A systematic review is a type of research that collects and analyses all the existing studies on a specific topic in a structured and organised way. Instead of just looking at one study, it combines results from many studies to get a clearer, more reliable answer to a question. However, the complex language used in systematic reviews often makes them inaccessible to the public, highlighting the need for effective communication strategies, particularly for reviews relating to health and social care or public health. However, there is limited research exploring alternative ways to present research articles, with only a few delivery methods studied so far. It remains unclear how different styles of communicating might effectively convey scientific findings accurately or enhance public engagement and understanding of complex topics.

Studies Within A Review (SWARs) are studies which are embedded into a systematic review and aim to form an evidence base to improve how we plan, do, and share systematic reviews. SWARs offer a promising way of improving the methodology of systematic reviews and dissemination of their findings.

This randomised trial aims to address the current research gap by identifying the effectiveness of two different ways to communicate systematic review findings to the public and determining which methods are more suitable for different audiences: participants will be asked to read a summary or watch an animated video of a summary of both reviews and then complete a questionnaire about the reviews' findings and conclusions. The study will assess outcomes such as comprehension, perceived understanding, engagement, and interest of participants in reading the full reviews.

By evaluating the impact of different communication strategies, this study aims to strengthen the evidence base for methods to communicate complex scientific findings to the public. The results are expected to provide valuable insights for optimising the communication of the key findings of systematic reviews, ensuring that summaries are clear, engaging and accessible.

This randomised Study Within a Review (SWAR) will address the uncertainty in communicating the findings of systematic reviews by comparing the effectiveness of two communication methods. We will evaluate participants' understanding of the key findings from two systematic reviews and their interest in seeking further information. These systematic reviews (summarised below), while covering entirely different topics, are both complex and highly relevant to public health.

Systematic Review 1: Clinical Utility of Biomarkers for Outcomes Prediction in Adults with Suspected Sepsis Presenting to the Emergency Department Sepsis is associated with a high mortality rate, and early detection and diagnosis is crucial. This review aimed to determine whether biomarkers measured in patients presenting to an emergency department with suspected sepsis may predict deterioration, including mortality, critical care admission, organ failure, and septic shock.

Systematic Review 2: Local antibiotics for patients undergoing surgery for open fractures Open fractures are serious injuries where the bone breaks through the skin, often leading to complications like infection. Treating these injuries can be complex and expensive, with many patients needing multiple operations and ongoing care. This review sought to determine if there is evidence that local antibiotics may reduce infection in people who are having surgery for open fractures.

The objectives of this study are

1. To determine whether a plain language summary or animated video summary is more effective in conveying the core message of a systematic review.
2. To compare the effects of the two methods on perceived understanding, engagement, and interest in reading the full text of the systematic review

Recruitment plan We will recruit using multiple methods. The study will be advertised through various channels, including posters displayed in common areas of the host university (Queen's University Belfast) and other popular locations across Belfast, social media platforms such as Instagram, Twitter and LinkedIN, and word of mouth. People interested in taking part will be able to contact the research team directly using the provided contact details.

Study procedures Potential participants will email or click on a QR code on the study posters (in person or via social media), which will bring them to the study information and a consent form. They will read that their participation will take a maximum of 30 minutes for the first round, and that they will asked to participate in a second round of questions 1 to 2 weeks later, which can be done via telephone pr email if preferred and would take less than 10 minutes. They will be asked to include their first name or a nick-name and contact details (email or telephone) so that the research team can contact them. Participants will also be asked to answer some additional questions to collect their age, scientific education and whether they had any scientific training after secondary education, and if they feel they know anything about the review topics.

The research team will contact those who have volunteered and have agreed to participate by email or telephone. A meeting will be arranged for a public space where they can sit comfortably with minimal noise and distractions. Participants will be randomly assigned to one of two groups: either the Reading Group or the Video Group (as shown in Table 1). Within each group, participants will be randomly assigned to start with Review 1 or Review 2. Once people are enrolled in the study, they will be assigned a unique ID number.

The intervention will be administered on a tablet computer. Those in the Reading Group will read the summary of their first review on the tablet and then answer related questions. After completing this review, they will read the summary of their second review and answer corresponding questions. Participants in the Video Group will use headphones while watching the Animated Video summary of their first review and then answer related questions on the tablet. After completing that review, they will watch an Animated Video summary of their second review and answer corresponding questions.

Participants will be reminded that they will be contacted for a follow-up assessment 1-2 weeks after the initial session. They will be contacted using the contact method they provided during the consent process. Follow-up can be face-to-face, or by email or phone.

Statistical analysis Participants' responses related to the Plain Language Summary and Animated Video Summary of Review 1 and Review 2 will be compared. Differences between groups will be assessed using the T-test/Mann-Whitney U test (as appropriate). A convenience sample of 100 participants will be sought, based on the time available for the researcher to conduct the data gathering.

Inclusion Criteria:

• Adults (aged 18 years+)
• Any gender
• Able to read and understand English
• Willing to read and listen to review summaries, and answer questions
• Provide informed consent to participate

Exclusion Criteria:

• People with learning difficulty
• People who do not read or understand English
• People with hearing or visual impairment
• People under 18 years of age