The DISCERN questionnaire provides a valid and reliable way for anyone to assess the quality of written information on treatment choices for a health problem. DISCERN can also be used by authors and publishers of information on treatment choices as a guide to the standard which users are entitled to expect.
A key aspect of increased consumer involvement in decisions about treatment is access to high quality information. Well written consumer health information about treatment choices:
- is accurate and based on the best, most up-to-date scientific evidence
- helps a person consider all aspects of a treatment choice (including the outcomes of a choice and any areas of uncertainty)
- helps a person to understand their treatment and to know what to expect.
Issues other than clinical effectiveness may also be important when deciding about treatment and good quality information will help people choose the option that is best for them. Not all consumer health information is based on good evidence. many publications provide inaccurate of confusing advice and it can be hard to know which information to use and which to discard.
What is DISCERN For?
DISCERN can be used to judge the quality of a publication without the need for specialist knowledge and without reference to other publications or advisers. It may raise issues which will lead users to seek further information or advice and may be useful for comparing a range of information about treatment choices.
DISCERN can be used to judge the reliability of a publication as a source of information about treatment choices and to assess whether the sources of evidence are explicit.
DISCERN cannot be used to assess the scientific quality or accuracy of the evidence on which a publication is based, as this would require checking against other sources.
DISCERN is designed to help rate the quality of a publication in terms of its content. It does not include questions about the presentation of information e.g layout, graphics and readability as there is already a lot of literature on the importance of these features. A publication that is well presented and readable is not necessarily informative and accurate.
who can use discern?
DISCERN can be used by anyone who users or produces information about treatment choices. Users include:
- People who want to know more about a treatment including consumers, family, friends and carers to assess the quality of written information and to increase involvement in decisions about treatment by raising issues to discuss with health professionals
- Health information providers can use DISCERN to assess the information they offer.
- Authors and producers of written consumer health information can use DISCERN as a checklist
- Health professionals can use DISCERN in training to improve communication and shared decision-making skills.
HOW WAS DISCERN DEVELOPED?
An expert panel analysed a random sample of consumer health information on treatment choices for three medical conditions with varying degrees of evidence: myocardial infarction, endometriosis and chronic fatigue syndrome. A draft tool based on this analysis was then tested by the panel on a random sample of new material for the same three conditions. The performance of the draft instrument was analysed using a measure of inter-rater agreement (weighted kappa) and panel debate. The instrument was re-drafted to take account of the results of the analyses. The final pilot of the DISCERN questionnaire was conducted by a national sample of 13 self-help group members and 15 information providers on a random sample of leaflets from 19 major national self-help organisations. Tests of inter-rater agreement were conducted and participants were asked to complete a questionnaire assessing their views on the validity and applicability of the instrument.
This rigorous process enabled us to identify a set of guidelines for the content of written information on treatment choices which can be consistently understood and applied by a wide range of users. DISCERN is the first standardised index of quality of consumer health information.
Further details of how DISCERN was developed were published in the Journal of Epidemiology & Community Health, February 1999.
The DISCERN project team
The team led by Sasha Shepperd and Deborah Charnock worked with:
- information specialists
- self-help group representatives
- a consumer health information expert
- a lay medical publisher
- a health journalist
- a health consumer representative
- a Community Health Council representative
- a Plain English Campaign representative
- an NHS Centre for Reviews and Dissemination representative.