Abstract

Accurately describing treatment effects using plain language and narrative statements is a critical step in communicating research findings to end users. However, the process of developing these narratives has not been historically guided by a specific framework. The Agency for Healthcare Research and Quality Evidence-based Practice Center Program developed guidance for narrative summaries of treatment effects that identifies five constructs. We explicitly identify these constructs to facilitate developing narrative statements (1) size of effect, (2) direction of effect, (3) clinical importance, (4) statistical significance, and (5) strength or certainty of evidence. These constructs clearly overlap. It may not always be feasible to address all five constructs. Based on context and intended audience, investigators can assess which constructs will be most important to address in narrative statements.

Contents

• Key Messages
• Preface
• Background
• Methods
• Results
  • Constructs That Can Be Used To Describe Treatment Effects
  • Overlap of Constructs
• Discussion
• References
• Abbreviations and Acronyms
• Appendixes
  • Appendix A. Suggested Phrases From Cochrane EPOC Guidance
  • Appendix B. Informative Statements To Communicate Results of Systematic Reviews From GRADE
  • Appendix C. Guide to Sections of EPC Reports Where Plain-Language Statements Are Most Useful

Suggested citation:

Gerrity M, Fiordalisi C, Pillay J, Wilt TJ, O’Connor E, Kahwati L, Hernandez AV, Rutter CM, Chou R, Balk EM, Steele DW, Saldanha IJ, Panagiotou OA, Chang S, Murad MH. Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews. Methods White Paper. (Prepared by the Scientific Resource Center under Contract No. 290-2017-00003C.) AHRQ Publication No. 20(21)-EHC018. Rockville, MD: Agency for Healthcare Research and Quality. November 2020. Posted final reports are located on the Effective Health Care Program search page. DOI: 10.23970/AHRQEPCWHITEPAPERNARRATIVELY.

This work was funded by the Agency for Healthcare Research and Quality through the following contracts: Mayo Clinic EPC (290-2015-00013-I), Scientific Resource Center (290-2017-00003-C), University of Alberta EPC (290-2015-00001-I), University of Minnesota EPC (290-2015-00008-I), Kaiser Permanente Research Affiliates EPC (290-2015-00007-I), RTI-University of North Carolina EPC (290-2015-00011-I), Southern California/RAND EPC (290-2015-00010-I), Pacific Northwest EPC (290-2015-00009-I), Brown University EPC (290-2015-00002), and 1R03HS025840-01A1. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help healthcare decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report is made available to the public under the terms of a licensing agreement between the authors and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

AHRQ appreciates appropriate acknowledgment and citation of its work. Suggested language for acknowledgment: This work was based on an evidence report, Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews, by the Evidence-based Practice Center Program at the Agency for Healthcare Research and Quality (AHRQ).