Establishing a library of resources to help people understand key concepts in assessing treatment claims—The “Critical thinking and Appraisal Resource Library” (CARL)

BackgroundPeople are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior.ObjectivesOur objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as ‘intermediaries’ of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups.MethodsCARL was populated with learning-resources identified from a variety of sources—two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by ‘Key Concepts’ needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org).ResultsWe have created a database of resources called CARL, which currently contains over 500 open-access learning-resources in a variety of formats: text, audio, video, webpages, cartoons, and lesson materials. These are aimed primarily at ‘Intermediaries’, that is, ‘teachers’, ‘communicators’, ‘advisors’, ‘researchers’, as well as for independent ‘learners’. The resources included in CARL are currently accessible at www.testingtreatments.org/category/learning-resourcesConclusionsWe hope that ready access to CARL will help to promote the critical thinking about treatment claims, needed to help improve healthcare choices.

【背景】人们时常会接触到关于治疗效果的不可信主张。若不加批判地接受此类主张，可能会作出欠佳乃至危险的治疗决策，还会造成时间与金钱的无谓浪费。当前，用于帮助人们批判性审视治疗主张的学习资源不仅稀缺，且分布零散。此外，极少有学习资源被评估过是否能够提升人们的相关知识与行为水平。

【目标】本研究旨在开发批判性思维与评估资源库（Critical thinking and Appraisal Resource Library，CARL）。该资源库将以数据库形式呈现，收录面向负责倡导批判性审视治疗主张人群的学习资源，并面向公众开放在线访问。我们计划纳入面向我们定义为“知识中介者”群体的资源，例如中小学教师、本科生与研究生授课教师（如循证医学（evidence-based medicine）授课者），以及向公众传递治疗主张的传播人员。在遴选资源时，我们将重点关注那些经过正式评估的资源，例如由资源创作者或独立研究团队开展评估的资源。

【方法】CARL的学习资源来源于多种渠道：两份此前已开发但未维护的资源清单、学习干预措施的系统综述、在线及数据库检索结果，以及项目组及其顾问团队成员的推荐。CARL内的学习资源按照用于判断治疗主张可信度所需的核心概念（Key Concepts）进行分类，并由詹姆斯·林德倡议测试治疗互动平台（Testing Treatments interactive，TTi）英文站（www.testingtreatments.org/category/learning-resources）面向公众开放在线访问。该TTi英文站同时整合了核心概念数据库，以及由知情医疗选择（Informed Healthcare Choices，IHC）项目开发的主张评估工具（informedhealthchoices.org）。

【结果】本研究已建成名为CARL的资源数据库，目前收录超过500种开放获取的学习资源，涵盖文本、音频、视频、网页、漫画及课程材料等多种形式。这些资源主要面向“知识中介者”群体，即教师、传播者、顾问、研究人员，同时也可供独立学习者使用。当前可通过www.testingtreatments.org/category/learning-resources访问CARL收录的全部资源。

【结论】我们期望，用户可便捷获取CARL，这将有助于推动针对治疗主张的批判性思维培养，进而助力优化医疗决策选择。