Abstract:
RATIONALE, AIMS, AND OBJECTIVES:Focusing on the implementation of clinical practice guidelines (CPGs) for the management of adult cancers, the objectives of this study were to (a) describe the intrinsic elements known to influence CPG use; (b) identify the ways in which CPGs are implemented; and (c) explore how CPG characteristics and contextual factors influence implementation and use. METHODS:We conducted a sequential mixed methods study. First, we performed a content analysis of all CPGs developed and approved for the management of adult cancers in Nova Scotia, Canada, from 2005 to 2015. CPGs were examined for the presence of 22 elements known to influence CPG use. Next, we conducted semistructured interviews with CPG developers and end users. Participants were purposively sampled, based on the findings of the content analysis. All interviews were audiotaped and transcribed verbatim. Data were analysed by two researchers using the Framework Method. RESULTS:CPGs (n = 20) demonstrated large variation with respect to elements shown to influence CPG use. For example, 85% included content related to individualization and objectives. Yet no CPGs (0%) had journal or patient versions; discussed the education, training, or competencies needed to deliver recommendations; contained an explicit statement on anticipated work changes, or on potential direct or productivity costs; or identified barriers or facilitators that might influence CPG adoption. Interview data from CPG developers (n = 4) and users (n = 6) revealed five themes related to CPG implementation and use: (a) lack of consistency in CPG development; (b) timing and nature of stakeholder engagement; (c) credibility of the CPG development process and final CPGs; (d) limited understanding of implementation as an active process; and (e) factors at organizational and system levels influence CPG implementation and use. CONCLUSIONS:This mixed methods study provides complementary data that may help inform more effective CPG implementation efforts and optimize their use in practice.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Urquhart R,Woodside H,Kendell C,Porter GAdoi
10.1111/jep.13073subject
Has Abstractpub_date
2019-08-01 00:00:00pages
656-663issue
4eissn
1356-1294issn
1365-2753journal_volume
25pub_type
杂志文章abstract::Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than cri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13109
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. STUDY DESIGN:An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01483.x
更新日期:2011-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evid...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12760
更新日期:2017-12-01 00:00:00
abstract::This paper investigates the translation of medical information into clinical practice and the role of thoughtful dissent by exploring the influence of sociological factors on change, the impact of evidence-based medicine (EBM), and the role of industry. Changing practice related to hormone therapy for menopausal and p...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2005.00608.x
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:The study aims to obtain the mean relative weights (MRWs) of the cost of care through the retrospective application of the adjusted clinical groups (ACGs) in several primary health care (PHC) centres in Catalonia (Spain) in routine clinical practice. METHODS:This is a retrospective study based on computerize...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01818.x
更新日期:2013-04-01 00:00:00
abstract::Results of renal transplantation have improved steadily over the years. This article reviews the current status of patient and graft survival and discusses major causes of mortality and renal allograft failure. Review of recent literature demonstrates that the traditional enemies of transplantation, acute rejection an...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2003.00408.x
更新日期:2004-02-01 00:00:00
abstract:RATIONALE:There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12539
更新日期:2016-10-01 00:00:00
abstract::In this paper we reflect upon and problematize the ways in which 'patient involvement' is interpreted in a substantial proportion of the research literature on involvement and shared decision making. Drawing upon an analysis of this literature we raise concerns about the 'medicalization of involvement' embedded in, an...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01725.x
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work. OBJECTIVES:To examine the application of EBP in clinical practice by regi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01316.x
更新日期:2009-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Chronic disorders of consciousness (CDoC) pose significant problems of understanding for both medical professionals and the relatives and friends of the patient. This paper explores the tensions between the different interpretative resources that are drawn upon by lay people and professio...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12220
更新日期:2015-06-01 00:00:00
abstract::Time and timeliness are key issues in appraising and ensuring the clinical relevance of systematic reviews. Time considerations entering the systematic review process include the history of the clinical problem, disease, or treatment that is the target of the review, and the history of the research conducted to addres...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00729.x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services. AIMS:To compare the ADAD with HoNOSCA; to examine their clinical usefulness. METHODS:Comparison of the ADAD and HoNOSCA o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00654.x
更新日期:2006-10-01 00:00:00
abstract:AIMS AND OBJECTIVES:The role of pharmacists in chronic disease state management has been shown to significantly improve patient health outcomes and reduce overall health care costs. The current study is designed to assess the roles and attitudes of West Virginia (WV) pharmacists toward diabetes, evaluate services provi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12677
更新日期:2017-06-01 00:00:00
abstract::Tough but constructive criticisms of evidence-based medicine (EBM) have without doubt informed the evolution and serial reconstitutions of this approach to clinical decision making and behaviour. Yet, concerns about EBM persist and as EBM changes in response to reflection and criticism, so too do the criticisms themse...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00617.x
更新日期:2006-08-01 00:00:00
abstract::I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer m...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12324
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To compare glycaemic control, as reflected in the A1c level, of diabetic patients with primary care vs. with specialist care. METHODS:The study used administrative data from eastern Ontario, Canada, and a database containing the results of all A1c tests from this region between 1 September 1999 and 1 Septemb...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2005.00582.x
更新日期:2005-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) for knee osteoarthritis (OA) guide the provision of high-quality healthcare for people with knee OA, which may improve outcomes. Our aim was to evaluate the quality of and content within recently published CPGs for people with knee OA. METHODS:CPGs (2...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13391
更新日期:2020-03-26 00:00:00
abstract:BACKGROUND:Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity-related diseases. Our aim was to compare these two procedures. MATERIALS AND METHODS:An electronic literature search was performed from inception to December 2018. The cli...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13170
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN:Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed as having a UTI. A t...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01037.x
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Unattended home sleep studies have been implemented to minimize the cost and delay in establishing obstructive sleep apnoea syndrome (OSAS) diagnosis and therapy. However, their accuracy and validity remain disputed. The purpose of our study is to assess their effectiveness (i.e. their technical reliability ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01365.x
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Geographical inequalities in lung cancer treatment and patient survival have been described. We hypothesized that lung cancer patients' access to treatment may be influenced by deprivation and the pathway to care. METHODS:Case notes were reviewed for patients resident in south-east London who were registere...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00644.x
更新日期:2006-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Ward rounds present opportunities for medical officers, nurses, allied health clinicians, and patients to interact and plan patient care. A recent literature review found eight types of rounding processes. Different purposes, varying levels of representation from clinical professions, an...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13248
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Models for the structured delivery of care rely on organizational attributes of practice teams. The Survey of Organizational Attributes for Primary Care (SOAPC) is known to be a valid instrument to measure this aspect in the primary care setting. The aim of this study was to determine the validity of a transl...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01330.x
更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION:Non-routine events (NREs) are atypical or unusual occurrences in a pre-defined process. Although some NREs in high-risk clinical settings have no adverse effects on patient care, others can potentially cause serious patient harm. A unified strategy for identifying and describing NREs in these domains will ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13456
更新日期:2020-08-16 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The purpose of this study is to systematically evaluate the quality of methodological guidelines for androgenetic alopecia (AGA) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument by searching and analysing the available worldwide guidelines. This could pr...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12474
更新日期:2015-12-01 00:00:00
abstract::The aim of this study was to evaluate the impact of a program of training, education and awareness on the accuracy of the data collected from hospital discharge abstracts. Four random samples of hospital discharge abstracts relating to four different periods were studied. The evaluation of the impact of systematic tra...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2000.00265.x
更新日期:2000-11-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners' (GPs) provision of services to patients. The aim of this study was to investigate the association of experiences of violence and percepti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00864.x
更新日期:2008-04-01 00:00:00
abstract::Recently, a court in Belgium awarded a sum of 400 000 euros to the parents of a child with disability who at that point had already died of Sanfilippo syndrome. Their charge was not that the baby was born with disability, but that the child was born. The charge was brought in the child's name, and so effectively, the ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12042
更新日期:2013-06-01 00:00:00
abstract::The goals of medical ethics education comprise several dimensions: legal duties to secure informed consent, tell the truth and protect confidentiality; objective competencies that include an understanding of DNR regulations and surrogate decision-making procedures; discursive moral skills such as moral sensitivity, re...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2001.00277.x
更新日期:2001-11-01 00:00:00
abstract::Given the growing concern for the safety, cost and adequacy of blood supply, there is an increasing need for appropriate blood product utilization. Despite a number of consensus guidelines for the transfusion of allogeneic blood products, inappropriate blood transfusion continues. We discuss the quality assurance proc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.1998.00010.x
更新日期:1998-05-01 00:00:00