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Evaluating the Usability of CER for Patient and Provider Decision Making

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Comparative effectiveness research (CER) has the potential to inform many decisions. While a common threshold for determining whether a CER finding should be disseminated to the public is its methodological quality, a study with high methodological quality is not necessarily one that patients and providers will find usable for their decision making.

Dialogue / Avalere Health and the National Health Council (NHC) hosted a Dialogue on July 10, 2013 that brought together leaders from across the healthcare community to: 1) corroborate the need for a systematic approach to evaluate the usability of CER findings; 2) define what is meant by usable CER; 3) agree on key attributes of usable CER findings; and 4) discuss how these concepts can be applied in practice. Following the Dialogue, Avalere and the NHC produced a white paper “Evaluating the Usability of CER for Patient and Provider Decision Making” that captured the discussion at the Dialogue, some of which is summarized below:

Usable CER / Usable CER is defined as a study that, based upon a user’s perspectives and needs, asks the best question, applies the best methods, and is communicated via the best approach to the intended audience of users.

Framework for Evaluating CER Usability / Dialogue participants identified several attributes of usable CER. The attributes were organized into three domains: meaningful, trustworthy, and translatable. Along with appropriate methods and evaluation, these three domains serve as the basis for a framework for the evaluation of CER usability.

Applying Usability Criteria in Practice / Developing a tool that assists a user in evaluating the usability of CER findings is expected to be the next step in this initiative. The framework outlined in this paper serves as a basis for usability criteria that can be applied to identify research that has the greatest potential to be usable for patients and providers. Usability criteria could be used by researchers and funders to help them clarify, refine, and prioritize the research questions that are likely to yield results that would be usable to patients and providers in their determination of the best choices for their healthcare. Usability criteria could guide thinking and planning around communications strategies of study results.

Following the research results, usability criteria can aid patients and providers in distilling and prioritizing healthcare evidence. Paired with tools that promote individualized care planning and shared decision making, usability criteria can help identify findings that enhance the quality of the interaction between patients and providers.

Finally, there is the application of usability criteria to evaluation and measurement. Evaluating usability is fundamental to the continuous improvement of design, conduct, and dissemination of CER. There is an equally important role for measuring and evaluating implementation in real-time shared decision making. One of the most powerful applications of a usability framework, therefore, may be in the future design of metrics that accelerate the feedback loop to funders, researchers, and providers about how patients use CER information and what really influences patient choices.

Please contact Sung Hee Choe or Elizabeth Walsh for additional information about the Dialogue and the white paper.

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