Table G-4. Key Question 3 Intervention Descriptions
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Table G-4. Key Question 3 intervention descriptions Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Akl et al., G1: Strong and weak G3: Strong and weak Two disease Paper-based Qualitative The participants read 20121 wording for or against recommendations for or conditions: irritable about a hypothetical drug guideline-supported against guideline- bowel syndrome In-person and then read the behavior (ACCP): supported behavior: or congestive statement that “a • “we recommend” “we recommend” “we heart failure and a 1 session with 2 guidelines group that you • “we suggest” conditionally related scenarios, total time trust has, based on • “we suggest...not” recommend” hypothetical not reported recent randomized “we recommend… “we conditionally medication to treat clinical trials, issued the not” recommend…not” those conditions. following “we recommend…not” recommendation:” The G2: Strong and weak American College participants read the wording for or against of Chest recommendation (with guideline-supported Physicians different wording for the 3 behavior (NICE): conferences on groups) and then made a • “clinicians should” antithrombotic and choice based on the • “clinicians might” thrombolytic recommendation. • “clinicians might therapy, the NICE, not” and the GRADE • “clinicians should working group not” No
No
G-1 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Brewer et G3: Described G1: women’s chance Breast cancer Paper-based G1: Each vignette described al., 20122 women’s chance of of breast cancer in 10 recurrence quantitative + a low, intermediate, or breast cancer years described as a In-person or by post qualitative high chance of breast recurrence in 10 years %. Interpreted with the Hypothetical G2, G3, G5: cancer recurrence in 10 as percentage (with a evaluative labels: low, recurrence risk 6 sessions, time not Quantitative years. Vignettes used 1 verbal interpretation of intermediate, or high results derived reported + qualitative of 5 risk formats of the percentage: low, chance. from standard + graphical various complexity that or medium, high) Oncotype DX (combined) a 6th format that used an [Elements of G1] + a G2: G1 + risk reports developed G6: graphical icon array risk continuum graphic continuum graphic (a by Genomic [G2] + text that horizontal bar chart Health, Inc. reported a 95% CI with from 0 to 100% a verbal translation partitioned into low, Yes “chance of recurrence intermediate, high could be as low as 5% chance) No or as high as 9% for almost all 95% G6: icon array patients” depicting a woman’s chances of breast cancer
G-2 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Brewer et G5: Standard al., 20122 Onctotype DX report. (continued) Report included a statement that said “It is unknown whether the findings summarized in the clinical experience are applicable to patients with features different from those described” + recurrence score, a recurrence risk, a graph, a 95% CI, plain language risk categories, an assay description, and miscellaneous information about the test and Genomic health
Note: Each format presents the likelihood of recurrence of breast cancer
G-3 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Han et al., G3: Text of range G1: Point estimate of Colorectal cancer Web-based G1: Participants were told 20113 representing hypothetical risk of risk quantitative what their chances were (Experiment confidence intervals colon cancer in text Online G2: of developing colon 1) for hypothetical risk (‘‘Your chances of NCI; evidence combined cancer in their lifetime. colon cancer (‘‘Your developing colon cancer report 1 session, time not G3: They were also provided chances of in your lifetime are reported quantitative with comparative risk developing colon 9%’’). Yes G4: information as a cancer in your combined secondary pre-post test lifetime are between G2: Point estimate of No following the main 5% and 13%’’). No hypothetical risk of assessment. point estimate colon cancer in provided. horizontal bar graph
G4: Horizontal bar graph with solid borders depicting range for hypothetical risk of colon cancer. No point estimate provided.
NOTE: Each format tested before and after delivery of information about the populations average risk of colon cancer (6% versus 2 to 10%).
G-4 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Han et al., G2: Same text as G1 G1: Range in Text: Text Colorectal cancer Web-based G1: The enhanced textual 20113 + solid bar graph only saying “Your risk quantitative representation aimed at (Experiment range chance of developing Online G2: more explicitly 2) colon cancer in your NCI; evidence combined emphasizing and G3: Same text as G1 lifetime are more likely report 1 session, time not G3: describing the meaning + bar graph range between 5%-13%, but reported combined of imprecision and with blurred edges to they could be higher or Yes uncertainty in risk reinforce the lower. Risk estimates predictions, whereas the presence of are not exact.” Yes enhanced visual ambiguity and the representation depicted a concept that confidence interval using probability a bar graph, but adding distributions lack firm, blurred edges to reinforce categorical the presence of boundaries. ambiguity and the concept that probability distributions lack firm, categorical boundaries. Longman G2: Text of small G1: Point estimate of Risk of side effect; Paper-based Quantitative Risk of side effect 20124 range representing risk of facial skin treatment information confidence intervals discoloration with acne In-person for risk of facial skin drug (20 out of 100) NA (risk discoloration with information was 1 session acne drug (16-24 out fabricated for the of 100) purpose of the experiment) G3: Text of large range representing No confidence intervals for risk of facial skin No discoloration with acne drug (8-32 out of 100)
G-5 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes McCormack G2: Information on G1: Control: usual care Prostate cancer In-person, video, Combined 20 intervention large et al., 20115 Prostate Cancer for prostate cancer screening web-based and group sessions, with 10- Screening Only screening paper 30 male participants per USPSTF; session with an oral G3: Information on guideline Community scripted presentation by Prostate Cancer physician a community physician Screening framed in Yes followed by a question- the context of Other #: 1 and-answer session, a More Beneficial Yes length: NA 20-minute video, a Men’s Health total time: 45 website, and print Services: colorectal minutes materials, including a tri- cancer screening and fold brochure, a 4-in x6- cardiovascular in. poster, and a shirt- screening (includes pocket card decision aid information on how certain doctors are that men will benefit from screening)
G-6 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Perneger et More than minimal Minimal (i.e., no) risk Unnamed cancer Paper-based mailed Quantitative Risk and benefits of Based on prior al., 20106 risk information information (aggregated screening test survey of hypothetical test work by same and 20117 (aggregated across across groups G1, G2, hypothetical vignette author groups G4-G9) a: G3) Meta-analysis of Moderate info: false- efficacy of Postal positive results Minimal (i.e., no) benefit screening A lot of info: false- information (aggregated mammography in #:1 positive and false- across groups G1, G4, JAMA (although length: NR negative results G7)a breast cancer not total time: NR indicated as the More than minimal condition in the benefit information vignette) (aggregated across groups G2, G3, G5, Unclear G6, G8, G9) a: Moderate info: Yes survival benefit A lot of info: survival benefit and reassurance of testing of the screening test.
Each participant received varying information about the benefits and harms of a screening test for an unnamed cancer.
G-7 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Schwartz et G2: Factual G1: Control. No Medical prevention Web-based Qualitative Received either an Pretests for both al., 20118 statement about the explanation about of heart explanation of logistics and evidence: (“It takes evidence. attacks/lower Web “surrogates do no always qualitative time to establish the cholesterol and translate into patient changes- pg. 1464. safety of new drugs” treatment of heart #: 1 outcomes” or “It takes or “Surrogates do not burn length: NR time to establish the always translate into total time: NR safety of new drugs” and patient outcomes.”) NR no directive advice or the explanation AND G3: Factual No DIRECTIVE advice “Ask statement about the for a drug shown to evidence and advice Yes reduce heart attacks” or about what to do “Ask for a drug with a (“Ask for a drug with Control longer track record” a longer track record” G1: Control. No or “Ask for a drug explanation about shown to reduce evidence. heart attacks.”).
Each participant sequentially randomized to 1 0f 3 groups for heart drug and then for heartburn drug
G-8 Table G-4. Key question 3 intervention descriptions (continued) Clinical Focus of the Evidence, Source Intervention of Information, Format, Author, Theory-Based, Delivery Agent, Evidence Message of Year Groups Comparators Prior Testing Intensity Presentation Intervention Other Notes Sheridan G2: Video-based G1: Educational video Prostate cancer Video and in-person Qualitative Information about 20129 decision aid and on highway safety screening (video prostate cancer and the coaching session for (control) Video and in-person discussion PSA test; harms and patients (net benefit) Systematic review; by a trained health about benefits of getting tested U.S. Preventive counselor information (uncertainty associated Combined analysis of Services Task and evidence with the PSA test and two trials in which G2 Force 1 session, regarding treatment outcomes); includes prostate 12-minute video + 8- prostate inform men of facts to only information or No minute coaching cancer help them clarify their prostate information session; screening) values; encourage framed in the context No total time: 20 and participation in shared of other men’s health minutes qualitative decisionmaking with services. (coaching doctor tool) Abbreviations: ACCP = American College of Clinical Pharmacy; CA = cancer; CI = confidence interval; DX = diagnosis; G = group; GRADE = Grading of Recommendations Assessment, Development and Evaluation; JAMA = Journal of the American Medical Association; NA = not applicable; NCI = National Cancer Institute; NICE = National Institute for Health and Clinical Excellence; NR = not reported; PSA = prostate-specific antigen; USPTF = US Preventive Services Task Force
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