ArticleJournal of evaluation in clinical practice2022
Evidence-basing for quality improvement; bringing clinical practice guidelines closer to their promise of improving care practices.
Article in Journal of evaluation in clinical practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Improvement of Clinical Practice Guideline Appraisal by Human Experts and AI Agents by Using Structured Guidance: Systematic Review, Meta-Analysis, and Validation Study.Journal of medical Internet research · 2026Pooled it
- Evidence-to-Decision Frameworks: Enhancing the Quality and Rigour of Guidelines and Recommendations.Clinical and public health guidelines · 2026Article
- Incorporating economic considerations in clinical practice guideline development: a scoping review.BMC health services research · 2026Article
- Assessing Guideline Knowledge Alignment of Large Language Models in Ophthalmology: A Preclinical Benchmarking Study on KLEx Evidence-Based Guidelines.Journal of ophthalmology · 2026Article
- Users' experience of frameworks to support evidence-informed decision-making in public health: a scoping review.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Benefits and Limitations of Real-World Patient-Reported Toxicity Symptom Monitoring for Guidelines and Care, as Perceived by Patients, Clinicians, and Guideline Developers.Cancer medicine · 2025Article
- Challenges and Stimulating Factors for the Incorporation of Economic Considerations in Clinical Practice Guidelines: A Scoping Review.Journal of evaluation in clinical practice · 2025Article
- Transforming healthcare in Libya - the need for clinical practice guidelines in disease management.Journal of pharmaceutical policy and practice · 2025Article
- Development and validity testing of a matrix to evaluate maturity of clinical pathways: a case study in Saskatchewan, Canada.BMC health services research · 2024Article
- A Guideline for Guidelines: A Novel Method to Assess the Helpfulness of Medical Guidelines.Journal of clinical medicine · 2024Article
- Creating an (ethical) epistemic space for the normalization of clinical and "real food" oral immunotherapy for food allergy.Health (London, England : 1997) · 2023Article
- Capturing Emerging Experiential Knowledge for Vaccination Guidelines Through Natural Language Processing: Proof-of-Concept Study.Journal of medical Internet research · 2023Article
- Evidence-basing for quality improvement; bringing clinical practice guidelines closer to their promise of improving care practices.Journal of evaluation in clinical practice · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundClinical practice guidelines (CPGs) have become central to efforts to change clinical practice and improve the quality of health care. Despite growing attention for rigorous development methodologies, it remains unclear what contribution CPGs make to quality improvement.
aimThis mixed methods study examines guideline quality in relation to the availability of certain types of evidence and reflects on the implications of CPGs' promise to improve the quality of care practices.
methodsThe quality of 62 CPGs was assessed with the Appraisal of Guidelines, Research, and Evaluation (AGREE) instrument. Findings were discussed in 19 follow-up interviews to examine how different quality aspects were considered during development.
resultsThe AGREE assessment showed that while some quality criteria were met, CPGs have limited coverage of domains such as stakeholder involvement and applicability, which generally lack a 'strong' evidence base (e.g., randomized controlled trials [RCT]). Qualitative findings uncovered barriers that impede the consolidation of evidence-based guideline development and quality improvement including guideline scoping based on the patient-intervention-comparison-outcome (PICO) question format and a lack of clinical experts involved in evidence appraisal. Developers used workarounds to include quality considerations that lack a strong base of RCT evidence, which often ended up in separate documents or appendices.
conclusionFindings suggest that CPGs mostly fail to integrate different epistemologies needed to inform the quality improvement of clinical practice. To bring CPGs closer to their promise, guideline scoping should maintain a focus on the most pertinent quality issues that point developers toward the most fitting knowledge for the question at hand, stretching beyond the PICO format. To address questions that lack a strong evidence base, developers actually need to appeal to other sources of knowledge, such as quality improvement, expert opinion, and best practices. Further research is needed to develop methods for the robust inclusion of other types of knowledge.
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What OpenQuestion holds
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.