How can clinicians incorporate research advances into practice?

Larson, Eric B.

doi:10.1046/j.1525-1497.12.s2.3.x

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…However, the assumption that research should be undertaken to change clinical practice needs to be empirically explored because the possibility remains that other less expensive and more efficient ways of providing clinical guidance exist. Indeed there is some indication that the link between clinical trial results and the impact on clinical practice is complex and much research may have little impact in practice (see, for example, Deber, 1992;Hampton, 1997;Larson, 1997;Lomas, 1991). To date this issue has not been sufficiently addressed in the 'payback' literature.…”

Section: Discussionmentioning

confidence: 99%

Setting priorities for research: a practical application of ‘payback’ and expected value of information

Fleurence¹

2007

Health Economics

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Section: Discussionmentioning

confidence: 99%

Setting priorities for research: a practical application of ‘payback’ and expected value of information

Fleurence¹

2007

Health Economics

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“…The major four pillars of clinical decision-making are scientific evidence, clinical judgment (in some complex cases, not isolated to one clinician but involving a team of healthcare professionals, each contributing their expertise), ethical considerations, and patient involvement, which are pivotal to the delivery of high-quality healthcare [6,7]. Clinical decision-making is not a static but rather dynamic, multifaceted, iterative process, based on reflective practice, which implies reviewing and auditing clinical decisions and outcomes to continuously learn and improve decision-making skills, in the face of uncertainty and epistemic risks [5,8].…”

Section: Clinical Decision-making and Clinical Intelligencementioning

confidence: 99%

Toward Clinical Generative AI: Conceptual Framework

Bragazzi,

Garbarino

2024

JMIR AI

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Clinical decision-making is a crucial aspect of healthcare, involving the balanced integration of scientific evidence, clinical judgment, ethical considerations, and patient involvement. This process is dynamic and multifaceted, relying on clinicians' knowledge, experience, and intuitive understanding to achieve optimal patient outcomes through informed, evidence-based choices. The advent of generative Artificial Intelligence (AI) presents a revolutionary opportunity in clinical decision-making. AI's advanced data analysis and pattern recognition capabilities can significantly enhance the diagnosis and treatment of diseases, processing vast medical data to identify patterns, tailor treatments, predict disease progression, and aid in proactive patient management. However, the incorporation of AI into clinical decision-making raises concerns regarding the reliability and accuracy of AI-generated insights. To address these concerns, eleven "verification paradigms" are here proposed, with each paradigm offering unique methods to verify the evidence-based nature of AI in clinical decision-making. The paper also frames the concept of "clinically explainable, fair, and responsible, clinician-, expert-, and patient-in-the-loop AI". This model focuses on ensuring AI's comprehensibility, collaborative nature, and ethical grounding, advocating for AI to serve as an augmentative tool, with its decision-making processes being transparent and understandable to clinicians and patients. The integration of AI should enhance, not replace, the clinician's judgment and should involve continuous learning and adaptation based on real-world outcomes and ethical and legal compliance. In conclusion, while generative AI holds immense promise in enhancing clinical decision-making, it is essential to ensure that it produces evidence-based, reliable, and impactful knowledge. Employing the outlined paradigms and approaches can help the medical and patient communities harness AI's potential while maintaining high patient care standards.

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“…4,5 Clinical practice guidelines (CPGs) development is based on research, expert opinion, and new technological advancements that assist clinicians in providing better care. 6 National and international guidelines provide guidance on clinical care and clinical decision making. 7 However, variations in existing guidelines recommendations may result in variations in clinical practice and standards.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and appraisal of clinical practice guidelines on pelvic organ prolapse using the AGREE II tool

Tsiapakidou

Nygaard

Falconi

et al. 2021

Neurourology and Urodynamics

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To systematically evaluate the content and quality of national and international clinical guidelines on pelvic organ prolapse (POP). Methods: We searched medical databases and organizations websites, to identify national and international guidelines on diagnosis and management of POP. Five authors independently assessed guidelines using the validated AGREE II tool. Its six domains include (1) scope and purpose, (2) stakeholder involvement, (3) rigor of development, (4) clarity of presentation, (5) applicability, and (6) editorial independence.Results: Eight guidelines met the inclusion criteria. Three hundred and thirteen different recommendations were identified. One hundred and ninety-nine recommendations were comparable across guidelines. Thirtyone recommendations were not supported by research evidence. Assessment by history and physical examination using the POP quantification system and consideration of imaging were recommendations featuring in all guidelines. Conservative treatment recommendations namely pelvic floor muscle training and vaginal pessaries were also found in all guidelines.Regarding surgical management, patient counseling, treating only symptomatic POP, consideration of apical fixation during surgical treatment, and use of biological or synthetic implants in recurrent cases were recommendations in all guidelines. Overall, the highest median scores were in the domains "scope and purpose" and "rigor of development". The lowest median score was for applicability (28.3%). Although the median score of "editorial independence" was high (85.4%), variability was also substantial (interquartile range: 12.5-100). Conclusion:We identified variations in quality and deficiencies in certain areas, especially "applicability" and "editorial independence." Improvements in these key domains may enhance the quality and clinical impact of clinical practice guidelines.

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How can clinicians incorporate research advances into practice?

Cited by 11 publications

References 13 publications

Setting priorities for research: a practical application of ‘payback’ and expected value of information

Setting priorities for research: a practical application of ‘payback’ and expected value of information

Toward Clinical Generative AI: Conceptual Framework

Systematic review and appraisal of clinical practice guidelines on pelvic organ prolapse using the AGREE II tool

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