title: Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results.
abstract: OBJECTIVE
  Most electronic health record systems provide laboratory test results to patients in table format. We tested whether presenting such results in visual displays (number lines) could improve understanding.
  
  
  METHODS
  We presented 1620 adults recruited from a demographically diverse Internet panel with hypothetical results from several common laboratory tests, first showing near-normal results and then more extreme values. Participants viewed results in either table format (with a "standard range" provided) or one of 3 number line formats: a simple 2-color format, a format with diagnostic categories such as "borderline high" indicated by colored blocks, and a gradient format that used color gradients to smoothly represent increasing risk as values deviated from standard ranges. We measured respondents' subjective sense of urgency about each test result, their behavioral intentions, and their perceptions of the display format.
  
  
  RESULTS
  Visual displays reduced respondents' perceived urgency and desire to contact health care providers immediately for near-normal test results compared to tables but did not affect their perceptions of extreme values. In regression analyses controlling for respondent health literacy, numeracy, and graphical literacy, gradient line displays resulted in the greatest sensitivity to changes in test results.
  
  
  CONCLUSIONS
  Unlike tables, which only tell patients whether test results are normal or not, visual displays can increase the meaningfulness of test results by clearly defining possible values and leveraging color cues and evaluative labels.
  
  
  CONCLUSIONS
  Patient-facing displays of laboratory test results should use visual displays rather than tables to increase people's sensitivity to variations in their results.
authors.affiliation: Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.|Department of Internal Medicine, University of Michigan.|Center for Bioethics and Social Sciences in Medicine, University of Michigan.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Zikmund-Fisher
authors.affiliation: Center for Bioethics and Social Sciences in Medicine, University of Michigan.|Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Scherer
authors.affiliation: Department of Family and Emergency Medicine, Laval University, Quebec City, Quebec, Canada.|Office of Education and Professional Development, Faculty of Medicine, Laval University.|Population Health and Optimal Health Practices Research Unit, Research Centre of the CHU de Québec-Université Laval.
authors.forename: Holly O
authors.initials: HO
authors.lastname: Witteman
authors.affiliation: Center for Bioethics and Social Sciences in Medicine, University of Michigan.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Solomon
authors.affiliation: Center for Bioethics and Social Sciences in Medicine, University of Michigan.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Exe
authors.affiliation: Department of Pediatrics, University of Iowa.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Tarini
authors.affiliation: Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
mesh_terms: D019411:Clinical Laboratory Techniques; D003196:Computer Graphics; D003657:Decision Making; D057286:Electronic Health Records; D006801:Humans; D033283:Patient Access to Records; D014584:User-Computer Interface
keywords: clinical laboratory information systems; computer graphics; decision making; education of patients; electronic health record