Development of the implementability assessment tool for clinical practice guidelines based on the COSMIN framework and factorial experiment: a study protocol

被引:0
作者
Zhong, Dongmei [1 ,2 ,3 ]
Aarons, Gregory A. [4 ]
Hutchinson, Alison M. [5 ,6 ]
Liu, Zhaolan [7 ]
Chen, Yaolong [8 ,9 ,10 ,11 ]
Wong, William C. W. [12 ,13 ]
Song, Zaiwei [14 ,15 ]
Wu, Yanni [16 ]
Yan, Lijiao [17 ]
Bishai, David Makram [18 ]
Yang, Nan [8 ]
Wang, Zijun [8 ]
Liu, Hui [8 ]
Xu, Dong [2 ,3 ,19 ]
机构
[1] Southern Med Univ, Sch Publ Hlth, Guangzhou, Peoples R China
[2] Southern Med Univ, Ctr World Hlth Org Studies, Sch Hlth Management, Guangzhou, Peoples R China
[3] Southern Med Univ SMU, Dermatol Hosp, SMU Inst Global Hlth SIGHT, Guangzhou, Peoples R China
[4] Univ Calif San Diego, Dept Psychiat, La Jolla, CA USA
[5] Deakin Univ, Inst Hlth Transformat, Ctr Qual & Patient Safety Res, Sch Nursing & Midwifery, Geelong, Vic, Australia
[6] Barwon Hlth, Geelong, Vic, Australia
[7] Beijing Univ Chinese Med, Ctr Evidence Based Chinese Med, Sch Tradit Chinese Med, Beijing, Peoples R China
[8] Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China
[9] Lanzhou Univ, Chinese Acad Med Sci, Sch Basic Med Sci, Res Unit Evidence Based Evaluat & Guidelines 2021R, Lanzhou, Peoples R China
[10] WHO Collaborating Ctr Guideline Implementat & Know, Lanzhou, Peoples R China
[11] Lanzhou Univ, Inst Hlth Data Sci, Lanzhou, Peoples R China
[12] Univ Hong Kong, Dept Family Med & Primary Care, Hong Kong, Peoples R China
[13] Univ Hong Kong, Shenzhen Hosp, Dept Family Med & Primary Care, Shenzhen, Peoples R China
[14] Peking Univ Third Hosp, Dept Pharm, Beijing, Peoples R China
[15] Peking Univ, Hlth Sci Ctr, Inst Drug Evaluat, Beijing, Peoples R China
[16] Southern Med Univ, Nanfang Hosp, Guangzhou, Peoples R China
[17] China Acad Chinese Med Sci, Inst Basic Clin Med Chinese Med, Beijing, Peoples R China
[18] Univ Hong Kong, Li Ka Shing Fac Med, Sch Publ Hlth, Hong Kong, Peoples R China
[19] Southern Med Univ, Sch Publ Hlth, Acacia Lab Implementat Sci, Guangzhou, Peoples R China
关键词
Implementability; Clinical practice guidelines; Implementation study; COSMIN framework; Factorial experiment; PRIMARY-HEALTH-CARE; QUALITY;
D O I
10.1186/s12913-024-11754-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
IntroductionClinical practice guidelines are essential tools for standardizing medical practices and improving healthcare quality. However, current guideline implementation is unsatisfactory. Barriers to guideline implementation include external environmental factors (e.g., medical personnel, medical institutions, local policies) and intrinsic characteristics (e.g., context, format, language etc.), with the latter being addressable by optimizing the guidelines themselves. This study aims to develop an appraisal tool to promote effective guideline implementation. Existing guideline implementability appraisal tools lack a clear theoretical basis, evidence of reliability and validity, and/or empirically-based guidance for effective implementation, all of which will be addressed in this study.Methods and analysisThe research is divided into four phases: (1) Generating a theoretical framework for guideline implementability (i.e., scoping review and concept analysis method); (2) Conducting a factorial experiment (i.e., guideline users simulate the use of different guideline versions to examine the relationship between constructs in the framework and implementability), and removing constructs with weak relationships to form the final implementability theoretical framework; (3) Generating dimensions and items for the guideline implementability appraisal tool based on the constructs in the theoretical framework, conducting comprehensive reliability and validity testing, usability testing, and iterative optimization according to the COSMIN guidelines; (4) Integrating the validated tool with the STAR guideline rating system for guideline appraisal and feedback to promote guideline implementability.Strengths and limitations(1) Our research will follow a standardized and rigorous process for developing measurement scales, ensuring that the resulting evaluation scale for the implementability of CPGs is theoretically grounded, internally consistent between theory and practice, and reliable and valid. (2) The theoretical framework developed in our study will strengthen the validity and rationality of constructs in the real world. (3) In the confirmatory factor analysis, this study will determine the dimensions and items' weight through factor loadings, allowing for the quantification of the implementability of CPGs and providing users of the guidelines with objective evaluative results. In addition, the clinical practice guideline implementability evaluation tool developed in this study can assist guideline developers in enhancing implementability before, during, and after guideline formulation.
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页数:11
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