A multi-dimensional model of clinical utility

Abstract

Clinical utility is an increasingly used concept in health care, but one that lacks an agreed formal definition or conceptualization. In this article, I show that the term is commonly used as a synonym for studies of clinical effectiveness and/or economic evaluations and argue that further factors relating to everyday working practice should be included under its auspices. I go on to develop a multi-dimensional model that outlines four factors in practitioners' judgements about clinical utility: appropriateness, accessibility, practicability, and acceptability.

In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers

“…Further examination is required of the clinical utility of this assessment in guiding home modification intervention. Although this preliminary investigation demonstrated acceptability to caregivers, additional information on the ability of the instrument to guide interventions, acceptability to clinicians, and time and training requirements would further clarify the clinical utility of the I-HOPE Assist (Smart, 2006). Additionally, the sensitivity of the instrument in measuring change should be evaluated.…”

Knowledge and use of asthma control measurement tools in the management of asthma: a survey of doctors working in family and internal medicine practice in Nigeria

“…Other factors are poor knowledge of the instrument, ease of interpretation especially in setting where there is no computer application to support interpretation in a busy clinic setting. [27][28] .…”

“…The use of ACM tools was also associated with doctors who graduated < 5 years prior to the survey. Doctors who graduated less than five years may not suffer from inertia of practice [27][28][29] .…”

Validation of the distress thermometer for use among adolescents and young adults with cancer in Australia: a multicenter study protocol

“…Clinical utility may broadly be understood in terms not only of clinical and cost-effectiveness, but also "… practitioners' perspectives about the usefulness, benefits, and drawbacks of an innovation for their working practice". 46 To ensure comprehensive evaluation of the clinical utility of the DT/PCL, the present study will test for the tool's clinical utility by using Smart's multidimensional model. 46 Clinical utility is defined by the concepts of "appropriateness" (ie, effectiveness and relevance), "practicability" (ie, the relationship between the tool and the practitioner's needs and capabilities), and "acceptability" (ie, patient and health care professional perspectives on ethics, psychological concerns, and service delivery).…”

“…46 To ensure comprehensive evaluation of the clinical utility of the DT/PCL, the present study will test for the tool's clinical utility by using Smart's multidimensional model. 46 Clinical utility is defined by the concepts of "appropriateness" (ie, effectiveness and relevance), "practicability" (ie, the relationship between the tool and the practitioner's needs and capabilities), and "acceptability" (ie, patient and health care professional perspectives on ethics, psychological concerns, and service delivery). Smart's model asserts that an overall assessment of clinical utility can be made by considering the degree to which a measure addresses the four individual concepts.…”