Refining a taxonomy for guideline implementation: results of an exercise in abstract classification.

Background: To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strategies.

Methods: A draft implementation taxonomy was developed based on the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist.

Reducing inappropriate diagnostic practice through education and decision support.

Objective: To quantify non-compliance of diagnostic practice with recommendations in Diagnostic Imaging Pathways and the impact of interventions to reduce non-compliance.

Design: Retrospective audits, followed by intervention and re-audits.

Setting: Emergency department (ED) of Royal Perth Hospital.

Imaging pathways: will they be well trodden or less traveled?

Evidence of inappropriate investigations is not hard to find, and these result in a range of adverse clinical and economic outcomes. An online, evidence-based education and decision support application called Diagnostic Imaging Pathways (DIP) has been developed to assist clinicians to request the most appropriate examinations in the best sequence to achieve diagnoses. The development of the clinical and academic content of DIP and its continuous review and revision involve a network of specialists and general practitioners coordinated by an editorial panel.

Diagnostic imaging pathways: development, dissemination, implementation, and evaluation.

Issue: There are signs of inappropriate application of medical imaging to diagnosis. Inappropriate imaging is a threat to effective diagnosis and effective allocation of resources. The development and deployment of knowledge-based clinical decision support systems is one strategy to reduce inappropriate imaging.

Comparison of cost and outcome of endovascular and neurosurgical procedures in the treatment of ruptured intracranial aneurysms.

Endovascular techniques for the treatment of intracranial aneurysms have gained rapid acceptance in some countries as an alternative to conventional neurosurgical treatment. The International Subarachnoid Aneurysm Trial (ISAT) is the first multicentre prospective randomized trial comparing neurosurgery with endovascular coil (Guglielmi detachable coil) treatment of acute subarachnoid haemorrhage. The cost and outcome of endovascular procedures was compared with neurosurgical procedures in the treatment of ruptured intracranial aneurysms within the context of the ISAT.