Methodology for selection of patient information material

The patient information materials cited within the Patient Information Zone are selected systematically. The selection process is outlined below.

1. Selection of conditions. The conditions included in the Patient Information Zone are selected by the editorial board as those that are frequency encountered in primary care and that typically require the provision of patient information material. The list of conditions will be expanded over time.
   
   
2. Scope of materials. Having identified a particular condition for inclusion, the GPnotebook editorial board is consulted for a list of questions and topics that may be raised by patients during a primary care consultation. For example, for asthma, relevant questions included:
   • What is asthma?
   • What treatments are available?
   • What does a diagnosis of asthma mean for my day-to-day life?
   • Air travel and asthma.
   • Exercise and asthma.
   • Smoking and asthma.
   • COVID-19 and asthma.
   • Steroids and asthma.
     
     
3. Search. A structured “Google search” is performed for each question and topic identified in step 2. Ignoring sponsored links, the search results that link to literature intended for patients (such as leaflets or information from charity websites) are considered.
   
   
4. Informal assessment. The highest-ranking applicable search result is informally assessed to determine whether it “answers” the question (or topic) of interest. If so, the resource is retained for formal assessment. If not, the next highest-ranking result is informally assessed, and so on. If no suitable results are identified, the topic/question may be refined (for example, to break it into two subtopics).
   
   
5. Formal assessment. All retained resources are assessed using the Patient Education Materials Assessment Tool (PEMAT) version 1.0. PEMAT is “a systematic method to evaluate and compare the understandability and actionability of patient education materials”. More information on the tool can be found at: https://www.ahrq.gov/health-literacy/patient-education/pemat.html. To be included in the Patient Information Zone, an information resource is required to score at least 50% on the understandability domain and at least 40% on the actionability domain.