Improving the Understanding of Test Results by Substituting (Not Adding) Goal Ranges: Web-Based Between-Subjects Experiment

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

doi:10.2196/11027

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Improving the Understanding of Test Results by Substituting (Not Adding) Goal Ranges: Web-Based Between-Subjects Experiment

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Improving the Understanding of Test Results by Substituting (Not Adding) Goal Ranges: Web-Based Between-Subjects Experiment

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

Journal of medical Internet research, Vol.20(10), pp.e11027-e11027

10/19/2018

DOI: 10.2196/11027

PMCID: PMC6231727

PMID: 30341053

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Abstract

Most displays of laboratory test results include a standard reference range. For some patients (eg, those with chronic conditions), however, getting a result within the standard range may be unachievable, inappropriate, or even harmful. The objective of our study was to test the impact of including clinically appropriate goal ranges outside the standard range in the visual displays of laboratory test results. Participants (N=6776) from a demographically diverse Web-based panel viewed hypothetical glycated hemoglobin (HbA ) test results (HbA either 6.2% or 8.2%) as part of a type 2 diabetes management scenario. Test result visual displays included either a standard range (4.5%-5.7%) only, a goal range (6.5%-7.5%) added to the standard range, or the goal range only. The results were displayed in 1 of the following 3 display formats: (1) a table; (2) a simple, two-colored number line (simple line); or (3) a number line with diagnostic categories indicated via colored blocks (block line). Primary outcome measures were comprehension of and negative reactions to test results. While goal range information did not influence the understanding of HbA =8.2% results, the goal range only display produced higher levels of comprehension and decreased negative reactions to HbA =6.2% test results compared with the no goal range and goal range added conditions. Goal range information was less helpful in the block line condition versus the other formats. Replacing the standard range with a clinically appropriate goal range could help patients better understand how their test results relate to their personal targets.

decision making, education of patients, electronic health record, computer graphics, clinical laboratory information systems

Details

Title: Subtitle: Improving the Understanding of Test Results by Substituting (Not Adding) Goal Ranges: Web-Based Between-Subjects Experiment
Creators: Aaron M Scherer - Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
Holly O Witteman - Population Health and Optimal Health Practices Research Unit, Research Centre of the CHU de Québec-Université Laval, Quebec City, QC, Canada
Jacob Solomon - Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States
Nicole L Exe - Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States
Angela Fagerlin - Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, United States
Brian J Zikmund-Fisher - Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
Resource Type: Journal article
Publication Details: Journal of medical Internet research, Vol.20(10), pp.e11027-e11027
DOI: 10.2196/11027
PMID: 30341053
PMCID: PMC6231727
NLM abbreviation: J Med Internet Res
ISSN: 1438-8871
eISSN: 1438-8871
Grant note: R01 HS021681 / AHRQ HHS
Language: English
Date published: 10/19/2018
Academic Unit: General Internal Medicine; Internal Medicine
Record Identifier: 9984094338602771

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