Efficacy of Three Numerical Presentation Formats on Lay People's Comprehension and Risk Perception of Fact Boxes-A Randomized Controlled Pilot Study.

(1) Background: Fact boxes present the benefits and harms of medical interventions in the form of tables. Some studies suggest that people with a lower level of education could profit more from graphic presentations. The objective of the study was to compare three different formats in fact boxes with regard to verbatim and gist knowledge in general and according to the educational background. (2) Methods: In May 2020, recruitment started for this randomized controlled trial. Participants were given one out of three presentation formats: natural frequencies, percentages, and graphic. We used Limesurvey® to assess comprehension/risk perception as the primary outcome. The Kruskal-Wallis test and the Mann-Whitney U test were used in addition to descriptive analyses. (3) Results: A total of 227 people took part in the study. Results of the groups were nearly identical in relation to the primary outcome verbatim knowledge, likewise in gist knowledge. However, participants with lower educational qualifications differed from participants with higher educational qualifications in terms of verbatim knowledge in the group percentages. (4) Conclusions: The results indicate that all three forms of presentation are suitable for conveying the content. Further research should take the individual preferences regarding the format into account.

Fact Boxes: What gets through? A focus group study.

BACKGROUND: The "fact box" format was developed to present the benefits and side effects of medical treatments without distortion and in a comprehensible manner. Few studies were able to show that fact boxes, when compared with other formats, significantly improve risk perception, comprehensibility and readability. The fact boxes available in Germany, however, vary with regard to how tables and accompanying texts are presented. It is unclear to what extent the existing evidence can be applied to these formats. Hardly any fact boxes have been piloted systematically. The aim was to pilot the fact box "Antibiotics for acute bronchitis" as a model for the format in terms of feasibility. METHOD: We used print and online media to recruit adults (> 18 years). The characteristics gender, age and level of education were considered for sampling. The feasibility was explored by means of a semi-structured interview guideline. The focus group interviews were audio-taped and then transcribed. Data analysis was conducted as content analysis according to Mayring. RESULTS: Five focus groups with a total of 28 participants took place between April 2018 and May 2019 (Halle/Saale, Saxony-Anhalt: n=3; St. Ingbert, Saarland: n=1; Trier, Rhineland-Palatinate: n=1). The fact box was piloted in an iterative process; the results were revised accordingly and checked again in focus groups until information saturation was achieved. The analysis identified the following main categories: interpretation of contents, readability, low reliability; credibility, relevance of the information, relevance of the presentation; superfluous information; completeness and layout. Overall, the fact box was hardly understood, especially regarding the numerical presentation given and the technical terms used. Both the objective and the intended addressees of the fact box were not clear. After revision, feasibility was established. DISCUSSION: The iterative revision process resulted in a final version that was well understood and perceived as a decision aid. CONCLUSION: The results support the demand of the guideline "Evidence-based Health Information" for piloting evidence-based health information prior to their dissemination and further evaluation. The next step will be to evaluate the fact box format in a randomised controlled trial.