Sity, Hamilton, Ontario, Canada * [email protected] ACCESS Citation: Mustafa RA, Wiercioch W, Santesso N, Cheung A, Prediger B, Baldeh T, et al. (2015) Decision-Making about Healthcare Related Tests and Diagnostic Strategies: User Testing of GRADE Evidence Tables. PLoS ONE 10(10): e0134553. doi:10.1371/journal.pone.0134553 Editor: Ramon Andrade de Mello, University of Algarve, PORTUGAL Received: January 26, 2015 Accepted: July 11, 2015 Published: October 16, 2015 Copyright: ?2015 Mustafa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: fpsyg.2014.00726 This work was partially funded by the German Insurance Fund agency as part of a larger project about decision-making for healthcare related tests and diagnostic strategies. It was also partially funded by a Methods Innovation Fund from the Cochrane Collaboration. The views presented here are those of the authors and should not be attributed to the funding agency or its staff.AbstractObjectiveTo develop guidance on what information to include and how to present it in tables summarizing the evidence from systematic reviews of test accuracy following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.MethodsTo design and refine the evidence tables, we used an get CBIC2 iterative process based on the analysis of data from four rounds of discussions, feedback and user testing. During the final round, we conducted one-on-one user testing with target end users. We presented a number of alternative formats of evidence tables to participants and obtained information about users’ understanding and preferences.ResultsMore than 150 users participated in initial discussions and provided their formal and informal feedback. 20 users completed one-on-one user testing interviews. Almost all participants preferred summarizing the results of systematic reviews of test accuracy in tabular format rather than plain text. Users generally preferred less complex tables but found presenting sensitivity and specificity estimates wcs.1183 only as too simplistic. Users found thePLOS ONE | DOI:10.1371/journal.pone.0134553 October 16,1 /User Testing of GRADE Evidence Tables for Test Accuracy ReviewsCompeting Interests: None financial. Some authors are members of the GRADE working group. HJS is one of the co conveners of the GRADE working group.presentation of test accuracy for several values of prevalence initially confusing but modifying table layout and adding sample clinical scenarios for each prevalence reduced this confusion. Providing information about clinical consequences of testing result was viewed as not feasible for authors of systematic reviews.ConclusionWe present the current formats for tables presenting test accuracy following the GRADE approach. These tables can be developed using GRADEpro guidelines development tool (www.guidelinedevelopment.org or www.gradepro.org) and are being further developed into electronic interactive tables that will suit the needs of BAY 11-7085 site different end users. The formatting of these tables, and how they influence result interpretation and decision-making will be further evaluated in a randomized trial.BackgroundThe Grading of Recommendations Assessment, Development and E.Sity, Hamilton, Ontario, Canada * [email protected] ACCESS Citation: Mustafa RA, Wiercioch W, Santesso N, Cheung A, Prediger B, Baldeh T, et al. (2015) Decision-Making about Healthcare Related Tests and Diagnostic Strategies: User Testing of GRADE Evidence Tables. PLoS ONE 10(10): e0134553. doi:10.1371/journal.pone.0134553 Editor: Ramon Andrade de Mello, University of Algarve, PORTUGAL Received: January 26, 2015 Accepted: July 11, 2015 Published: October 16, 2015 Copyright: ?2015 Mustafa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: fpsyg.2014.00726 This work was partially funded by the German Insurance Fund agency as part of a larger project about decision-making for healthcare related tests and diagnostic strategies. It was also partially funded by a Methods Innovation Fund from the Cochrane Collaboration. The views presented here are those of the authors and should not be attributed to the funding agency or its staff.AbstractObjectiveTo develop guidance on what information to include and how to present it in tables summarizing the evidence from systematic reviews of test accuracy following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.MethodsTo design and refine the evidence tables, we used an iterative process based on the analysis of data from four rounds of discussions, feedback and user testing. During the final round, we conducted one-on-one user testing with target end users. We presented a number of alternative formats of evidence tables to participants and obtained information about users’ understanding and preferences.ResultsMore than 150 users participated in initial discussions and provided their formal and informal feedback. 20 users completed one-on-one user testing interviews. Almost all participants preferred summarizing the results of systematic reviews of test accuracy in tabular format rather than plain text. Users generally preferred less complex tables but found presenting sensitivity and specificity estimates wcs.1183 only as too simplistic. Users found thePLOS ONE | DOI:10.1371/journal.pone.0134553 October 16,1 /User Testing of GRADE Evidence Tables for Test Accuracy ReviewsCompeting Interests: None financial. Some authors are members of the GRADE working group. HJS is one of the co conveners of the GRADE working group.presentation of test accuracy for several values of prevalence initially confusing but modifying table layout and adding sample clinical scenarios for each prevalence reduced this confusion. Providing information about clinical consequences of testing result was viewed as not feasible for authors of systematic reviews.ConclusionWe present the current formats for tables presenting test accuracy following the GRADE approach. These tables can be developed using GRADEpro guidelines development tool (www.guidelinedevelopment.org or www.gradepro.org) and are being further developed into electronic interactive tables that will suit the needs of different end users. The formatting of these tables, and how they influence result interpretation and decision-making will be further evaluated in a randomized trial.BackgroundThe Grading of Recommendations Assessment, Development and E.
