benefit to patients, though its use will be improved by training.
The current study failed to find any evidence of laboratory counter-regulation amongst restrained eaters given a preload, regardless of the measures of dietary restraint used to classify subjects, including dieting status on the day of the study. Furthermore, there was no evidence to suggest that high restrainers characteristically overeat or experience a sense of loss of control over eating in naturalistic settings. These findings indicate that the link between dietary restraint and overeating or bulimic episodes is, at most, a weak one. Future investigations must incorporate more detailed and sensitive measures of both restraint and overeating if analogue studies are to be useful for understanding the process involved in clinically significant episodes of overeating or binge eating.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.