Abstract:
BACKGROUND:Accurate measures of health professionals' clinical practice are critically important to guide health policy decisions, as well as for professional self-evaluation and for research-based investigation of clinical practice and process of care. It is often not feasible or ethical to measure behaviour through direct observation, and rigorous behavioural measures are difficult and costly to use. The aim of this review was to identify the current evidence relating to the relationships between proxy measures and direct measures of clinical behaviour. In particular, the accuracy of medical record review, clinician self-reported and patient-reported behaviour was assessed relative to directly observed behaviour. METHODS:We searched: PsycINFO; MEDLINE; EMBASE; CINAHL; Cochrane Central Register of Controlled Trials; science/social science citation index; Current contents (social & behavioural med/clinical med); ISI conference proceedings; and Index to Theses. INCLUSION CRITERIA:empirical, quantitative studies; and examining clinical behaviours. An independent, direct measure of behaviour (by standardised patient, other trained observer or by video/audio recording) was considered the 'gold standard' for comparison. Proxy measures of behaviour included: retrospective self-report; patient-report; or chart-review. All titles, abstracts, and full text articles retrieved by electronic searching were screened for inclusion and abstracted independently by two reviewers. Disagreements were resolved by discussion with a third reviewer where necessary. RESULTS:Fifteen reports originating from 11 studies met the inclusion criteria. The method of direct measurement was by standardised patient in six reports, trained observer in three reports, and audio/video recording in six reports. Multiple proxy measures of behaviour were compared in five of 15 reports. Only four of 15 reports used appropriate statistical methods to compare measures. Some direct measures failed to meet our validity criteria. The accuracy of patient report and chart review as proxy measures varied considerably across a wide range of clinical actions. The evidence for clinician self-report was inconclusive. CONCLUSION:Valid measures of clinical behaviour are of fundamental importance to accurately identify gaps in care delivery, improve quality of care, and ultimately to improve patient care. However, the evidence base for three commonly used proxy measures of clinicians' behaviour is very limited. Further research is needed to better establish the methods of development, application, and analysis for a range of both direct and proxy measures of behaviour.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Hrisos S,Eccles MP,Francis JJ,Dickinson HO,Kaner EF,Beyer F,Johnston Mdoi
10.1186/1748-5908-4-37subject
Has Abstractpub_date
2009-07-03 00:00:00pages
37issn
1748-5908pii
1748-5908-4-37journal_volume
4pub_type
杂志文章abstract:BACKGROUND:Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level ...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-8-22
更新日期:2013-02-17 00:00:00
abstract:BACKGROUND:How humans think and make decisions is important in understanding behaviour. Hence an understanding of cognitive processes among physicians may inform our understanding of behaviour in relation to evidence implementation strategies. A personality theory, Cognitive-Experiential Self Theory (CEST) proposes a r...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-23
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abstract::This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-base...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-7-43
更新日期:2012-05-14 00:00:00
abstract:BACKGROUND:In addition to their more traditional clinical role, midwives are expected to perform various health promotion practice behaviours (HePPBes) such as informing pregnant women about the benefits of physical activity during pregnancy and asking women about their alcohol consumption. There is evidence to suggest...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0913-3
更新日期:2019-06-18 00:00:00
abstract::Complex behaviour change interventions are not well described; when they are described, the terminology used is inconsistent. This constrains scientific replication, and limits the subsequent introduction of successful interventions. Implementation Science is introducing a policy of initially encouraging and subsequen...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/1748-5908-4-40
更新日期:2009-07-16 00:00:00
abstract:BACKGROUND:The need to better understand processes of removing, reducing, or replacing healthcare services that are no longer deemed essential or effective is common across publicly funded healthcare systems. This paper explores expert international opinion regarding, first, the factors and processes that shape the suc...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0123-y
更新日期:2014-09-10 00:00:00
abstract:BACKGROUND:The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in dec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0693-6
更新日期:2018-01-25 00:00:00
abstract:BACKGROUND:Guideline development and uptake are still suboptimal; they focus on clinical aspects of diseases rather than on improving the integration of care. We used a patient-centered network approach to develop five harmonized guidelines (one multidisciplinary and four monodisciplinary) around clinical pathways in f...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-68
更新日期:2014-06-04 00:00:00
abstract:BACKGROUND:Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta be...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-6-94
更新日期:2011-08-11 00:00:00
abstract:BACKGROUND:Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other inte...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-23
更新日期:2006-10-18 00:00:00
abstract:BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address rese...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01002-1
更新日期:2020-09-03 00:00:00
abstract:BACKGROUND:This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Pe...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-017-0553-4
更新日期:2017-02-23 00:00:00
abstract:BACKGROUND:Effective provider-parent communication can improve childhood vaccination uptake and strengthen immunisation services in low- and middle-income countries (LMICs). Building capacity to improve communication strategies has been neglected. Rigorous research exists but is not readily found or applicable to LMICs...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-125
更新日期:2011-12-02 00:00:00
abstract:BACKGROUND:Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff m...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-95
更新日期:2010-11-29 00:00:00
abstract:BACKGROUND:Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-19
更新日期:2008-04-09 00:00:00
abstract:PURPOSE:The purpose of this study was to undertake a systematic assessment of the need for research-based information by decision-makers working in community-based organizations. It is part of a more comprehensive knowledge transfer and exchange strategy that seeks to understand both the content required and the format...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-2-20
更新日期:2007-07-03 00:00:00
abstract:BACKGROUND:Significant gaps related to measurement issues are among the most critical barriers to advancing implementation science. Three issues motivated the study aims: (a) the lack of stakeholder involvement in defining pragmatic measure qualities; (b) the dearth of measures, particularly for implementation outcomes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0287-0
更新日期:2015-07-22 00:00:00
abstract:BACKGROUND:To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the attitudes and perceived competence of...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-35
更新日期:2010-05-14 00:00:00
abstract:BACKGROUND:Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. METHODS:Thirty-six participants met for two days. RESULTS:Participants suggested ways to improve an environmental scan that h...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-68
更新日期:2011-07-05 00:00:00
abstract:BACKGROUND:Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-42
更新日期:2014-04-03 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-53
更新日期:2014-05-02 00:00:00
abstract:BACKGROUND:Denmark has inferior cancer survival rates compared with many European countries. The main reason for this is suggested to be late diagnosis at advanced cancer stages. Cancer diagnostic work-up begins in general practice in 85% of all cancer cases. Thus, general practitioners (GPs) play a key role in the dia...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-11-07 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0399-1
更新日期:2016-03-17 00:00:00
abstract:BACKGROUND:Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-21
更新日期:2006-09-27 00:00:00
abstract:BACKGROUND:This study examined the effectiveness of seven different interventions designed to increase the proportion of general practitioners (GPs) accepting an offer of free access to an online evidence-based resource. METHODS:Australian GPs (n = 14,000) were randomly selected and assigned to seven intervention grou...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-68
更新日期:2009-10-20 00:00:00
abstract:BACKGROUND:Fecal incontinence has a high prevalence in the nursing home population which cannot be explained by co-morbidity or anatomic and physiological changes of aging alone. Our hypothesis is that fecal incontinence can be prevented, cured, or ameliorated by offering care staff knowledge of best practice. However,...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-015-0263-8
更新日期:2015-05-23 00:00:00
abstract:BACKGROUND:Over the past years, implementation science has gained more and more importance in German-speaking countries. Reliable and valid questionnaires are needed for evaluating the implementation of evidence-based practices. On an international level, several initiatives focused on the identification of questionnai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0837-3
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Community health worker (CHW)-delivered support visits to children living with HIV and their caregivers significantly reduced odds of virological failure among the children in the ZENITH trial conducted in Zimbabwe. We conducted a process evaluation to assess fidelity, acceptability, and feasibility of this ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0762-5
更新日期:2018-05-23 00:00:00
abstract:BACKGROUND:Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-017-0614-8
更新日期:2017-07-03 00:00:00
abstract:BACKGROUND:Implementation of the 'Sepsis Six' clinical care bundle within an hour of recognition of sepsis is recommended as an approach to reduce mortality in patients with sepsis, but achieving reliable delivery of the bundle has proved challenging. There remains little understanding of the barriers to reliable imple...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-016-0518-z
更新日期:2016-11-16 00:00:00