Bariatric Surgery Decision-Making Calculator: A Novel Mobile App for Evidence-Based Clinical Practice

2017 ◽  
Vol 13 (10) ◽  
pp. S147 ◽  
Author(s):  
Ali Aminian ◽  
Stacey Clemence ◽  
Jay Alberts ◽  
Philip Schauer ◽  
Stacy Brethauer
Keyword(s):  
Bariatric Surgery ◽  
Decision Making ◽  
Clinical Practice ◽  
Mobile App ◽  
Evidence Based

scholarly journals Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation (Preprint)

2018 ◽  
Author(s):  
Jhon Camacho ◽  
Ana María Medina Ch. ◽  
Zach Landis-Lewis ◽  
Gerald Douglas ◽  
Richard Boyce
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Mobile App ◽  
Second Phase ◽  
Evidence Based ◽  
Clinical Algorithm ◽  
Qualitative Evidence ◽  
Printed Materials

BACKGROUND The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. OBJECTIVE The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. METHODS We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. RESULTS We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. CONCLUSIONS Our study will further the understanding of the role of mobile decision support systems in the implementation of clinical practice guidelines. Furthermore, we will provide qualitative evidence to aid decisions made by low- and middle-income countries’ ministries of health about investments in these technologies.

scholarly journals Reframing Perceptions in Restorative Dentistry: Evidence-Based Dentistry and Clinical Decision-Making

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Ayah A Al-Asmar ◽  
Ahmad S Al-Hiyasat ◽  
Motasum Abu-Awwad ◽  
Hakam N Mousa ◽  
Nesreen A Salim ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Root Canal ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Root Canal Treatment ◽  
Evidence Based ◽  
Dental Practice ◽  
Restorative Dentistry ◽  
Evidence Based Dentistry

Objectives. The worldwide interest of both dentists and patients in esthetic dentistry has affected decision-making in dental practice. The aim of this study was to investigate contemporary dental practice in restorative dentistry and the relationship between evidence-based dentistry in caries research and decision-making in clinical practice in restorative dentistry. Methods. The study was conducted through a structured questionnaire distributed randomly at the Jordanian Dental Association registered dentists in Jordan. The questionnaire aimed to clarify the degree of knowledge and practice of evidence-based dentistry in caries research the dentists hold regarding clinical decision-making in restorative dentistry. Results. The majority of the surveyed dentists (77%) treat teeth with irreversible pulpitis with root canal treatment rather than vital pulp therapy. 13.8% routinely insert a post and 23% routinely crown the tooth after root canal treatment regardless of the remaining tooth structure. Badly damaged teeth are treated with full crowns in 72% of the cases. Regarding Hollywood smile or smile makeover, the majority of dentists choose conservative approaches, and implants were the first choice to replace missing teeth for 93.8% of the surveyed dentists. Conclusion. A higher degree of implementation of evidence-based dentistry in clinical decision-making was found in Prosthetic Dentistry than in Endodontics. Yet, the gap between evidence-based data and clinical practice needs bridging. More emphasis on communicating these data to educators to integrate them into the dental curriculum is a must.

scholarly journals Analysis of the Status and Trends of Chinese Clinical Practice Guideline Development Between 2010 and 2020: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Rong Zhang ◽  
Si-yu Yan ◽  
Yun-yun Wang ◽  
Qiao Huang ◽  
Xiang-ying Ren ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Methodological Quality ◽  
Evidence Based ◽  
Healthcare Decision ◽  
Inclusion Criteria ◽  
Healthcare Decision Making ◽  
Status And Trends ◽  
The Status

Objective: This study aimed to systematically review the status and trends of Chinese clinical practice guidelines (CPGs) during the time period 2010–2020 and explore their methodological characteristics. Then, based on the strengths and weaknesses in development, offer several recommendations for the quality improvement which will serve as a reference for the users and developers of CPG.Introduction: With the development of evidence-based medicine (EBM), the CPGs play an increasingly important role in healthcare decision-making both in China and worldwide.Inclusion criteria: The CPGs that have been used to help the health professionals in the healthcare decision-making were included.Methodology: The China National Knowledge Infrastructure (CNKI) and WanFang databases were searched from 2010 to 2020 for the studies describing the general and methodological characteristics of Chinese CPGs. Comparisons of the methodological characteristics between the groups were conducted using the chi-square test or Fisher's exact test. The M-K test was adopted to identify the monotonically increasing or decreasing trends of methodological characteristics over the timespan.Results: A total of 2,654 CPGs fulfilled the inclusion criteria. The quantity and quality of the guidelines developed in China have improved over the time span. From 2010 to 2020,the guidelines had differing characteristics and covered a wide range of subjects. In total, 2,318(87.34%) guidelines focused on Western Medicine. Eight (0.30%) had been developed for patient versions of guidelines, 10(0.38%) were tentative guidelines, and 16(0.60%) were rapid advice guidelines. Medical specialty societies (including their branches) (71.1%) were the main guideline makers. The most addressed diseases were neoplasms (14.43%). The target population is mainly adults (84.97%). The methodological quality of consensus-based (CB)-CPGs was obviously lower than evidence-based (EB)-CPGs. Except for the item, “recommendations were based on evidence of systematic reviews,” there were statistical differences in all other methodological items between the EB-CPGS and CB-CPGS (P < 0.01). Higher methodological quality has been observed in EB-CPGs. All the data relating to the methodological characteristics indicated that higher methodological quality was present in the guidelines using GRADE (P < 0.01).Conclusion: The quantity and quality of the guidelines developed in China have improved between 2010 and 2020. CB-CPGs have also paid attention to the methodology quality, but obviously, this is lower than that in the EB-CPGs.

scholarly journals Adoption of the concept of person-centred care into discourse in Europe: a systematic literature review

2021 ◽  
Vol 35 (9) ◽  
pp. 265-280 ◽  
Author(s):  
Kristina Rosengren ◽  
Petra Brannefors ◽  
Eric Carlstrom
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Literature Review ◽  
Systematic Approach ◽  
Grey Literature ◽  
Quality Of Healthcare ◽  
Healthcare Systems ◽  
Evidence Based ◽  
Content Type ◽  
Healthcare Settings

PurposeThis study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).Design/methodology/approachA literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.FindingsResults from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).Practical implicationsAdoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.Social implicationsEvidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.Originality/valueOur findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.

scholarly journals Desenvolvimento e Avaliação de uma Plataforma Colaborativa Digital para Educação e Tomada de Decisão Médica Baseada em Evidências

2019 ◽  
Vol 43 (1 suppl 1) ◽  
pp. 513-524
Author(s):  
Álisson Oliveira dos Santos ◽  
Alexandre Sztajnberg ◽  
Tales Mota Machado ◽  
Daniel Magalhães Nobre ◽  
Adriano Neves de Paula e Souza ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Real Life ◽  
Evaluation Process ◽  
Clinical Decision ◽  
Medical Decision ◽  
Alternative Form ◽  
Evidence Based ◽  
Life Problems

ABSTRACT The medical education for clinical decision-making has undergone changes in recent years. Previously supported by printed material, problem solving in clinical practice has recently been aided by digital tools known as summaries platforms. Doctors and medical students have been using such tools from questions found in practice scenarios. These platforms have the advantage of high-quality, evidence-based and always up-to-date content. Its popularization was mainly due to the rise of the internet use and, more recently, of mobile devices such as tablets and smartphones, facilitating their use in clinical practice. Despite this platform is widely available, the most of them actually present several access barriers as costs, foreign language and not be able to Brazilian epidemiology. A free national platform of evidence-based medical summaries was proposed, using the crowdsourcing concept to resolve those barriers. Furthermore, concepts of gamification and content evaluation were implemented. Also, there is the possibility of evaluation by the users, who assigns note for each content created. The platform was built with modern technological tools and made available for web and mobile application. After development, an evaluation process was conducted by researchers to attest to the valid of content, usability, and user satisfying. Consolidated questionnaires and evaluation tools by the literature were applied. The process of developing the digital platform fostered interdisciplinarity, from the involvement of medical and information technology professionals. The work also allowed the reflection on the innovative educational processes, in which the learning from real life problems and the construction of knowledge in a collaborative way are integrated. The assessment results suggest that platform can be real alternative form the evidence-based medical decision-making.

scholarly journals Progress in Clinical Neurosciences: Evidence Based Care in the Neurosciences

2002 ◽  
Vol 29 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Samuel Wiebe ◽  
Bart Demaerschalk
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Ease Of Use ◽  
Evidence Based ◽  
Content Accessibility ◽  
Evidence Based Care

Abstract:We examine the relevance of Evidence Based Care (EBC) to the field of clinical neurosciences, with particular emphasis on feasible methods of implementing EBC in clinical practice. By using pre-appraised EBC summaries, busy clinicians can move toward EBC without engaging in the laborious process of searching and critically appraising the literature. After reviewing the neurological content, accessibility and ease of use of current sources of EBC summaries, we find them substantially lacking in coverage of the neurosciences, and therefore of limited use to clinicians in this field. We emphasize a particular type of EBC summary, the critically appraised topic, and comment on its usefulness and limitations as a tool to assist clinical decision-making in the neurosciences. Finally, we propose that a collection of easily accessible, good quality, peer reviewed critically appraised topics, covering a breadth of relevant topics, is a reasonable way of moving toward EBC in the clinical neurosciences.

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