DISCERN

There are several tools available for appraising the content of information for patients, both local efforts and higher profile national initiatives ¹ . DISCERN stands out amongst those I have seen by virtue of the `hints' it offers after each criteria, these elaborate on what to look for and make the meaning of the questions much clearer. DISCERN also avoids being overly prescriptive about what a publication should or should not contain. A by‐product of this is that it is of manageable size: sitting down to apply it does not feel too daunting – an important feature if it is to be widely taken up by consumers those who are not information professionals. It directs attention to crucial issues and is generally clear and easy to understand. The accompanying handbook is slightly weighty but again clearly written and of help in using the instrument. As with any tool, DISCERN gets easier to apply consistently with practice.

However, there are a few suggestions for improvement. Firstly, the instrument is written in two main sections `Is the publication reliable?' and `How good is the quality of information on treatment choices?' with a third brief section judging overall quality. The first section could be used to good effect on publications other than those concerned specifically with treatment outcomes. The handbook states that sets of questions should not be used separately from the whole tool. This is unfortunate and is probably unrealistic: it would be possible to use the first section as standard with following sections available according to the type of publication under review. Many publications dealing with treatments also describe the condition and a section assessing this type of information would enable a better overall judgement of the item. It would be valuable to have the option of subsequent sections dealing with information on diseases and conditions, on treatment options, on healthy lifestyles etc., to be used together or separately as appropriate, but always following the first section as standard.

Secondly, DISCERN would benefit from the option to add comments, especially in relation to the overall quality of the publication. Currently DISCERN does not reflect the fact that a publication can be particularly strong on one subject area and what this is. For example, a leaflet may mention several treatments but deal with only one outstandingly well. (Or it may be poor on treatments but very good on description of the condition.) Ideally this should be reflected in the stated aims of the leaflet but often is nοt. The leaflet might then score low on DISCERN yet still have value in a particular situation or with a particular client group. It would be helpful to have some way of indicating what these good uses are, if they are not clear in the aims.

Lastly, the handbook stresses that DISCERN cannot answer questions about the clinical accuracy of the information, it can, however, point to gaps and encourage further information seeking. Perhaps something to this effect on the checklist itself would be beneficial, to encourage consumers not to see DISCERN as the end of the process.