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Question 4: Is it clear what sources of information were used to compile the publication (other than the author or producer)?

What the question is about and why it is important

Information about treatment choices should be accurate and based on the best available scientific evidence. DISCERN cannot be used to tell you whether information is true or based on sound evidence, as this would require checking against other sources. However, a good quality publication will make it clear where the evidence for the information about treatment choices has come from. Details of the sources of evidence are important, as they enable you to check the information or decide to seek further information. Sources of evidence can include research articles and the opinions of experts such as clinicians and representatives from self-help organisations. The author or producer is not considered a source for this question, as this information is nearly always provided and will not help you discriminate between good and poor quality publications.

Rating the question

There are two parts to the question that are reflected in the hints:

  1. a main statement or ‘fact’ about a treatment choice should be accompanied by a reference to the source of evidence in the text in the main part of the publication [e.g. ‘Treatment using X has been found to be successful (reference)’]

  2. a source of evidence should be listed in a bibliography or reference list at the end of the publication, or inserted as an external link to another online publication or organisation.

These two parts may not both be present.

It is not possible to make recommendations as to how many statements about treatment choices should be referenced or how many references should be listed at the end of the publication or included as links.

Additional sources of support and information, such as ‘Further reading’ or ‘Useful addresses’, should not be rated as the sources of evidence for the information about treatment choices. The information provided by ‘additional’ sources will not necessarily have been used to compile this publication, and in many cases may provide very different information (see Question 7).

Guidelines for rating the question:

  • 5: Yes - the sources of evidence are very clear and the publication enables you to link the source mentioned in the text to a full reference at the end of the publication or to another online source of information. It is possible that a publication referring to a single source in both the text and the reference list or link will rate high on this question. Judging the quality of a publication based on a single source of information is a separate issue that is addressed in Question 6.

  • 2 - 4Partially - the sources of evidence are clear to some extent. Give a partial rating if one of the hints is fulfilled. You may also give a partial rating to a publication which quotes a reference in the text for some but not all of the main statements or ‘facts’ about treatment choices, although you will need to use your judgement to decide when a reference would be expected.

  • 1: No - no sources of evidence for the information are mentioned.

Remember: a high rating on this question does not mean that the information is accurate or of good scientific quality. It tells you it meets our criterion of the sources of evidence being explicit.

It is not yet common practice to include references and therefore it is very unlikely that many publications will rate highly on this question.


Hint 1 (in the text)Hint 2  (1(b) and 2(b) will be in a reference list or bibliography at the end)
1 (a) ‘In the short-term, treatment X can halt the weight loss associated with Jones’ disease. It can also reduce the symptoms of pain and breathlessness (Jones and Jones, 1995).’1 (b) Jones J, Jones A. 'The Diagnosis and Management of Jones’ Disease'. London: Jones & Co. 1995, 2nd edition.
2 (a) ‘The most common side-effects you may experience with treatment X are sleepiness and slight confusion, but there are no known long-term side-effects or risks associated with this treatment.82 (b) 8 Jones SS. A randomised controlled trial of treatment X for Jones’ disease. 'Journal of Jones' Science', 1998; 3: 11 - 20.
3 (a) ‘According to the Jones' Disease Association, patients who decide to postpone treatment do not run any greater risk of lung damage later in life than those opting for early treatment.'3 (b) External link: takes you the Jones' Disease Association website.

In each example, a 5 rating is appropriate if both parts (a) and (b) are provided, whilst a partial rating will be given if part (a) or part (b) only is provided. If statements or ‘facts’ are presented with no accompanying reference and there is no reference list or link to the sources used, the publication will be rated 1.