Evidence map›Paper›PMID 38570788›Full record

ArticleBMC health services research2024

Is it possible to make 'living' guidelines? An evaluation of the Australian Living Stroke Guidelines.

Louise Wiles, Peter D Hibbert, Yvonne Zurynski, Carolynn L Smith, Gaston Arnolda, Louise A Ellis, Rebecca Lake, Brona Nic Giolla Easpaig, Charlotte Molloy, Sandy Middleton and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Louise WilesAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Peter D HibbertAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia. peter.hibbert@mq.edu.au.
Yvonne ZurynskiAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Carolynn L SmithAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Gaston ArnoldaAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Louise A EllisAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Rebecca LakeAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Brona Nic Giolla EaspaigAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Charlotte MolloyAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Sandy MiddletonNursing Research Institute, St Vincent's Health Network Sydney and Australian Catholic University, Sydney, Australia.
Jeffrey BraithwaiteAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Kelvin HillThe Stroke Foundation, Sydney, Australia.
Tari TurnerSchool of Population Health and Preventive Medicine, Monash University, Melbourne, Australia.

Funding

Department of Health and Aged Care, Australian Government MRFF-N-SFStroke Foundation 9100002
6 · The paper itself

Abstract

backgroundKeeping best practice guidelines up-to-date with rapidly emerging research evidence is challenging. 'Living guidelines' approaches enable continual incorporation of new research, assisting healthcare professionals to apply the latest evidence to their clinical practice. However, information about how living guidelines are developed, maintained and applied is limited. The Stroke Foundation in Australia was one of the first organisations to apply living guideline development methods for their Living Stroke Guidelines (LSGs), presenting a unique opportunity to evaluate the process and impact of this novel approach.

methodsA mixed-methods study was conducted to understand the experience of LSGs developers and end-users. We used thematic analysis of one-on-one semi-structured interview and online survey data to determine the feasibility, acceptability, and facilitators and barriers of the LSGs. Website analytics data were also reviewed to understand usage.

resultsOverall, the living guidelines approach was both feasible and acceptable to developers and users. Facilitators to use included collaboration with multidisciplinary clinicians and stroke survivors or carers. Increased workload for developers, workload unpredictability, and limited information sharing, and interoperability of technological platforms were identified as barriers. Users indicated increased trust in the LSGs (69%), likelihood of following the LSGs (66%), and frequency of access (58%), compared with previous static versions. Web analytics data showed individual access by 16,517 users in 2016 rising to 53,154 users in 2020, a threefold increase. There was also a fourfold increase in unique LSG pageviews from 2016 to 2020.

conclusionsThis study, the first evaluation of living guidelines, demonstrates that this approach to stroke guideline development is feasible and acceptable, that these approaches may add value to developers and users, and may increase guideline use. Future evaluations should be embedded along with guideline implementation to capture data prospectively.

Indexed as

Health PersonnelStrokeAustraliaHumansClinical guidelinesEvidence based healthcare managementGuideline adherenceLiving guidelines

Identifiers

PMID38570788
PMCPMC10988967

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LicenceCC BY
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Registered trials

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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.