Category | Identified problem (Number of respondents) | Suggestions to improve (Number of respondents) | How to do it |
---|---|---|---|
Perception | Disorganized (N = 8) | Visually separate (N = 5), organize (N = 4) | Create organized lists, groups, tables; Create flowchart |
Wordy (N = 6) | Simplify, shorten (N = 2), visually separate (N = 5) | Point form, tables | |
Long (N = 4) | Simplify, shorten (N = 2); visually separate (N = 5) | Lists, tables | |
Cognition | Do not understand grading of evidence quality (N = 6) | Define grading system of evidence quality (N = 6) | Use footnotes to explain grading of evidence; Hyperlink to more information about how grading is defined |
Confusing/complex (N = 4) | Visually separate (N = 5); organize (N = 4); match the system with the real world (N = 3) | Create organized lists, groups, tables; create flowchart; use terms familiar to physicians | |
Lacking information (N = 4) | Define terms and phrases (N = 4) | Define acronyms; define vague terms | |
Agreement | Not practical (lacking necessary resources, incongruent with provider and patient values) (N = 11) | Individualize (N = 4) | When formulating recommendations, consider costs, human resources, & provider & patient values |
Poor evidence (N = 6) | If the evidence is poor, simplify the recommendation (N = 4) | Do not give detailed and specific recommendations when there is weak evidence to support it | |
Does not make clinical sense (no clear direction, missing information) (N = 6) | Clear and actionable language; provide more background information (N = 4) | Use active voice; include clear targets; include information about benefits and harms | |
Too aggressive (i.e., targets, intervention, monitoring) (N = 4) | Provide background information for the recommendation (N = 8) | Acknowledge that it is a change from current practice and underscore the rationale |