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Development of the implementability assessment tool for clinical practice guidelines based on the COSMIN framework
Dongmei Zhong1,2,3, Gregory A Aarons4, Alison M Hutchinson5,6
1School of Public Health, Southern Medical University, Guangzhou, China.
BMC Health Services Research
|November 13, 2024
Summary
This study develops a new appraisal tool to improve the implementation of clinical practice guidelines. The tool is theoretically grounded, reliable, and valid, aiding guideline developers in enhancing their usability.
Area of Science:
- Healthcare Quality Improvement
- Clinical Practice Guideline Development
- Health Services Research
Background:
- Clinical practice guidelines are crucial for standardizing medical care but face implementation challenges.
- Barriers to guideline implementation stem from external factors and intrinsic guideline characteristics.
- Existing appraisal tools for guideline implementability lack theoretical grounding and empirical validation.
Purpose of the Study:
- To develop a theoretically grounded, reliable, and valid appraisal tool for clinical practice guideline implementability.
- To address the limitations of current tools by providing empirically-based guidance for effective implementation.
- To assist guideline developers in optimizing guidelines for better real-world application.
Main Methods:
- A four-phase research process including theoretical framework generation, factorial experimentation, and rigorous scale development (reliability, validity, usability testing) following COSMIN guidelines.
- Development of dimensions and items for the appraisal tool based on a validated theoretical framework.
- Integration of the validated tool with the STAR guideline rating system for comprehensive guideline appraisal.
Main Results:
- A theoretically grounded, reliable, and valid appraisal tool for clinical practice guideline implementability.
- Quantification of guideline implementability through factor loadings in confirmatory factor analysis.
- Objective evaluative results for guideline users and enhanced implementability for guideline developers.
Conclusions:
- The developed appraisal tool offers a robust method for evaluating and enhancing clinical practice guideline implementability.
- This tool supports guideline developers in improving guideline quality before, during, and after formulation.
- The research contributes a validated instrument to strengthen the practical application and impact of clinical practice guidelines.
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