Preferences of Knowledge Users for Two Formats of Summarizing Results from Systematic Reviews: Infographics and Critical Appraisals

Crick, K. & Hartling, L. (2015). Preferences of knowledge users for two formats of summarizing results from systematic reviews: Infographics and critical appraisals. PLoS One, 10(10), 1-8. doi: 10.1371/journal.pone.0140029
Objectives: To examine and compare preferences of knowledge users for two different formats of summarizing results from systematic reviews: infographics and critical appraisals.
Design: Cross-sectional.
Setting: Annual members’ meeting of a Network of Centres of Excellence in Knowledge Mobilization called TREKK (Translating Emergency Knowledge for Kids). TREKK is a national network of researchers, clinicians, health consumers, and relevant organizations with the goal of mobilizing knowledge to improve emergency care for children.
Participants: Members of the TREKK Network attending the annual meeting in October 2013.
Outcome Measures: Overall preference for infographic vs. critical appraisal format. Members’ rating of each format on a 10-point Likert scale for clarity, comprehensibility, and aesthetic appeal. Members’ impressions of the appropriateness of the two formats for their professional role and for other audiences.
Results: Among 64 attendees, 58 members provided feedback (91%). Overall, their preferred format was divided with 24/47 (51%) preferring the infographic to the critical appraisal. Preference varied by professional role, with 15/22 (68%) of physicians preferring the critical appraisal and 8/12 (67%) of nurses preferring the infographic. The critical appraisal was rated higher for clarity (mean 7.8 vs. 7.0; p = 0.03), while the infographic was rated higher for aesthetic appeal (mean 7.2 vs. 5.0; p<0.001). There was no difference between formats for comprehensibility (mean 7.6 critical appraisal vs. 7.1 infographic; p = 0.09). Respondents indicated the infographic would be most useful for patients and their caregivers, while the critical appraisal would be most useful for their professional roles.
Conclusions: Infographics are considered more aesthetically appealing for summarizing evidence; however, critical appraisal formats are considered clearer and more comprehensible. Our findings show differences in terms of audience-specific preferences for presentation of research results. This study supports other research indicating that tools for knowledge dissemination and translation need to be targeted to specific end users’ preferences and needs.
I really wanted to review this short article because it is the only article I know that explores the utility of infographics as a tool for knowledge mobilization. Working from an NCE KM(Network of Centres of Excellence in Knowledge Mobilization) called TREKK (Translating Emergency Knowledge for Kids) this article compared an infographic and a Critical Appraisal both summarizing the same evidence. The article asked physicians and nurses as well as a few parent advisors and a handful of “others” (researchers, research staff, allied health professionals) to rate the Critical Appraisal and Infographic on:

  • characteristics
  • appropriateness for different audiences
  • preference by professional role

Bottom line: everyone liked both, most preferred the Critical Appraisal for their professional work and felt the infographic would be better for patients and caregivers. No real surprise there although the small number of respondents representing the public/parents/families means that the conclusions are based on what physicians and nurses think about the preferences of non-professional audiences.
Some respondents found the infographic to be too busy, difficult to interpret and follow, and difficult to determine the take home message.” Two things here:

  1. the infographic shown in the article is very busy. I would be interested to know how many versions of the infographic were produced before landing on this final version. It is important that data/evidence are presented in a graphic fashion that is also accessible to a wide audience. My sense if there is too much information in the infographic presented in the paper. If your audience is the public and the goal is to raise awareness then not everything in the Clinical Appraisal needs to be in the infographic.
  2. There is no take home message explicitly in the infographic. The Critical Appraisal gives the take home message (literally). “Clinical Bottom Line: The primary use of Ibuprofen is justified based on safety and efficacy with triptans as a suitable choice for those in whom Ibuprofen has failed“. This clinical bottom line belongs in the infographic as well.

It would be interesting to see what the preferences of parents/families/public were regarding these two KT tools. In the KT world we often assume that parents want summaries of research, and they do, but they may prefer to a Critical Appraisal or clear language research summary over an infographic. Our work in NeuroDevNet has shown a positive response from parents to ResearchSnapshot clear language research summaries when tested in Linked In and Facebook groups. We just don’t know until we ask the question. Nonetheless, if you’re going to produce an infographic aimed at public/families then test the infographic before finalizing it.
This is recognized by the authors who state, “the results of this research demonstrate the importance of understanding the preferences of the target audience when designing knowledge translation tools.”
As mentioned above, this is the first article I have seen starting a critical inquiry into infographics. A google scholar search on the word “infographic” yielded lots of articles referencing infographics but none of them were about infographics per se. The authors acknowledge this. “This study is the first of its kind to compare infographic and critical appraisal formats as a knowledge translation tool for the results of systematic reviews. Infographics have become a popular format of data presentation; however, there is little research evidence to support their use or preferences among target audiences.”
Despite the lack of evidence that infographics actually work to provide evidence to decision makers (be they health professionals or parents/families) they are increasingly used as part of KT practice. NeuroDevNet produced an infographic on our KT activities. The HomelessHub has produced many infographics. They can be visually appealing. They are an established part of the KT tool kit. But do they work? This article doesn’t ask that question, but it starts the critical inquiry into user preferences for infographics.
Questions for brokers:

  1. Are you using infographics? Why or why not?
  2. Why do we continue to be knowledge hypocrites and use practices that are not supported by evidence?
  3. We know that making evidence accessible in different formats is necessary but not sufficient to inform behaviour change but as KT practitioners we continue to create our tools and then what…post them on the internet?  Probably. What more do we need to do beyond the infographic (for example) to help decision makers use the evidence presented in different formats?

ResearchImpact-RéseauImpactRecherche (RIR) is producing this journal club series as a way to make evidence on KMb more accessible to knowledge brokers and to create on line discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read this open access article. Then come back to this post and join the journal club by posting your comments.