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

2016 ◽  
Vol 24 (3) ◽  
pp. 520-528 ◽  
Author(s):  
Brian J Zikmund-Fisher ◽  
Aaron M Scherer ◽  
Holly O Witteman ◽  
Jacob B Solomon ◽  
Nicole L Exe ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Health Care Providers ◽  
Extreme Values ◽  
Number Line ◽  
Test Results ◽  
Care Providers ◽  
Visual Displays ◽  
Normal Test ◽  
Laboratory Test Results ◽  
Color Gradients

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.

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

2018 ◽  
Author(s):  
Aaron M Scherer ◽  
Holly O Witteman ◽  
Jacob Solomon ◽  
Nicole L Exe ◽  
Angela Fagerlin ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Diabetes Management ◽  
Number Line ◽  
Test Results ◽  
Visual Displays ◽  
Web Based ◽  
Condition Versus ◽  
Laboratory Test Results ◽  
The Impact ◽  
Standard Range

BACKGROUND 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. OBJECTIVE 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. METHODS Participants (N=6776) from a demographically diverse Web-based panel viewed hypothetical glycated hemoglobin (HbA1c) test results (HbA1c 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. RESULTS While goal range information did not influence the understanding of HbA1c=8.2% results, the goal range only display produced higher levels of comprehension and decreased negative reactions to HbA1c=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. CONCLUSIONS Replacing the standard range with a clinically appropriate goal range could help patients better understand how their test results relate to their personal targets.

Primary Care Providers’ Preferences and Concerns Regarding Specific Visual Displays for Returning Hemoglobin A1c Test Results to Patients

2019 ◽  
Vol 39 (7) ◽  
pp. 796-804
Author(s):  
Brian J. Zikmund-Fisher ◽  
Jacob B. Solomon ◽  
Aaron M. Scherer ◽  
Nicole L. Exe ◽  
Beth A. Tarini ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Hemoglobin A1c ◽  
Primary Care Providers ◽  
Test Results ◽  
Care Providers ◽  
Visual Displays ◽  
Hba1c Test ◽  
Laboratory Test Results ◽  
Physician Workload

Purpose. Patient portals of electronic health record systems currently present patients with tables of laboratory test results, but visual displays can increase patient understanding and sensitivity to result variations. We sought to assess physician preferences and concerns about visual display designs as potential motivators or barriers to their implementation. Methods. In an online survey, 327 primary care physicians (>50% patient care time) recruited through the online e-community/survey research firm SERMO compared hemoglobin A1c (HbA1c) test results presented in table format to various visual displays (number line formats) previously tested in public samples. Half of participants also compared additional visual formats displaying target goal ranges. Outcome measures included preferred display format and whether any displays were unacceptable, would change physician workload, or would induce liability concerns. Results. Most (85%–89%) respondents preferred visual displays over tables for result communications both to patients tested for diagnosis purposes and to diagnosed patients, with a design with color-coded categories most preferred. However, for each format (including tables), 11% to 23% rated them as unacceptable. Most respondents also preferred adding goal range information (in addition to standard ranges) for diagnosed patients. While most physicians anticipated no workload changes, 19% to 32% anticipated increased physician workload while 9% to 28% anticipated decreased workload. Between 32% and 40% had at least some liability concerns. Conclusions. Most primary care physicians prefer visual displays of HbA1c test results over table formats when communicating results to patients. However, workload and liability concerns from a minority of physicians represent a barrier for adoption of such designs in clinical settings.

scholarly journals Redundant laboratory testing on referral from general practice to the outpatient clinic

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0134
Author(s):  
Bram EL Vrijsen ◽  
Maarten J ten Berg ◽  
Wouter W van Solinge ◽  
Jan Westerink
Keyword(s):  
General Practitioner ◽  
Laboratory Test ◽  
Outpatient Clinic ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Referral Letter ◽  
Test Results ◽  
Normal Test ◽  
Laboratory Test Results ◽  
High Level

BackgroundInappropriately repeated laboratory testing is a commonly occurring problem. However, this has not been studied extensively in the outpatient clinic after referral by general practitioners.AimThe aim of this study was to investigate how often laboratory tests ordered by the general practitioner were repeated on referral to the outpatient clinic, and how many of the normal test results remained normal on repetition.Design & settingThis is a post hoc analysis of a study on laboratory testing strategies in patients newly referred to the outpatient clinic.MethodAll patients who had a referral letter including laboratory test results ordered by the general practitioner were included. These results were compared to the laboratory test results ordered in the outpatient clinic.ResultsData were available for 295 patients, 191 of which had post-visit testing done. In this group, 56% of tests ordered by the general practitioner were repeated. Tests with abnormal results were repeated more frequently than tests with normal results (65% vs 53%; P<0.001). A longer test interval was associated with slightly smaller odds of tests being repeated (OR 0.97 [0.95–0.99]; P=0.003). Of the tests with normal test results that were repeated, 90% remained normal. This was independent of testing interval or testing strategy.ConclusionLaboratory tests ordered by the general practitioner are commonly repeated on referral to the outpatient clinic. The number of test results remaining normal on repetition suggests a high level of redundancy in laboratory test repetition.

Effect of Ibuprofen on Serum Laboratory Test Results

1983 ◽  
Vol 40 (6) ◽  
pp. 1025-1034
Author(s):  
Carol L. Colvin ◽  
Raymond J. Townsend ◽  
William R. Gillespie ◽  
Kenneth S. Albert
Keyword(s):  
Laboratory Test ◽  
Test Results ◽  
Laboratory Test Results
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