Table2_The effectiveness of video animations as information tools for patients and the general public: A systematic review.docx

Background and objectivesVideo animations are used increasingly as patient information tools; however, we do not know their value compared to other formats of delivery, such as printed materials, verbal consultations or static images.
MethodsThis review compares the effectiveness of video animations as information tools vs. other formats of delivery on patient knowledge, attitudes and cognitions, and behaviours. Included studies had the following features: controlled design with random or quasi-random allocation; patients being informed about any health condition or members of the public being informed about a public health topic; comparing video animation with another delivery format. Multiple digital databases were searched from 1996-June 2021. We also undertook citation searching. We used dual, independent decision-making for inclusion assessment, data extraction and quality appraisal. Included studies were appraised using the Cochrane ROB2 tool. Findings were reported using narrative synthesis.
ResultsWe included 38 trials, focussed on: explaining medical or surgical procedures (n = 17); management of long-term conditions (n = 11); public health, health-promotion or illness-prevention (n = 10). Studies evaluated cartoon animations (n = 29), 3D animations (n = 6), or 2D animations, “white-board” animations or avatars (n = 1 each). Knowledge was assessed in 30 studies, showing greater knowledge from animations in 19 studies, compared to a range of comparators. Attitudes and cognitions were assessed in 21 studies, and animations resulted in positive outcomes in six studies, null effects in 14 studies, and less positive outcomes than standard care in one study. Patient behaviours were assessed in nine studies, with animations resulting in positive outcomes in four and null effects in the remainder. Overall risk of bias was “high” (n = 18), “some concerns” (n = 16) or “low” (n = 4). Common reasons for increased risk of bias were randomisation processes, small sample size or lack of sample size calculation, missing outcome data, and lack of protocol publication.
DiscussionThe overall evidence base is highly variable, with mostly small trials. Video animations show promise as patient information tools, particularly for effects on knowledge, but further evaluation is needed in higher quality studies.
Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?, identifier: CRD42021236296.

背景与目的：
视频动画（video animations）作为患者信息工具的应用日益广泛，但目前尚不清楚其相较于印刷材料（printed materials）、口头咨询（verbal consultations）、静态图片（static images）等其他信息传递形式的应用价值。

方法：
本系统综述对比了视频动画作为信息工具与其他传递形式在患者知识、态度、认知及行为层面的干预效果。纳入研究需满足以下特征：采用随机或半随机分配的对照设计；研究对象为需了解任意健康疾病状况的患者，或需知晓公共卫生主题的普通民众；比较视频动画与其他信息传递形式的效果。本研究检索了1996年至2021年6月期间的多个数字化数据库，并辅以引文检索。研究纳入评估、数据提取及质量评价环节均采用双人独立决策模式。纳入研究采用Cochrane偏倚风险2号工具（Cochrane ROB2）进行质量评价，结果采用叙述性合成（narrative synthesis）方法进行报告。

结果：
本研究共纳入38项试验，研究主题涵盖：医疗或手术操作讲解（n=17）、慢性疾病管理（n=11）、公共卫生、健康促进或疾病预防（n=10）。所纳入的研究中，29项评估了卡通动画（cartoon animations）、6项评估了三维动画（3D animations），剩余3项分别评估了二维动画（2D animations）、白板动画（white-board animations）及虚拟化身（avatars）。其中30项研究对患者知识水平进行了评估，结果显示相较于各类对照干预，19项研究中视频动画可提升患者知识水平。21项研究评估了患者的态度与认知，其中6项研究显示视频动画可带来积极结局，14项研究未观察到显著效果，另有1项研究显示其效果劣于标准护理方案。9项研究评估了患者行为，其中4项研究显示视频动画可带来积极结局，其余研究未观察到显著效果。整体偏倚风险分级为“高”（n=18）、“存在一定顾虑”（n=16）或“低”（n=4）。偏倚风险升高的常见原因包括随机化流程不规范、样本量较小或未进行样本量计算、结局数据缺失以及未预注册研究方案。

讨论：
现有证据基础异质性较高，且多数试验为小样本研究。视频动画作为患者信息工具展现出良好的应用前景，尤其在提升患者知识水平方面，但仍需开展更高质量的研究以进一步验证其效果。

系统综述注册：https://www.crd.york.ac.uk/prospero/display_record.php?，标识符：CRD42021236296。