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 healthcare, including appropriate use of blood. However, its effects are often inconsistent, indicating the need for coordinated research including more head-to-head trials comparing different ways of delivering feedback. A programmatic series of research projects, termed the 'Audit and Feedback INterventions to Increase evidence-based Transfusion practIcE' (AFFINITIE) programme, aims to test different ways of developing and delivering feedback within an existing national audit structure. METHODS:The evaluation will comprise two linked 2×2 factorial, cross-sectional cluster-randomised controlled trials. Each trial will estimate the effects of two feedback interventions, 'enhanced content' and 'enhanced follow-on support', designed in earlier stages of the AFFINITIE programme, compared to current practice. The interventions will be embedded within two rounds of the UK National Comparative Audit of Blood Transfusion (NCABT) focusing on patient blood management in surgery and use of blood transfusions in patients with haematological malignancies. The unit of randomisation will be National Health Service (NHS) trust or health board. Clusters providing care relevant to the audit topics will be randomised following each baseline audit (separately for each trial), with stratification for size (volume of blood transfusions) and region (Regional Transfusion Committee). The primary outcome for each topic will be the proportion of patients receiving a transfusion coded as unnecessary. For each audit topic a linked, mixed-method fidelity assessment and cost-effectiveness analysis will be conducted in parallel to the trial. DISCUSSION:AFFINITIE involves a series of studies to explore how A&F may be refined to change practice including two cluster randomised trials linked to national audits of transfusion practice. The methodology represents a step-wise increment in study design to more fully evaluate the effects of two enhanced feedback interventions on patient- and trust-level clinical, cost, safety and process outcomes. TRIAL REGISTRATION:http://www.isrctn.com/ISRCTN15490813.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Hartley S,Foy R,Walwyn REA,Cicero R,Farrin AJ,Francis JJ,Lorencatto F,Gould NJ,Grant-Casey J,Grimshaw JM,Glidewell L,Michie S,Morris S,Stanworth SJ,AFFINITIE programme.doi
10.1186/s13012-017-0614-8subject
Has Abstractpub_date
2017-07-03 00:00:00pages
84issue
1issn
1748-5908pii
10.1186/s13012-017-0614-8journal_volume
12pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. METHODS:The study will compare the effectiveness of educational out...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-9-10
更新日期:2014-01-15 00:00:00
abstract:BACKGROUND:The recent growth in organized efforts to advance dissemination and implementation (D & I) science suggests a rapidly expanding community focused on the adoption and sustainment of evidence-based practices (EBPs). Although promising for the D & I of EBPs, the proliferation of initiatives is difficult for any...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0673-x
更新日期:2017-11-21 00:00:00
abstract:BACKGROUND:The use of opinion leaders is a strategy used to speed the process of translating research into practice. Much is still unknown about opinion leader attributes and activities and the context in which they are most effective. Agent-based modeling is a methodological tool that enables demonstration of the inte...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0136-6
更新日期:2014-09-27 00:00:00
abstract:BACKGROUND:Evidence-based clinical practice guidelines may improve treatment quality, but the uptake of guideline recommendations is often incomplete and slow. Recently new low back pain guidelines are being launched in Denmark. The guidelines are considered to reduce personal and public costs. The aim of this study is...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-8-124
更新日期:2013-10-20 00:00:00
abstract:BACKGROUND:In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was ther...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0283-4
更新日期:2015-06-30 00:00:00
abstract:BACKGROUND:Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-82
更新日期:2009-12-30 00:00:00
abstract:BACKGROUND:Uterine fibroids are non-cancerous overgrowths of the smooth muscle in the uterus. As they grow, some cause problems such as heavy menstrual bleeding, pelvic pain, discomfort during sexual intercourse, and rarely pregnancy complications or difficulty becoming pregnant. Multiple treatment options are availabl...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-019-0933-z
更新日期:2019-09-02 00:00:00
abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-81
更新日期:2010-10-22 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-73
更新日期:2010-10-08 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-6
更新日期:2008-01-31 00:00:00
abstract:BACKGROUND:Practice guidelines (PGs) are systematically developed statements intended to assist in patient and practitioner decisions. The AGREE II is the revised tool for PG development, reporting, and evaluation, comprised of 23 items, two global rating scores, and a new User's Manual. In this study, we sought to dev...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-81
更新日期:2011-07-26 00:00:00
abstract:BACKGROUND:The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, mos...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-112
更新日期:2012-11-21 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
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0316-z
更新日期:2015-08-21 00:00:00
abstract:BACKGROUND:In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appro...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0602-z
更新日期:2017-05-26 00:00:00
abstract:BACKGROUND:With the current funding climate and need for advancements in implementation science, there is a growing demand for grantsmanship workshops to increase the quality and rigor of proposals. A group-based implementation science-focused grantsmanship workshop, the Implementation Development Workshop (IDW), is on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0429-z
更新日期:2016-05-06 00:00:00
abstract:BACKGROUND:Adverse drug events could often be prevented. One of their main causes is that patients rarely know how to detect them. Another cause is inadequate communication between patients and physicians. If patients were to be effectively trained in detecting and reporting adverse drug events, this should help to pre...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-8-69
更新日期:2013-06-19 00:00:00
abstract:BACKGROUND:An international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-116
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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:2011-08-11 00:00:00
abstract:BACKGROUND:A recent review of frameworks used in dissemination and implementation (D&I) science described 61 judged to be related either to dissemination, implementation, or both. The current use of these frameworks and their contributions to D&I science more broadly has yet to be reviewed. For these reasons, our objec...
journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章
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更新日期:2010-11-29 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0202-0
更新日期:2015-02-06 00:00:00
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journal_title:Implementation science : IS
pub_type: 社论
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更新日期:2009-07-16 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0959-2
更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit impleme...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
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更新日期:2019-02-12 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract::Economic evaluations can inform decisions about the efficiency and allocation of resources to implementation strategies-strategies explicitly designed to inform care providers and patients about the best available research evidence and to enhance its use in their practices. These strategies are increasingly popular in...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-014-0168-y
更新日期:2014-12-18 00:00:00
abstract:BACKGROUND:Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge. METHODS:T...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-20
更新日期:2012-03-20 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
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更新日期:2019-01-18 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