DISCERN: an instrument for judging the quality of written consumer health information on treatment choices
DISCERN: an instrument for judging the quality of written consumer health information on treatment choices
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DOI：
10.1136/jech.53.2.105
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发表时间：
1999-02-01
影响因子：
6.3
通讯作者：
Gann, R
中科院分区：
文献类型：
--
作者：
Charnock, D;Shepperd, S;Gann, R
开发一种称为DISCERN的简短工具，使患者和信息提供者能够判断有关治疗选择的书面信息的质量。DISCERN还将促进新的、高质量的、基于证据的消费者健康信息的制作。设计-一个代表消费者健康信息领域一系列专业知识的专家小组，从随机信息样本中生成了具有不同程度证据的三种医疗状况的标准：心肌梗死、子宫内膜异位症和慢性疲劳综合症。专家组在这一分析的基础上，对新材料的随机样本在同样的三种条件下进行了测试。专家组重新起草了文书，以考虑到测试结果。DISCERN工具最后由15名信息提供者和13名自助小组成员在19个主要国家自助组织的传单上随机抽样进行测试，参与者还完成了一份关于工具表面和内容效度的8项问卷。结果：专家组总体质量等级的机会校正一致性（加权kappa）为kappa=0.53（95%CI kappa=0.48至kappa=0.59），信息提供者为kappa=0.40（95%CI kappa=0.36至kappa=0.43），自助小组成员为kappa=0.23（95%CI kappa=0.19至kappa=0.27）。较高的协议水平与使用该工具的经验和消费者健康信息的专业知识。文书上各个项目的一致程度各不相同，反映出在对某些标准进行评级时需要主观性。所有组的一致性水平趋势相似。最后的调查问卷包括15个问题和一个总体质量评分。最后的测试后的问卷调查结果显示，该仪器具有良好的面子和内容的有效性，并普遍适用。结论-DISCERN是一个可靠的和有效的工具，判断书面消费者健康信息的质量。虽然某些标准的评级需要一定的主观性，但研究结果表明，该工具可以由经验丰富的用户和卫生信息提供者应用，以区分高质量和低质量的出版物。该仪器也将对患者有益，但其使用将通过培训得到改进。
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 draft 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.