DISCERN

In recent years the amount of information written for consumers about health and treatment choices has grown at an unprecedented rate. ¹ Patients can now obtain information on treatment choices from multiple sources. However, despite this growing investment the quality of information remains variable. ^{2 , 3} Only a small proportion of this material is evidence‐based, the majority focusing on the processes rather than the outcomes of treatment. It can be difficult to know which information to use and which to discard.

Health professionals can access tools and training which enable them to critically appraise scientific information about treatment. DISCERN was developed to help patients, information providers and producers appraise the quality of written consumer health information on treatment choices in a similarly systematic way. ⁴ A range of experts, including patients, developed and tested DISCERN. This diverse group agreed on a set of criteria to be used to judge the quality of consumer health information about treatment choices. The criteria were piloted and formally tested to ensure that they could be applied by a wide range of users. Consequently, DISCERN is the first standardized index of consumer health information. DISCERN consists of 15 questions plus an overall quality rating. Each of the 15 questions represents a feature that is an important part of good quality information on treatment choices. A number of hints are given after each question to guide the user. The overall quality rating at the end of the instrument is an intuitive summary of answers to all of the 15 questions. The quality rating can be used to select and reject publications or to highlight their limitations.

DISCERN focuses on treatment choices, as this is a key area for increasing patient involvement in healthcare. Patients can only make meaningful decisions about treatment if they can access good quality information. There is evidence to suggest that increasing patients'_participation in treatment decisions can lead to improvements in health status, better quality of life, and more satisfactory doctor‐patient consultation. ⁵ , 6, 7, ^–8 However, consumers are often dependent on the knowledge base and attitude of the giver of the information. Although respected sources are available, some information can be misleading or confusing. In some cases the information may be completely inaccurate with poignant case scenarios unduly influencing the patient's perception of risk. Ideally patients should be given detailed explanations of the likely outcomes with and without treatment. This information should be derived from the best and most up‐to‐date scientific evidence.

DISCERN will not only enable information providers and patients to judge the quality of written information about treatment choices; it will also facilitate the production of high quality evidence‐based consumer health information by setting standards, and by providing a reference point for authors. Users of DISCERN report that using the instrument has led to the adoption of good practice in producing and selecting consumer health information. Given the rapid growth and flow of information, both written and electronic, the management of information has become a key issue. As the demand for information continues to increase DISCERN will play a vital role in the delivery of effective healthcare by enabling patients to make informed treatment choices based on good evidence.

Acknowledgements

The DISCERN project was funded by the British Library.