Evidence map›Paper›PMID 40634845›Full record

ArticleBMC medical research methodology2025

A framework for clinical care pathway renewal: an example from inflammatory bowel disease.

K D Chappell, L Olayinka, R Sutton, C H Seow, J deBruyn, S V van Zanten, C Ma, B Halloran, L A Dieleman, K Wong and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical research methodology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Nationalization of clinical care pathways for inflammatory bowel disease management in Canada.Journal of the Canadian Association of Gastroenterology · 2026
    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

12 authors.

K D ChappellDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
L OlayinkaAlberta Precision Laboratories, Edmonton, AB, Canada.
R SuttonDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
C H SeowDivision of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
J deBruynDepartment of Pediatrics, University of Calgary, Calgary, AB, Canada.
S V van ZantenDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
C MaDivision of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
B HalloranDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
L A DielemanDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
K WongDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada.
R PanaccioneDivision of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
K I KroekerDivision of Gastroenterolgy, Department of Medicine, University of Alberta, Edmonton, Zeidler Ledcor Building; 8540 - 112 Street, AB, T6G 2X8, Canada. karen.kroeker@ualberta.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical care pathways (CCPs) contribute to standardized, high-quality care and reduce variation in healthcare delivery. However, CCPs must be regularly reviewed and updated to reflect current evidence-based clinical practice guidelines. In the literature, the development and implementation of CCPs is well described, but there is little to guide the process for renewal of CCPs as new evidence becomes available.

methodsWe sought to develop a recurrent framework for CCP renewal and apply this to provincial established CCPs for inflammatory bowel disease (IBD). The proposed framework was guided by a review matrix stratified based on two factors: risk to change and clinical impact of the CCPs. An in-person CCP workshop was conducted to facilitate advisor engagement, establish consensus on the review process, and apply the review matrix to existing IBD CCPs. Attendees, including gastroenterologists, nurses, pharmacists, colorectal surgeons, and a family physician, were invited to offer feedback on the proposed framework and vote on the definitions associated with each level of the matrix. They then applied the framework to existing CCPs in two voting rounds.

resultsA proposed framework for CCP renewal was drafted by a multidisciplinary leadership group and presented to 22 IBD stakeholders at the in-person workshop. After a discussion, attendees agreed the matrix should include four levels, based on either high or low risk to change and high or low clinical impact. Risk to change was defined as how quickly new evidence would evolve and render the CCP out of date, and clinical impact was defined as how important the CCP is to quality IBD care. Using the revised review matrix, the attendees were able to reach agreement regarding the level to be assigned to each existing CCP.

conclusionsThe framework, based on risk to change and clinical impact is a valuable starting point to standardize the process of updating and renewing clinical pathways. Revising CCPs using our proposed framework ensures pathways are up-to-date and available to assist healthcare professionals in clinical decision-making. This framework can be adapted and customized to suit CCPs across healthcare disciplines and to facilitate the establishment of a renewal process.

Indexed as

Critical PathwaysInflammatory Bowel DiseasesDelivery of Health CareEvidence-Based MedicineHumansPractice Guidelines as TopicClinical care pathwaysClinical decision makingClinical practice guidelinesDecision making frameworkHealthcare qualityInflammatory bowel diseaseTherapy decision

Identifiers

PMID40634845
PMCPMC12239251

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.