JMIR Publications

ABSTRACT

Background:

Summary of Findings (SoF) tables are a key component of evidence summaries in systematic reviews, intended to communicate results clearly and transparently. However, users frequently report challenges in interpreting them, suggesting that the current format may not fully support comprehension, usability, and evidence-based decision-making.

Objective:

To investigate how different types of users: GRADE/Cochrane experts, practicing clinicians, and healthcare users, cognitively interact with Summary of Findings (SoF) tables when answering intervention-related questions.

Methods:

We used the Read&Learn tool in an online, single-session study to evaluate participants’ interactions with SoF tables. Participants (n=120; 40 per group) accessed pre-selected SoF tables via a secure link and unique login. The intervention involved blurring specific table cells, which had to be clicked to reveal the content. Four SoF tables of increasing complexity were presented.

Results:

Participants without prior extensive experience in SoF tables, including clinicians, had difficulty interpreting information as table complexity and task difficulty increased. The rising intrinsic and extraneous load in the third and fourth tables was high enough to challenge all groups, leveling performance between experts and non-experts. Experts outperformed others in only four to five out of 13 interaction parameters in the third and fourth table. Across groups, the majority of participants struggled to move beyond basic comprehension and application.

Conclusions:

SoF tables are cognitively demanding even for experts in evidence synthesis, suggesting that prior knowledge provided some advantage but could not fully offset the cognitive demands of high element interactivity. Prioritizing critical outcomes, presenting absolute and relative effects with certainty ratings, and adopting interactive formats may improve usability.