Evidence map›Paper›PMID 9275952›Full record

SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1997

Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines.

D A Davis, A Taylor-Vaisey

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC
In one paragraph

Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02831439 (A Statewide Intervention to Reduce Use of Unproven or Ineffective Breast Cancer Care), which is not on this map. Cited by 357 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
357citing papers in PubMed, 15 pooled it
–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.

NCT02831439 nacompletednot on this mapstarted 2014, after this paper: background citation

A Statewide Intervention to Reduce Use of Unproven or Ineffective Breast Cancer Care

TypeinterventionalSponsorMedical College of WisconsinRan2014 to 2019Enrolled400,415ConditionsBreast CancerArmsBasic public reporting, Enhanced intervention, Control group - observational
3 · Its place in the literature

Who cites it

357 citing papers in PubMed, 15 syntheses or guidelines pooled it.

  1. Systematic Review of Clinical Practice Guidelines for Oral Health in Children With Cleft Lip and Palate.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2022
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  15. Mobile phone messaging for preventive health care.The Cochrane database of systematic reviews · 2012
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297 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

D A DavisDepartment of Family and Community Medicine, Faculty of Medicine, University of Toronto, Ont.
A Taylor-Vaisey

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo recommend effective strategies for implementing clinical practice guidelines (CPGs). DATA SOURCES: The Research and Development Resource Base in Continuing Medical Education, maintained by the University of Toronto, was searched, as was MEDLINE from January 1990 to June 1996, inclusive, with the use of the MeSH heading "practice guidelines" and relevant text words. STUDY SELECTION: Studies of CPG implementation strategies and reviews of such studies were selected. Randomized controlled trials and trials that objectively measured physicians' performance or health care outcomes were emphasized. DATA EXTRACTION: Articles were reviewed to determine the effect of various factors on the adoption of guidelines. DATA SYNTHESIS: The articles showed that CPG dissemination or implementation processes have mixed results. Variables that affect the adoption of guidelines include qualities of the guidelines, characteristics of the health care professional, characteristics of the practice setting, incentives, regulation and patient factors. Specific strategies fell into 2 categories: primary strategies involving mailing or publication of the actual guidelines and secondary interventional strategies to reinforce the guidelines. The interventions were shown to be weak (didactic, traditional continuing medical education and mailings), moderately effective (audit and feedback, especially concurrent, targeted to specific providers and delivered by peers or opinion leaders) and relatively strong (reminder systems, academic detailing and multiple interventions).

conclusionsThe evidence shows serious deficiencies in the adoption of CPGs in practice. Future implementation strategies must overcome this failure through an understanding of the forces and variables influencing practice and through the use of methods that are practice- and community-based rather than didactic.

Indexed as

Practice Guidelines as TopicPractice Patterns, Physicians'Clinical Trials as TopicEducation, Medical, ContinuingHumans

Identifiers

PMID9275952
PMCPMC1227916

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.