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Related Experiment Videos

[Medico-economic assessment of two methods for implementing thyroid testing guidelines].

F Saillour-Glénisson1, P Michel, V Daucourt

  • 1Comité de Coordination de l'Evaluation Clinique et de la Qualité en Aquitaine (CCECQA), Hôpital Xavier-Arnozan, 33604 Pessac Cedex. florence.saillour@ccecqa.asso.fr

Revue D'Epidemiologie Et De Sante Publique
|December 6, 2005
PubMed
Summary

The Test Request Form (TRF) intervention effectively improved thyroid function test guideline adherence more than the Memorandum Pocket Card (MPC). TRF was also the most cost-effective method for guideline implementation.

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Area of Science:

  • Clinical Practice Guidelines
  • Health Services Research
  • Medical Test Ordering

Background:

  • Guidelines for thyroid function tests require effective implementation strategies.
  • Two interventions, Memorandum Pocket Card (MPC) and Test Request Form (TRF), were evaluated for guideline implementation.
  • Ward-level interventions were assessed for their impact on test ordering practices.

Purpose of the Study:

  • To compare the independent and combined effectiveness of MPC and TRF interventions.
  • To evaluate the cost-effectiveness of these guideline implementation strategies.
  • To determine the optimal approach for improving thyroid function test ordering.

Main Methods:

  • A 2x2 factorial design was employed, matching hospitals and wards.

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  • Four groups were established: dual intervention, TRF only, MPC only, and control.
  • The Guideline Conformity Rate (GCR) was the primary outcome measure.

    • Main Results:

    • The order form group achieved the highest GCR (83%), followed by the dual intervention (78%) and pocket card group (73%).
    • The Test Request Form (TRF) significantly increased GCR compared to simple information (OR=2.65).
    • TRF was identified as the less expensive and most effective intervention.

    Conclusions:

    • The Test Request Form (TRF) demonstrated greater effectiveness than the Memorandum Pocket Card (MPC) in implementing thyroid function test guidelines.
    • The combination of interventions did not yield a significant additive effect.
    • Guideline implementation research presents opportunities within clinical practice improvement projects.