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By JoVE, I think they’ve got it!  A multimedia approach to intervention description

9 Apr, 2014

collageWellcome Trust Senior Investigator Mary Dixon-Woods is Professor of Medical Sociology at the University of Leicester. She was recently involved in a large international team that published the TIDieR checklist in the BMJ, aimed at improving the way interventions are described in research papers. Better descriptions of interventions can help ensure better care for patients and cut research waste. Here she and her co-authors Tammy Hoffmann and Paul Glasziou, from Bond University in Australia, explain how researchers can go beyond the traditional peer-reviewed article to enable patients and clinicians to adopt useful interventions and support researchers in replicating studies.

Back in the early 20th century, branded drugs could not be evaluated independently because they contained secret ingredients. Fortunately that’s no longer true, thanks to persistent campaigning. Yet poorly described health interventions – whether they are drugs or health promotion campaigns, or anything else – remain remarkably common.

Now, incomplete intervention descriptions arise not because manufacturers are jealously guarding trade secrets, but instead because of problems in communication, awareness and attention among authors, editors and reviewers – as well as restrictions on word limits in journals.

The traditional medical journal article may well be too stifling a format for communicating the content and mechanisms of interventions in full. Researchers are now embracing more creative multimedia solutions to ensure full and explicit accounts of interventions are available. Below aresome examples. We hope that use of the TIDieR checklist that we have developed, alongside more innovative methods of sharing information, will help to solve the issues related with poor communication of, and lack of space for, information about the interventions.

TIDieR checklist - portion

Study websites

A trial or study website can be used to host multiple resources, including published peer-reviewed papers, intervention manuals, data collection templates, patient information leaflets, participant newsletters, online appendices, protocols, a PaT plot (a graphical method of depicting the components of complex interventions)and links to participating organisations – all in one place.

An example is, the website of a large-scale trial that was the first to test and compare the effectiveness of four of the main treatments for people suffering from chronic fatigue syndrome (CFS).

Online handbooks

Online handbooks can provide highly structured and accessible ‘how to’ guides for the consumers or deliverers of interventions. The free-to-access HANDI site (Handbook of Non-Drug Interventions) was developed in partnership with the Royal Australian College of GPs.

Aimed at clinicians, the entries range from the ‘mother’s kiss’ technique for removing foreign bodies from the nose to pulmonary rehabilitation for COPD. Readers are invited to give feedback and submit suggestions of interventions for inclusion into this database. The format of the HANDI entries, together with its interactive features, may offer a useful model for authors seeking to provide a comprehensive range of materials related to their interventions.

Smartphone apps

Apps are a great way of connecting with the potential users of interventions, though they do require the right expertise and a budget for app development, and they are likely to be suitable only for some kinds of intervention.

Interventions that involve patients in ‘doing something’ (e.g. home-based exercise programmes, dietary interventions) may especially lend themselves to this interactive, ‘carry everywhere’ format. An example is the Dutch ‘Versterk je Enkel’ (Strengthen your Ankle) interactive app available on iOS and Android. As well as general advice on bracing and taping, the app delivers an evidence-based, cost-effective neuromuscular training programme to prevent ankle sprains.



Videos, made available online (e.g. with YouTube/Vimeo), or by DVD are likely to be especially helpful for interventions with difficult-to-describe procedures (such as physiotherapy manipulation techniques and surgical procedures). Depending on the amount of voice-over required, they may also provide a way around language translation issues.

Well worth a look is the ‘first scientific video journal’ JoVE, the Journal of Visualised Experiments. It is a peer-reviewed, PubMed-indexed journal devoted to the publication of biological, medical, chemical and physical research in a video format.

The advantages and disadvantages of using multimedia in communicating intervention details are worth bearing in mind.

On the plus side many new formats are flexible and user-friendly. Without limitation of word limits or particular styles of writing, they can enable fuller, more explicit descriptions and create interactive learning opportunities. But they also require careful design to avoid the pitfalls of unwieldy navigation and they may be time-consuming and expensive to develop. At the moment they may not attract the academic kudos of other outputs.

Perhaps more mundane but nonetheless important are practical issues such as obtaining copyright permissions, ensuring compliance with legal requirements, and ensuring all URLs are live and remain unbroken. And finally, access to descriptions of interventions should be free where possible, so funding models to enable this will need to be found.

We hope our efforts to improve descriptions – the TIDieR checklist – will be the first step in an intervention description revolution and we look forward to seeing how people implement it.



One Comment leave one →
  1. 10 Apr, 2014 8:53 am

    TIDieR is only one of many useful checklists/ guidelines that help in presenting an accurate and complete account of a research study and thus increasing the value and usability of such research.
    Other checklists, internationally accepted by journals and organisations, are available on the EQUATOR Network website (
    Check it out – it will help you not only in writing your paper but also in planning your research and writing a study protocol.

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