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 diagnostic process. The latest Danish Cancer Plan included continuing medical education (CME) on early cancer diagnosis in general practice to improve early diagnosis. This dual aims of this protocol are, first, to describe the conceptualisation, operationalisation and implementation of the CME and, second, to describe the study design and outcomes chosen to evaluate the effects of the CME. METHODS/DESIGN:The intervention is a CME in early cancer diagnosis targeting individual GPs. It was developed by a step-wise approach. Barriers for early cancer diagnosis at GP level were identified systematically and analysed using the behaviour system involving capability, opportunity and motivation described by Michie et al. The study will be designed as a geographical cluster randomised stepped wedge study. The study population counts 836 GPs from 417 general practices in the Central Denmark Region, geographically divided into eight clusters. GPs from each cluster will be invited to a CME meeting at a certain date three weeks apart. The primary outcomes will be primary care interval and GP referral rate on cancer suspicion. Data will be obtained from national registries, GP-completed forms on patients referred to cancer fast-track pathways and GP-completed online questionnaires before and after the intervention. DISCUSSION:To our knowledge, this will be the first study to measure the effect of a theory-based CME in early cancer diagnosis at three levels: GP knowledge and attitude, GP activity and patient outcomes. The achieved knowledge will contribute to the understanding of whether and how general practice's ability to perform cancer diagnosis may be improved. TRIAL REGISTRATION:Registered as NCT02069470 on ClinicalTrials.gov.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Toftegaard BS,Bro F,Vedsted Pdoi
10.1186/s13012-014-0159-zsubject
Has Abstractpub_date
2014-11-07 00:00:00pages
159issn
1748-5908pii
s13012-014-0159-zjournal_volume
9pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Theories, models, and frameworks (TMF) are foundational for generalizing implementation efforts and research findings. However, TMF and the criteria used to select them are not often described in published articles, perhaps due in part to the challenge of selecting from among the many TMF that exist in the f...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0836-4
更新日期:2018-11-22 00:00:00
abstract:BACKGROUND:An important gap exists between research production and its utilization. Few studies have examined the factors affecting knowledge utilization in the field of child and family social services. METHODS:The objectives of the study are to describe knowledge utilization by child protection administrators and pr...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-41
更新日期:2010-06-03 00:00:00
abstract:BACKGROUND:In health care, a well recognized gap exists between what we know should be done based on accumulated evidence and what we actually do in practice. A body of empirical literature shows organizations, like individuals, are difficult to change. In the business literature, knowledge management and transfer has ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-2-44
更新日期:2007-12-20 00:00:00
abstract:BACKGROUND:Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical sett...
journal_title:Implementation science : IS
pub_type: 临床试验,杂志文章
doi:10.1186/s13012-015-0334-x
更新日期:2015-10-14 00:00:00
abstract:BACKGROUND:The Graded Repetitive Arm Supplementary Program (GRASP) is a hand and arm exercise programme designed to increase the intensity of exercise achieved in inpatient stroke rehabilitation. GRASP was shown to be effective in a randomised controlled trial in 2009 and has since experienced unusually rapid uptake in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0090-3
更新日期:2014-08-12 00:00:00
abstract::Following publication of the original article [1], the authors reported an error in one of the authors' names. In this Correction the incorrect and correct author name are shown. The original article has been corrected. ...
journal_title:Implementation science : IS
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13012-019-0862-x
更新日期:2019-02-08 00:00:00
abstract:BACKGROUND:Scientific knowledge is in constant change. The flow of new information requires a frequent re-evaluation of the available research results. Clinical practice guidelines (CPGs) are not exempted from this phenomenon and need to be kept updated to maintain the validity of their recommendations. The objective o...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-7-109
更新日期:2012-11-19 00:00:00
abstract:BACKGROUND:Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-102
更新日期:2011-09-06 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract:BACKGROUND:Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. METHODS/DESIGN:This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-re...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-114
更新日期:2011-10-03 00:00:00
abstract:BACKGROUND:The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-105
更新日期:2013-09-05 00:00:00
abstract:BACKGROUND:While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation o...
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/s13012-019-0865-7
更新日期:2019-02-18 00:00:00
abstract::Trainees (e.g., graduate students, residents, fellows) are increasingly identifying knowledge translation as their research discipline. In Canada, a group of trainees have created a trainee-initiated and trainee-led national collaborative to provide a vehicle for trainees to examine the diversity of knowledge translat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-98
更新日期:2011-08-25 00:00:00
abstract:BACKGROUND:Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted be...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-28
更新日期:2006-11-21 00:00:00
abstract:BACKGROUND:There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered t...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0600-1
更新日期:2017-05-18 00:00:00
abstract:BACKGROUND:In Belgium, the construction of the national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, healthcare providers, Evidence-Based Medicine (EBM) partners, and vend...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-83
更新日期:2013-08-05 00:00:00
abstract:BACKGROUND:Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity preven...
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/s13012-017-0624-6
更新日期:2017-07-18 00:00:00
abstract:BACKGROUND:Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of inter...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0956-5
更新日期:2019-12-17 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
abstract:BACKGROUND:Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for change...
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/s13012-016-0425-3
更新日期:2016-05-17 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:The Department of Veterans Affairs (VA) has led the industry in measuring facility performance as a critical element in improving quality of care, investing substantial resources to develop and maintain valid and cost-effective measures. The External Peer Review Program (EPRP) of the VA is the official data ...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/1748-5908-7-45
更新日期:2012-05-18 00:00:00
abstract:BACKGROUND:Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to i...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-3
更新日期:2008-01-16 00:00:00
abstract:BACKGROUND:Shared decision-making (SDM) is rarely implemented in pediatric practice. Pediatric health decision-making differs from that of adult practice. Yet, little is known about the factors that influence the implementation of pediatric shared decision-making (SDM). We synthesized pediatric SDM barriers and facilit...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0851-5
更新日期:2019-01-18 00:00:00
abstract:BACKGROUND:The adoption and diffusion of clinical information systems has become one of the critical benchmarks for achieving several healthcare organizational reform priorities, including home care, primary care, and integrated care networks. However, these systems are often strongly resisted by the same community tha...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-15
更新日期:2011-02-28 00:00:00
abstract:BACKGROUND:The continuing gap between available evidence and current practice in health care reinforces the need for more effective solutions, in particular related to organizational context. Considerable advances have been made within the U.S. Veterans Health Administration (VA) in systematically implementing evidence...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-30
更新日期:2008-05-29 00:00:00
abstract:BACKGROUND:Patients with chronic illness typically receive ambulatory treatment from multiple health professionals. Connectedness between these professionals may influence their clinical decisions and the coordination of patient care. We aimed to describe and analyze connectedness in a regional network of health profes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-67
更新日期:2011-07-03 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: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:Knowledge translation (KT) aims to close the research-practice gap in order to realize and maximize the benefits of research within the practice setting. Previous studies have investigated KT strategies in nursing and medicine; however, the present study is the first systematic review of the effectiveness of...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-7-70
更新日期:2012-07-25 00:00:00