ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2020
Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
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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
48 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review of the power of standardization in pediatric neurosurgery.Neurosurgical review · 2023Pooled it
- Radical prostatectomy versus external beam radiotherapy with androgen deprivation therapy for high-risk prostate cancer: a systematic review.BMC cancer · 2023Pooled it
- Efficacy of regional anesthesia techniques for postoperative analgesia in patients undergoing major oncologic breast surgeries: a systematic review and network meta-analysis of randomized controlled trials.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Pooled it
- Multiple Suggested Care Alternatives and Decision-Making of Primary Care Physicians: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Effectiveness and Implementation of a Clinical Risk Score for Early Diagnosis of Tuberculosis in Uganda: A Pragmatic, Clustered Randomization Clinical Trial.Annals of the American Thoracic Society · 2025Trial
- Variation in Outcomes and Number of Visits Following Care Guideline Implementation: Part 2 of an Analysis of 12 355 Patients After Total Knee Arthroplasty.The Journal of orthopaedic and sports physical therapy · 2023Trial
- Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial.Journal of medical Internet research · 2021Trial
- Dealing With Conflicts in Medical Decisions: Epistemic Reasonable Disagreement Between Parents and Medical Staff.Bioethics · 2026Article
- Exploring the Socio-Economic Toll of Non-Communicable Diseases in Low-Resource Settings: Novel Evidence From Mozambique.The International journal of health planning and management · 2026Article
- Investigating clinical practice variations in coronary artery disease treatment using reinforcement and transfer learning.NPJ cardiovascular health · 2026Article
- Physiotherapy in deceased organ donation: A mixed methods study of current practice and perceptions amongst UK-based intensive care physiotherapists.Journal of the Intensive Care Society · 2026Article
- Enhancing neonatal vascular access: proposing a patient-centered framework based on 7-Rights.Pediatric research · 2026Article
- Article
- Hospital variation in the treatment of cT1a renal cancer.BJUI compass · 2026Article
- Identifying Clinical Variations Across NSW Public Dental Service: An Essential Step to Develop a Roadmap for Value-Based Oral Healthcare.Australian dental journal · 2026Article
- Developing Evidence-Based Implementation Strategies for the Management of Women With Early Pregnancy Bleeding in the Emergency Department: A Multi-Method Study.Journal of advanced nursing · 2026Article
- Treatment variation in acute management of patients with aneurysmal subarachnoid hemorrhage: a multicenter case vignette study.Brain & spine · 2026Article
- Outcome centred process mapping in healthcare using random forest and process mining.Scientific reports · 2025Article
- Plantar Heel Pain Management: A Survey of UK Registered Healthcare Professionals.Journal of foot and ankle research · 2025Article
- Bridging the gap between evidence and practice: a national level initiative to implement Standard Treatment Guidelines (STGs) in clinical practice.BMC health services research · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the past decades, extensive research has been performed on the phenomenon of unwarranted clinical variation in clinical practice. Many studies have been performed on signaling, describing and visualizing clinical variation. We argue that it is time for next steps in practice variation research. In addition to describing and signaling variation patterns, we argue that a better understanding of causes of variation should be gained. Moreover, target points for improving and decreasing clinical variation should be created. Key elements in this new focus should be research on the complex interaction of networks, reflective medicine, patient beliefs and objective criteria for treatment choices. By combining these different concepts, alternative research objectives and new targets for improving and reducing unwarranted variation may be defined. In this perspective, we reflect on these concepts and propose target points for future research.
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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.