Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results

Brian J Zikmund-Fisher; Aaron M Scherer; Holly O Witteman; Jacob B Solomon; Nicole L Exe; Beth A Tarini; Angela Fagerlin

doi:10.1093/jamia/ocw169

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Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results

Journal article

Open access

Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results

Brian J Zikmund-Fisher, Aaron M Scherer, Holly O Witteman, Jacob B Solomon, Nicole L Exe, Beth A Tarini and Angela Fagerlin

Journal of the American Medical Informatics Association : JAMIA, Vol.24(3), pp.520-528

05/01/2017

DOI: 10.1093/jamia/ocw169

PMCID: PMC5565988

PMID: 28040686

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Abstract

ABSTRACT Objective: Most electronic health record systems provide laboratory test results to patients in table format. We tested whether presenting such results in visual displays (number lines) could improve understanding. Materials and Methods: We presented 1620 adults recruited from a demographically diverse Internet panel with hypothetical results from several common laboratory tests, first showing near-normal results and then more extreme values. Participants viewed results in either table format (with a “standard range” provided) or one of 3 number line formats: a simple 2-color format, a format with diagnostic categories such as “borderline high” indicated by colored blocks, and a gradient format that used color gradients to smoothly represent increasing risk as values deviated from standard ranges. We measured respondents’ subjective sense of urgency about each test result, their behavioral intentions, and their perceptions of the display format. Results: Visual displays reduced respondents’ perceived urgency and desire to contact health care providers immediately for near-normal test results compared to tables but did not affect their perceptions of extreme values. In regression analyses controlling for respondent health literacy, numeracy, and graphical literacy, gradient line displays resulted in the greatest sensitivity to changes in test results. Discussion: Unlike tables, which only tell patients whether test results are normal or not, visual displays can increase the meaningfulness of test results by clearly defining possible values and leveraging color cues and evaluative labels. Conclusion: Patient-facing displays of laboratory test results should use visual displays rather than tables to increase people’s sensitivity to variations in their results.

education of patients

computer graphics

electronic health record

clinical laboratory information systems

decision making

Details

Title: Subtitle: Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results
Creators: Brian J Zikmund-Fisher - 1Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
Aaron M Scherer - 3Center for Bioethics and Social Sciences in Medicine, University of Michigan
Holly O Witteman - 5Department of Family and Emergency Medicine, Laval University, Quebec City, Quebec, Canada
Jacob B Solomon - 3Center for Bioethics and Social Sciences in Medicine, University of Michigan
Nicole L Exe - 3Center for Bioethics and Social Sciences in Medicine, University of Michigan
Beth A Tarini - 8Department of Pediatrics, University of Iowa
Angela Fagerlin - 9Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
Resource Type: Journal article
Publication Details: Journal of the American Medical Informatics Association : JAMIA, Vol.24(3), pp.520-528
DOI: 10.1093/jamia/ocw169
PMID: 28040686
PMCID: PMC5565988
NLM abbreviation: J Am Med Inform Assoc
ISSN: 1067-5027
eISSN: 1527-974X
Publisher: Oxford University Press
Language: English
Date published: 05/01/2017
Academic Unit: Nursing; General Internal Medicine; Internal Medicine
Record Identifier: 9984094506702771

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