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A method for guideline development: assessing practical feasibility and adaptation of thyroid nodule guidelines
G M Vidal-Trécan1, L H Pazart, J A Massol
1Département de Santé publique, CHU Cochin Port-Royal, Université René Descartes, Paris, France.
Journal of Evaluation in Clinical Practice
|September 2, 1999
Summary
This study assessed practice guidelines for thyroid nodule management, finding them applicable with minor improvements. Adapting guidelines to clinical practice can enhance their use and improve patient care quality.
Area of Science:
- Endocrinology
- Clinical Practice Guidelines
- Health Services Research
Background:
- Effective management of thyroid nodules requires clear, adaptable practice guidelines.
- Physician adherence and feedback are crucial for guideline refinement and implementation.
Purpose of the Study:
- To evaluate the adaptation and feasibility of draft practice guidelines for thyroid nodule management.
- To gather physician feedback on guideline usability and agreement.
Main Methods:
- A one-month prospective study involving 160 physicians (endocrinologists, surgeons, general practitioners) across France.
- Physicians completed semi-structured questionnaires for each patient regarding draft guideline applicability and recommendations.
- Key outcomes included case identification, recommendation accessibility, and physician agreement with recommendations.
Main Results:
- The draft guidelines were applicable, though specific patient scenarios (pregnancy, large/retrosternal nodules) required refinement.
- Physician agreement with recommendations was 77%, with general practitioners showing more disagreement than surgeons or endocrinologists.
- Physicians in private practice were less likely to identify patient cases within the guidelines.
Conclusions:
- The draft thyroid nodule management guidelines were feasible and adaptable for clinical practice.
- Guideline adaptation based on physician feedback can improve usability and healthcare quality.
- Evidence-based practice should guide any proposed modifications to clinical guidelines.