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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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A framework for practical issues was developed to inform shared decision-making tools and clinical guidelines.

Anja Fog Heen1, Per Olav Vandvik2, Linn Brandt1

  • 1Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway.

Journal of Clinical Epidemiology
|October 13, 2020
PubMed
Summary

A new framework systematically incorporates patient practical issues into evidence summaries. This approach is feasible and can enhance shared decision-making tools for improved patient-centered care.

Keywords:
Clinical practice guidelinesDecision aidsPatient experiencePatient-important outcomesShared decision-making tools

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Area of Science:

  • Health Services Research
  • Patient-Centered Care
  • Shared Decision-Making

Background:

  • Existing guidelines and shared decision-making tools often overlook practical issues impacting patient care implementation.
  • Patients face daily challenges integrating medical advice into their routines, which are not typically addressed.

Purpose of the Study:

  • To develop and assess the feasibility of a framework for patient-important practical issues.
  • To integrate this framework into clinical decision-making tools and evidence summaries.

Main Methods:

  • Grounded theory was used to identify and categorize practical issues from patient registries and decision aids.
  • The developed framework was integrated into the MAGIC authoring and publication platform.
  • Its application was evaluated within The BMJ Rapid Recommendations.

Main Results:

  • A framework comprising 15 categories of practical issues was developed.
  • Implementation in 15 BMJ Rapid Recommendations added 283 practical issues to 35 recommendations.
  • The most frequently utilized categories were 'procedure and device,' while 'social life and relationships' were least frequent.

Conclusions:

  • Systematically including practical patient issues in evidence summaries is feasible.
  • This inclusion can inform the development of better guidelines and shared decision-making tools.
  • Further research is needed to determine the impact on patient-centered care.