258 8 Chapter 8 translation of scientific data and information into tailored content. Whereas, the design cycle is the incorporation of core components on navigation, organisation, design aesthetics and semiotics. For conceptual and illustrative purposes, we made a clear distinction between the approaches. In practice however, the two approaches are complex and intertwined with each other. Translational cycle During the translational cycle research findings (non-translated knowledge) generated during the FRESH AIR project were passed through a number of consecutive steps. Through the integration of the translational core components this resulted in the generation of content tailored to decision-makers (translated knowledge). As individual studies rarely provide sufficient evidence for decision making, evidence was also synthesized from other sources (43). Evidence acquired per topic (Step 1) was synthesized and critically appraised (Step 2). Critical appraisal, defined as the examination of research evidence on the level of evidence and relevance, is an important step within the translational process (44). Critical appraisal was performed using a flow-chart like tool. The flow-chart integrated multiple appraisal tools on grey literature with the Scottish Intercollegiate Guidelines Network (SIGN) grading system on scientific evidence to create a tool that can be applied to all types of evidence (45, 46). The level of evidence and relevance was categorized into five categories. Scientific evidence that was based on metaanalysis, rigorous systematic reviews or RCT with very low risk of bias according to the SIGN grading system (Grade A), was extracted (Step 3). In the case of disputable evidence (Grade E or D) due to either a high risk of bias, low level of evidence or evidence-based on non-analytical studies such as expert opinion or a case report, an annotation was added. Based on the extracted data key message were formulated (Step 4) and data was aggregated into explorative or explanatory overview charts, infographics, visuals, textual statements or narratives (Step 5). Before incorporation into the knowledge platform the product was run through a set of criteria to determine whether all core translational components were sufficiently integrated (see checklist in Figure 2). When the translated knowledge product scored insufficiently, it re-entered the translational cycle. Design cycle Parallel to the translational cycle the communication channel was designed. Core components on navigation, organisation, design aesthetics and semiotics were integrated into so called ‘proof of concepts’ (trial products) which were subsequently tested on the experience of the user (user-experience analysis). ‘Proof of concepts’ allow for iterative amendments during several moments of evaluation, thereby warranting feasibility and sustainability early on (47, 48).
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