A scoping review protocol of evidence-based guidance and guidelines published by general practitioner professional organisations

Introduction: General practitioners (GPs) strive to use a patient centered approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. In order to achieve this standard of care, GPs require relevant, up to date and high quality evidence. Currently there is a gap in the literature regarding the role of GP professional organisations internationally in producing and publishing evidence based guidance and clinical guidelines for GPs. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally in terms of topic content, the structure and methods used to develop guidance and ways of disseminating this guidance, to support general practice clinical decision making. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted. Conclusions: This scoping review will examine current practice internationally regarding the role of General Practice professional organisations in producing and publishing clinical guidelines and evidence based guidance to support general practitioner’s clinical decision making to benefit patient care.

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A scoping review protocol of evidence-based guidance published by general practitioner professional organisations

HRB Open Research ◽

10.12688/hrbopenres.13268.1 ◽

2021 ◽

Vol 4 ◽

pp. 53

Author(s):

Emer O'Brien ◽

Barbara Clyne ◽

Susan M. Smith ◽

Noirin O'Herlihy ◽

Velma Harkins ◽

...

Keyword(s):

Decision Making ◽

General Practitioner ◽

General Practitioners ◽

Scoping Review ◽

Clinical Decision Making ◽

Grey Literature ◽

Clinical Decision ◽

Cochrane Library ◽

Evidence Based ◽

Scoping Reviews

Introduction: General practitioners (GPs) strive to use a patient centred approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally to support general practice clinical decision making. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted. Conclusions: This scoping review will identify the role of GP professional organisations in generating, endorsing and/or disseminating evidence-based guidance for supporting general practitioner’s clinical decision making to benefit patient care.

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What is Evidence-Based Practice?

British Journal of Occupational Therapy ◽

10.1177/030802269706001102 ◽

1997 ◽

Vol 60 (11) ◽

pp. 470-474 ◽

Cited By ~ 31

Author(s):

M Clare Taylor

Keyword(s):

Systematic Reviews ◽

Clinical Guidelines ◽

Critical Appraisal ◽

Clinical Decision Making ◽

Evidence Based Practice ◽

Occupational Therapists ◽

Clinical Decision ◽

Evidence Based ◽

Critical Appraisal Skills

Evidence-based practice are the buzz words of current health care. This article explores what evidence-based practice actually means for occupational therapists. Evidence-based practice has two strands. The first strand involves using the best available evidence as part of the clinical decision-making process. The second strand involves drawing the evidence together in the form of systematic reviews. These reviews may then be used to help inform the development of clinical guidelines. This article outlines and discusses both strands of evidence-based practice and the relevance of each strand to practising occupational therapists. It explores how therapists can locate, evaluate and use evidence to inform their practice. The article focuses particularly on the development of critical appraisal skills. The role of systematic reviews and the relevance of clinical guidelines for occupational therapy are discussed.

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Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing

BMC Family Practice ◽

10.1186/s12875-021-01574-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Resha Al-Azzawi ◽

Peder A. Halvorsen ◽

Torsten Risør

Keyword(s):

Decision Making ◽

General Practitioner ◽

Scoping Review ◽

English Language ◽

Clinical Decision Making ◽

Contextual Factors ◽

Real Life ◽

Clinical Decision ◽

Antibiotic Prescribing ◽

Consultation Process

Abstract Background How contextual factors may influence GP decisions in real life practice is poorly understood. The authors have undertaken a scoping review of antibiotic prescribing in primary care, with a focus on the interaction between context and GP decision-making, and what it means for the decisions made. Method The authors searched Medline, Embase and Cinahl databases for English language articles published between 1946 and 2019, focusing on general practitioner prescribing of antibiotics. Articles discussing decision-making, reasoning, judgement, or uncertainty in relation to antibiotic prescribing were assessed. As no universal definition of context has been agreed, any papers discussing terms synonymous with context were reviewed. Terms encountered included contextual factors, non-medical factors, and non-clinical factors. Results Three hundred seventy-seven full text articles were assessed for eligibility, resulting in the inclusion of 47. This article documented the experiences of general practitioners from over 18 countries, collected in 47 papers, over the course of 3 decades. Contextual factors fell under 7 themes that emerged in the process of analysis. These were space and place, time, stress and emotion, patient characteristics, therapeutic relationship, negotiating decisions and practice style, managing uncertainty, and clinical experience. Contextual presence was in every part of the consultation process, was vital to management, and often resulted in prescribing. Conclusion Context is essential in real life decision-making, and yet it does not feature in current representations of clinical decision-making. With an incomplete picture of how doctors make decisions in real life practice, we risk missing important opportunities to improve decision-making, such as antibiotic prescribing.

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Evidence-based Guidelines for Anxiety Disorders: Can They Improve Clinical Outcomes?

CNS Spectrums ◽

10.1017/s1092852900025839 ◽

2006 ◽

Vol 11 (S12) ◽

pp. 34-39 ◽

Cited By ~ 11

Author(s):

David S. Baldwin

Keyword(s):

Decision Making ◽

Anxiety Disorders ◽

Clinical Outcomes ◽

Clinical Guidelines ◽

Clinical Decision Making ◽

Treatment Guidelines ◽

Clinical Decision ◽

Evidence Based ◽

Mental Health Programs ◽

Evidence Based Guidelines

AbstractEvidence-based medicine (EBM) enables clinicians to justify decision making, enhances the quality of medical practice, identifies unanswered research questions, and ensures the efficient practice of medicine. Implementation of evidence-based mental health programs requires education, time, and improved effort by administration, regulatory, and clinical professionals. Essential to these efforts are consistent incentives for change, effective training materials, and clear clinical guidelines. Guidelines exist within the framework of EBM. Good guidelines are simple, specific, and user friendly, focus on key clinical decisions, are based on research evidence, and present evidence and recommendations in a concise and accessible format. Potential limitations of guidelines to improve clinical outcomes in anxiety disorders are the widespread distribution of anxiety symptoms in primary care, health inequalities across patient groups, persistent misconceptions regarding psychotropic drugs, and low confidence in using simple psychological treatments. Clinical guidelines generally specify therapeutic areas covered and not covered, but often there is no mention of cost or cost effectiveness of treatment. Guidelines can inform clinical decision making, but administrators of drug formularies may regard themselves as being primarily responsible for limiting costs and access to certain medications, even if these decisions are at odds with guideline recommendations.

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Evidence‐Based Medicine for Clinical Decision Making in Sexual Health Care Management: Role of The Journal of Sexual Medicine

Journal of Sexual Medicine ◽

10.1111/j.1743-6109.2004.04020.x ◽

2004 ◽

Vol 1 (2) ◽

pp. 125-127 ◽

Cited By ~ 1

Author(s):

Irwin Goldstein

Keyword(s):

Health Care ◽

Decision Making ◽

Care Management ◽

Clinical Decision Making ◽

Clinical Decision ◽

Evidence Based ◽

Sexual Medicine ◽

Sexual Health Care ◽

Based Medicine

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Impact of guideline awareness on the counseling of patients with acute cough among general practitioners and pharmacy personnel

PLoS ONE ◽

10.1371/journal.pone.0254086 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0254086

Author(s):

Peter Kardos ◽

Kai-Michael Beeh ◽

Ulrike Sent ◽

Guido Bissmann

Keyword(s):

Decision Making ◽

General Practitioners ◽

Online Survey ◽

Clinical Decision Making ◽

Daily Practice ◽

Clinical Decision ◽

Case Vignette ◽

Guideline Recommendation ◽

Evidence Based ◽

Acute Cough

Objective To explore the awareness and knowledge of applicable guidelines on acute cough among general practitioners, pharmacists and pharmacy technicians and to compare their recommendation behavior and clinical decision making to the evidence-based recommendation in the applicable guidelines. Methods An anonymous online survey was performed among 303 members of an existing panel of healthcare professionals (HCPs). They were presented with a hypothetical case vignette representative of their daily practice and asked for their treatment recommendations. After being shown an excerpt from the applicable guidelines, these questions were repeated. Results Forty-six % of participants reported to seek information on cough and respiratory conditions very often or often. Among 12 non-prescription treatments-commonly used over-the-counter-products for acute cough, HCPs most often recommended various plant extract-based products (phytotherapeutic remedies) for the acute cough case, whereas chemically defined options such as ambroxol or N-acetyl-cysteine were recommended less often. Following presentation of the guidelines excerpt, recommendations of the phytotherapeutic remedies decreased moderately whereas that of the guideline-recommended ambroxol more than doubled. Among stated reasons for the recommendation guideline conformity increased from 5% to 35% among the top-3 reasons. Conclusions The recommendations for the treatment of acute cough by professionals involved in primary healthcare deviated considerably from the applicable guideline recommendation but changed after presentation of a guidelines excerpt and knowledge thereof. We conclude that dissemination of applicable guideline knowledge is relevant to improve evidence-based healthcare and clinical decision making.

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Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd20.4.121 ◽

2011 ◽

Vol 20 (4) ◽

pp. 121-123

Author(s):

Jeri A. Logemann

Keyword(s):

Decision Making ◽

Patient Care ◽

Clinical Outcomes ◽

Clinical Judgment ◽

Clinical Decision Making ◽

Evidence Based Practice ◽

Clinical Decision ◽

Evidence Based ◽

Clinical Method ◽

Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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