Language for Actionable Recommendations in Clinical Guidelines

Klasco, Richard; Glinert, Lewis

doi:10.1001/jama.2016.20670

Cited by 12 publications

(9 citation statements)

References 8 publications

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“…There is evidence in the health promotion domain that users prefer messages that are correctly spelled and grammatically correct and directive rather than passive or interrogative. 39 Emphasis on objectivity and clarity are also recommended for creating medical guidelines, 40 41 though empirical evidence is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Determinants of usefulness in professional behaviour change interventions: observational study of a 15-year national program

et al. 2020

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ObjectiveEducational, and audit and feedback interventions are effective in promoting health professional behaviour change and evidence adoption. However, we lack evidence to pinpoint which particular features make them most effective. Our objective is to identify determinants of quality in professional behaviour change interventions, as perceived by participants.DesignWe performed a comparative observational study using data from the Veterans’ Medicines Advice and Therapeutics Education Services program, a nation-wide Australian Government Department of Veterans’ Affairs funded program that provides medicines advice and promotes physician adoption of best practices by use of a multifaceted intervention (educational material and a feedback document containing individual patient information).SettingPrimary care practices providing care to Australian veterans.ParticipantsGeneral practitioners (GPs) targeted by 51 distinct behaviour change interventions, implemented between November 2004 and June 2018.Primary and secondary outcome measuresWe extracted features related to presentation (number of images, tables and characters), content (polarity and subjectivity using sentiment analysis, number of external links and medicine mentions) and the use of five behaviour change techniques (prompt/cues, goal setting, discrepancy between current behaviour and goal, information about health consequences, feedback on behaviour). The main outcome was perceived usefulness, extracted from postintervention survey.ResultsOn average, each intervention was delivered to 9667 GPs. Prompt and goal setting strategies in the audit and feedback were independently correlated to perceived usefulness (p=0.030 and p=0.005, respectively). The number of distinct behaviour change techniques in the audit and feedback was correlated with improved usefulness (Pearson’s coefficient 0.45 (0.19, 0.65), p=0.001). No presentation or content features in the educational material were correlated with perceived usefulness.ConclusionsThe finding provides additional evidence encouraging the use of behaviour change techniques, in particular prompt and goal setting, in audit and feedback interventions.

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Section: Discussionmentioning

confidence: 99%

Determinants of usefulness in professional behaviour change interventions: observational study of a 15-year national program

et al. 2020

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“…Recommendations in practice guidelines should, therefore, define a standard of care for physicians who must act in the absence of evidentiary certainty. It should be acknowledged that the recommendations in guidelines may change as new data become available, but those recommendations should always represent the best evidence and the best expert opinion currently available” . After a decade of gout guideline development without measuring physician performance, data support that a significant performance gap continues to exist .…”

Section: Discussionmentioning

confidence: 99%

Development of the American College of Rheumatology Electronic Clinical Quality Measures for Gout

Fitzgerald

Mikuls

Neogi

et al. 2018

Arthritis Care & Research

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“…Delphi conferences are not the panacea for poor evidence; 11 the weaker the evidence, the more the process becomes subject to individual opinion. Instead, research should be triggered, and in the meantime the pros and cons of medical interventions should be discussed with patients on an individual basis, 12 resulting in shared decisions. In view of the weak evidence with respect to some aspects…”

Section: Issues With European Guidelines For Phenylketonuriamentioning

confidence: 99%