Generalizing disease management program results: how to get from here to there

Area of Science:

• Health Services Research
• Clinical Trial Design

Background:

• Disease management (DM) programs aim to improve patient outcomes and reduce healthcare costs.
• Assessing the generalizability of DM program findings (external validity) is critical for widespread application.
• Internal validity alone is insufficient for evaluating the real-world impact of DM interventions.

Purpose of the Study:

• To provide an overview of threats to the external validity of disease management programs.
• To offer methods for enhancing the generalizability of results from DM programs.
• To emphasize the importance of evaluating external validity early in the DM program selection process.

Main Methods:

• Literature review and synthesis of existing research on external validity in health interventions.
• Analysis of factors that impact the generalizability of DM program outcomes.
• Discussion of strategies to improve the external validity of DM programs.

Main Results:

• Several factors can threaten the external validity of DM programs, including differences in population characteristics, settings, and disease contexts.
• Proactive evaluation of external validity before program implementation is necessary.
• Methods exist to improve generalizability, such as careful participant selection and program adaptation.

Conclusions:

• External validity is a key consideration for the successful implementation and scaling of disease management programs.
• Understanding and mitigating threats to external validity can enhance the impact and reach of DM interventions.
• Early assessment of generalizability ensures that DM programs are relevant and effective for diverse populations and settings.