A new graphical format to communicate treatment effects to patients—A web-based randomized controlled trial

Abstract

<p><i>Objective</i>: Patients making treatment decisions require understandable evidence‐based information. However, evidence on graphical presentation of benefits and side‐effects of medical treatments is not conclusive. The study evaluated a new space‐saving format, CLARIFIG (clarifying risk figures), aiming to facilitate accuracy of comprehension.</p>

<p><i>Methods</i>: CLARIFIG displays groups of patients with and without treatment benefits as coloured sectors of a proportional bar graph representing in total 100 patients. Supplementary icons indicate the corresponding group's actual condition. The study used an application showing effects of immunotherapy intended to slow disease progression in multiple sclerosis (MS). In a four‐arm web‐based randomized controlled trial, CLARIFIG was compared to the reference standard, multifigure pictographs (MFP), regarding comprehension (primary outcome) and processing time. Both formats were presented as static and animated versions. People with MS were recruited through the website of the German MS society.</p>

<p><i>Results</i>: Six hundred and eighty‐two patients were randomized and analysed for the primary end point. There were no differences in comprehension rates (MFP_static=46%, CLARIFIG_static=44%; P=.59; MFP_animated=23%, CLARIFIG_animated=30%; P=.134). Processing time for CLARIFIG was shorter only in the animated version (MFP_static=162 seconds, CLARIFIG_static=155 seconds; P=.653; MFP_animated=286 seconds, CLARIFIG_animated=189 seconds; P≤.001). However, both animated versions caused more wrong answers and longer processing time than static presentation (MFP_static vs _animated: P≤.001/.001, CLARIFIG_static vs animated: P=.027/.017).</p>

<p><i>Conclusion</i>: Comprehension of the new format is comparable to MFP. CLARIFIG has the potential to simplify presentation in more complex contexts such as comparison of several treatment options in patient decision aids, but further studies are needed.