ArticleEpidemiology and psychiatric sciences2017
From the EBM pyramid to the Greek temple: a new conceptual approach to Guidelines as implementation tools in mental health.
Article in Epidemiology and psychiatric sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Health risk behaviours, mental health and HbA1c: an overview of reviews of observational studies.BMJ open · 2025Pooled it
- Development and implementation of guidelines for the management of depression: a systematic review.Bulletin of the World Health Organization · 2020Pooled it
- Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines.Canadian family physician Medecin de famille canadien · 2018Guideline
- Proof of concept studies in mental health systems research: strategy and steps.International journal of mental health systems · 2025Review
- Good mental health for people with intellectual disabilities: a participatory focus group study.International journal for equity in health · 2025Article
- Modelling the impact on a local mental health system of previously implemented care programs: the experience of assertive outreach teams in Bizkaia (Spain).Epidemiology and psychiatric sciences · 2025Article
- Assessment of care provision integration in a community-based mental health system: balanced care model implementation in Andalusia (Spain).BMC public health · 2024Article
- Determining the future role of clinical practice guidelines: The experience of Australia and New Zealand.The Australian and New Zealand journal of psychiatry · 2024Article
- Co-creating community wellbeing initiatives: what is the evidence and how do they work?International journal of mental health systems · 2024Review
- The EMPOWER Occupational e-Mental Health Intervention Implementation Checklist to Foster e-Mental Health Interventions in the Workplace: Development Study.Journal of medical Internet research · 2024Article
- Applying the health ecosystem approach in the analysis of health care and support for first nations in the pacific.The Lancet regional health. Western Pacific · 2024Article
- Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health.Health research policy and systems · 2024Review
- A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools-What Works, for Whom, and under What Circumstances?International journal of environmental research and public health · 2023Article
- An ecosystems approach to mental health services research.BJPsych international · 2021Review
- Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery.BMC health services research · 2019Article
- Different knowledge, different styles of reasoning: a challenge for guideline development.BMJ evidence-based medicine · 2018Article
- Use of the self-organising map network (SOMNet) as a decision support system for regional mental health planning.Health research policy and systems · 2018Article
- Article
- Approaches to primary care of adults with intellectual and developmental disabilities: Importance of frameworks for guidelines.Canadian family physician Medecin de famille canadien · 2018Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development. In addition to these advances, a new framework based on the philosophy of science is required. Guidelines should be defined as implementation decision support tools for improving the decision-making process in real-world practice and not only as a procedure to optimise the knowledge base of scientific discovery and corroboration. A shift from the model of the EBM pyramid of corroboration of evidence to the use of broader multi-domain perspective graphically depicted as 'Greek temple' could be considered. This model takes into account the different stages of scientific knowledge (discovery, corroboration and implementation), the sources of knowledge relevant to guideline development (experimental, observational, contextual, expert-based and experiential); their underlying inference mechanisms (deduction, induction, abduction, means-end inferences) and a more precise definition of evidence and related terms. The applicability of this broader approach is presented for the development of the Canadian Consensus Guidelines for the Primary Care of People with Developmental Disabilities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.