scholarly journals Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2522 ◽  
Author(s):  
Shannon E. Kelly ◽  
David Moher ◽  
Tammy J. Clifford
Keyword(s):  
Decision Making ◽  
Q Methodology ◽  
Evidence Synthesis ◽  
Synthesis Process ◽  
Free Text ◽  
Healthcare Decision ◽  
Rapid Reviews ◽  
Healthcare Decision Making ◽  
Attitudes And Perceptions ◽  
Factor C

BackgroundRapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews.MethodsA Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation). Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described.ResultsAnalysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process.ConclusionResults show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments.

DEFINING RAPID REVIEWS: A MODIFIED DELPHI CONSENSUS APPROACH

2016 ◽  
Vol 32 (4) ◽  
pp. 265-275 ◽  
Author(s):  
Shannon E. Kelly ◽  
David Moher ◽  
Tammy J. Clifford
Keyword(s):  
Decision Maker ◽  
Evidence Synthesis ◽  
Time Frame ◽  
Rapid Review ◽  
Synthesis Process ◽  
Free Text ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Rapid Reviews

Objectives: Rapid reviews are characterized as an accelerated evidence synthesis approach with no universally accepted methodology or definition. This modified Delphi consensus study aimed to develop a comprehensive set of defining characteristics for rapid reviews that may be used as a functional definition.Methods: Expert panelists with knowledge in rapid reviews and evidence synthesis were identified. In the first round, panelists were asked to answer a seventeen-item survey addressing a variety of rapid review topics. Results led to the development of statements describing the characteristics of rapid reviews that were circulated to experts for agreement in a second survey round and further revised in a third round. Consensus was reached if ≥70 percent of experts agreed and there was stability in free-text comments.Results: A panel of sixty-six experts participated. Consensus was reached on ten of eleven statements describing the characteristics of rapid reviews. According to the panel, rapid reviews aim to meet the requirements and timelines of a decision maker and should be conducted in less time than a systematic review. They use a variety of approaches to accelerate the evidence synthesis process, tailor the methods conventionally used to carry out systematic reviews, and use the most rigorous methods that the delivery time frame will allow.Conclusions: This study achieved consensus on ten statements describing the defining characteristics of rapid reviews based on the opinion of a panel of knowledgeable experts. Areas of disagreement were also highlighted. Findings emphasize the role of the decision maker and stress the importance of transparent reporting.

scholarly journals Development of a Video-based Evidence Synthesis Knowledge Translation Resource: Applying a User-Centred Approach

2021 ◽  
Author(s):  
Cristian Deliv ◽  
El Putnam ◽  
Declan Devane ◽  
Patricia Healy ◽  
Amanda Hall ◽  
...  
Keyword(s):  
Decision Making ◽  
Knowledge Translation ◽  
General Public ◽  
Evidence Synthesis ◽  
Idea Generation ◽  
Perceived Usefulness ◽  
Think Aloud ◽  
Healthcare Decision ◽  
The Public ◽  
Healthcare Decision Making

Background: People of all ages and walks of life are bombarded with health claims from an array of sources. An understanding of evidence synthesis is important for people to make truly informed healthcare decisions. There is an increasing focus on the use of knowledge translation resources within healthcare; however, the development of these resources has often been poorly described or studied. Objectives: This study employs a user-centred approach to develop a video animation resource to explain the purpose, use and importance of evidence synthesis to the general public regarding healthcare decision-making. Methods: We employed a user-centred approach to developing a spoken animated video that could explain evidence synthesis to a public audience, conducting several cycles of idea generation, prototyping, user-testing, analysis and refinement. Six researchers with expertise in evidence synthesis and knowledge translation resource development gave input on the key messages of the video animation and informed the first draft of the storyboard and script. Seven members of the public provided feedback on this draft through Think-aloud interviews, which we used to develop a video animation prototype. Seven additional members of the public participated in Think-aloud interviews while watching the video prototype. In addition to interviews, participants completed a questionnaire that collected data on perceived usefulness, desirability, clarity and credibility. One experienced patient and public involvement (PPI) advocate also provided feedback on the script and prototype. At the end of each feedback cycle, we assimilated all data and made necessary changes, resulting in a final, rendered version of the animation video. Results: Researchers identified the initial key messages for the SAV as 1) the importance of evidence synthesis, 2) what an evidence synthesis is and 3) how evidence synthesis can impact healthcare decision-making. Using guidance and feedback from members of the public, we produced a three-and-a-half-minute video animation that members of the public rated 9/10 for usefulness, 8/10 for desirability, 8/10 for clarity and 9/10 for credibility. The video was uploaded on YouTube (https://www.youtube.com/watch?v=nZR0xQmZVQg) and has been viewed over 5500 times to date. Conclusions: Employing a user-centred approach, we developed a video animation knowledge translation resource to explain evidence synthesis to the general public that was assessed as useful, desirable and clear by its intended target audience. This study describes the structured and systematic development of this knowledge translation resource and how key stakeholders and end-users informed the final output.

scholarly journals Framework for the synthesis of non-randomised studies and randomised controlled trials: a guidance on conducting a systematic review and meta-analysis for healthcare decision making

2020 ◽  
pp. bmjebm-2020-111493
Author(s):  
Grammati Sarri ◽  
Elisabetta Patorno ◽  
Hongbo Yuan ◽  
Jianfei (Jeff) Guo ◽  
Dimitri Bennett ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomised Controlled Trials ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Healthcare Decision ◽  
Data Types ◽  
Healthcare Decision Making ◽  
Formal Framework ◽  
Randomised Controlled

Introduction: High-quality randomised controlled trials (RCTs) provide the most reliable evidence on the comparative efficacy of new medicines. However, non-randomised studies (NRS) are increasingly recognised as a source of insights into the real-world performance of novel therapeutic products, particularly when traditional RCTs are impractical or lack generalisability. This means there is a growing need for synthesising evidence from RCTs and NRS in healthcare decision making, particularly given recent developments such as innovative study designs, digital technologies and linked databases across countries. Crucially, however, no formal framework exists to guide the integration of these data types. Objectives and Methods: To address this gap, we used a mixed methods approach (review of existing guidance, methodological papers, Delphi survey) to develop guidance for researchers and healthcare decision-makers on when and how to best combine evidence from NRS and RCTs to improve transparency and build confidence in the resulting summary effect estimates. Results: Our framework comprises seven steps on guiding the integration and interpretation of evidence from NRS and RCTs and we offer recommendations on the most appropriate statistical approaches based on three main analytical scenarios in healthcare decision making (specifically, ‘high-bar evidence’ when RCTs are the preferred source of evidence, ‘medium,’ and ‘low’ when NRS is the main source of inference). Conclusion: Our framework augments existing guidance on assessing the quality of NRS and their compatibility with RCTs for evidence synthesis, while also highlighting potential challenges in implementing it. This manuscript received endorsement from the International Society for Pharmacoepidemiology.

scholarly journals Nursing Home Staff’s Perceptions of Healthcare Decision Making for Unbefriended Residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 384-384
Author(s):  
Hyejin Kim ◽  
Molly Perkins ◽  
Thaddeus Pope ◽  
Patricia Comer ◽  
Mi-Kyung Song
Keyword(s):  
Decision Making ◽  
Geographic Area ◽  
Care Physician ◽  
Healthcare Decision ◽  
Do Not Resuscitate ◽  
Best Interest ◽  
Care Plans ◽  
Course Of Action ◽  
Healthcare Decision Making ◽  
Facility Level

Abstract ‘Unbefriended’ adults are those who lack decision-making capacity and have no surrogates or advance care plans. Little data exist on nursing homes (NHs)’ healthcare decision-making practices for unbefriended residents. This study aimed to describe NH staff’s perceptions of healthcare decision making on behalf of unbefriended residents. Sixty-six staff including administrators, physicians, nurses, and social workers from three NHs in one geographic area of Georgia, USA participated in a 31-item survey. Their responses were analyzed using descriptive statistics and conventional content analysis. Of 66 participants, eleven had been involved in healthcare decision-making for unbefriended residents. The most common decision was do-not-resuscitate orders. Decisions primarily were made by relying on the resident’s primary care physician and/or discussing within a facility interdisciplinary team. Key considerations in the decision-making process included “evidence that the resident would not have wanted further treatment” and the perception that “further treatment would not be in the resident’s best interest”. Compared with decision making for residents with surrogates, participants perceived decision making for unbefriended residents to be equally-more difficult. Key barriers to making decisions included uncertainty regarding what the resident would have wanted in the given situation and concerns regarding the ethically and legally right course of action. Facilitators (reported by 52 participants) included some information/knowledge about the resident, an understanding regarding decision-making-related law/policy, and facility-level support. The findings highlight the complexity and difficulty of healthcare decision making for unbefriended residents and suggest more discussions among all key stakeholders to develop practical strategies to support decision-making practices in NHs.

Perceived Financial Insecurity Impacts Healthcare Decision‐Making Among Patients With Sinusitis

2021 ◽  
Author(s):  
Vivek C. Pandrangi ◽  
Nyssa Fox Farrell ◽  
Jess C. Mace ◽  
Kara Y. Detwiller ◽  
Timothy L. Smith ◽  
...  
Keyword(s):  
Decision Making ◽  
Healthcare Decision ◽  
Healthcare Decision Making

scholarly journals 307 - Exploratory Study on Healthcare Decision-Making Capacity Assessment

2020 ◽  
Vol 32 (S1) ◽  
pp. 65-65
Author(s):  
Ana Saraiva Amaral ◽  
Rosa Marina Afonso ◽  
Mário R. Simões ◽  
Sandra Freitas
Keyword(s):  
Decision Making ◽  
Content Analysis ◽  
Focus Groups ◽  
Exploratory Study ◽  
Assessment Instrument ◽  
Funding Agency ◽  
Capacity Assessment ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Decision Making Capacity

Mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) prevalence is expected to continue to increase, due to the population ageing. MCI and AD may impact patients’ decision-making capacities, which should be assessed through the disease course. These medical conditions can affect the various areas of decision-making capacity in different ways. Decision-making capacity in healthcare is particularly relevant among this population. Elders often suffer from multimorbidity and are frequently asked to make healthcare decisions, which can vary from consenting a routine diagnostic procedure to decide receiving highly risk treatments.To assess this capacity in elders with MCI or AD, we developed the Healthcare Decision-Making Capacity Assessment Instrument (IACTD-CS - Instrumento de Avaliação da Capacidade de Tomada de Decisão em Cuidados de Saúde). This project is funded by Portuguese national funding agency for science, research and technology, FCT (SFRH/BD/139344/2018). IACTD-CS was developed based on Appelbaum and Grisso four abilities model, literature review and review of international assessment instruments. After IACTD-CS first version development, an exploratory study with focus groups was conducted. This study included focus groups with healthcare professionals and nursing homes’ professionals.The focus groups main goals were: 1) understand the participants perception regarding healthcare decision-making capacity, 2) distinguish relevant aspects of decision-making, 3) discuss the abilities and items included in IACTD-CS and 4) identify new aspects or items to be added to IACTD-CS. A content analysis of the focus groups results, with resource to MAXQDA, was conducted afterwards. This exploratory study allowed to identify professionals’ perceptions on healthcare decision-making and its results were a significant contribute to IACTD-CS development. The proposed communication aims to describe the methodology used and present the results of content analysis.

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