Decision aids linked to evidence summaries and clinical practice guidelines: results from user-testing in clinical encounters.

Background: Tools for shared decision-making (e.g. decision aids) are intended to support health care professionals and patients engaged in clinical encounters involving shared decision-making.

A framework for practical issues was developed to inform shared decision-making tools and clinical guidelines.

Objectives: The objective of the study was to develop and test feasibility of a framework of patient-important practical issues.

Study Design And Setting: Guidelines and shared decision-making tools help facilitate discussions about patient-important outcomes of care alternatives, but typically ignore practical issues patients consider when implementing care into their daily routines. Using grounded theory, practical issues in the HealthTalk.

Are systematic review and guideline development tools useful? A Guidelines International Network survey of user preferences.

Background: There are now over 140 tools/programs that can assist in developing systematic reviews or clinical practice guidelines (CPGs). It is currently unclear which tools are used by systematic reviewers and CPG developers, which development processes they are used for, and what facilitators or barriers to their use exist.

Methods: To determine which tools are currently being used by systematic reviewers and CPG developers, an online survey was administered during July-August 2017.

A systematic review of trials evaluating success factors of interventions with computerised clinical decision support.

Background: Computerised clinical decision support (CDS) can potentially better inform decisions, and it can help with the management of information overload. It is perceived to be a key component of a learning health care system. Despite its increasing implementation worldwide, it remains uncertain why the effect of CDS varies and which factors make CDS more effective.

Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial.

Objectives: To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format-compared to a standard format-as well as conceptual understanding of trustworthy guideline concepts.

Design: Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts.

Decision aids that really promote shared decision making: the pace quickens.

Decision aids can help shared decision making, but most have been hard to produce, onerous to update, and are not being used widely. explore why and describe a new electronic model that holds promise of being more useful for clinicians and patients to use together at the point of care

Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis.

We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness of computerized decision support systems (CDSSs) featuring rule- or algorithm-based software integrated with electronic health records (EHRs) and evidence-based knowledge. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects. Information on system design, capabilities, acquisition, implementation context, and effects on mortality, morbidity, and economic outcomes were extracted.

Development of a novel, multilayered presentation format for clinical practice guidelines.

Background: Bridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs).

Methods: We carried out multiple cycles of brainstorming and sketching, developing a prototype.

Applying new strategies for the national adaptation, updating, and dissemination of trustworthy guidelines: results from the Norwegian adaptation of the Antithrombotic Therapy and the Prevention of Thrombosis, 9th Ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Background: The Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (AT9) represent trustworthy international guidelines for antithrombotic treatment and thromboprophylaxis. We describe major changes to the format and content resulting from applying new strategies for guideline adaptation and dissemination.

Methods: A Norwegian guideline panel of 46 experts completed a structured and systematic adaptation process, updated the recommendations based on new evidence, and rewrote the recommendations in an electronic multilayered presentation format.

Adaptation of trustworthy guidelines developed using the GRADE methodology: a novel five-step process.

Background: Adaptation of guidelines for use at the national or local level can facilitate their implementation. We developed and evaluated an adaptation process in adherence with standards for trustworthy guidelines and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, aiming for efficiency and transparency. This article is the first in a series describing our adaptation of Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines for a Norwegian setting.

[A new generation of reliable clinical practice guidelines through MAGIC].

Safe and effective disease diagnosis and treatment requires that health personnel can access the best evidence, preferably through reliable clinical practice guidelines. Most guidelines have methodological weaknesses, suboptimal reporting formats, and frequently fail to update content. New standards developed by the US Institute of Medicine and the Guidelines International Network and Systems for Trustworthy Guidelines offer better opportunities for success in the development of guidelines, but also increase the demand for methodological competence, clinical experience and time.

Creating clinical practice guidelines we can trust, use, and share: a new era is imminent.

Standards and guidance for developing trustworthy clinical practice guidelines are now available, and a number of leading guidelines adhere to the key standards. Even current trustworthy guidelines, however, generally suffer from a cumbersome development process, suboptimal presentation formats, inefficient dissemination to clinicians at the point of care, high risk of becoming quickly outdated, and suboptimal facilitation of shared decision-making with patients. To address these limitations, we have--in our innovative research program and nonprofit organization, MAGIC (Making GRADE the Irresistible Choice)--constructed a conceptual framework and tools to facilitate the creation, dissemination, and dynamic updating of trustworthy guidelines.

Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

Background: Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear.

Methods: GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions.

Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

Objective: To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility.

Study Design And Setting: We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives.