• Annette Kristiansen, Linn Brandt, Pablo Alonso-Coello, Thomas Agoritsas, Elie A Akl, Tara Conboy, Mahmoud Elbarbary, Mazen Ferwana, Wedad Medani, Mohammad Hassan Murad, David Rigau, Sarah Rosenbaum, Frederick A Spencer, Shaun Treweek, Gordon Guyatt, and Per Olav Vandvik.
• Department of Internal Medicine, Institute for Health and Society, Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway.
• Chest. 2015 Mar 1; 147 (3): 754-763.

BackgroundBridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs).MethodsWe carried out multiple cycles of brainstorming and sketching, developing a prototype. Physicians participating in the user testing viewed CPG formats linked to clinical scenarios and engaged in semistructured interviews applying a think-aloud method for exploring important aspects of user experience.ResultsWe developed a multilayered presentation format that allows clinicians to successively view more in-depth information. Starting with the recommendations, clinicians can, on demand, access a rationale and a key information section containing statements on quality of the evidence, balance between desirable and undesirable consequences, values and preferences, and resource considerations. We collected feedback from 27 stakeholders and performed user testing with 47 practicing physicians from six countries. Advisory group feedback and user testing of the first version revealed problems with conceptual understanding of underlying CPG methodology, as well as difficulties with the complexity of the layout and content. Extensive revisions made before the second round of user testing resulted in most participants expressing overall satisfaction with the final presentation format.ConclusionsWe have developed an electronic, multilayered, CPG format that enhances the usability of CPGs for frontline clinicians. We have implemented the format in electronic guideline tools that guideline organizations can now use when authoring and publishing their guidelines.

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