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Barriers and facilitators to implementing the living guideline development framework in oncology: a mixed methods
Nofisat Ismaila1,2, Brittany E Harvey2, Kaitlin Einhaus2
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada ismailon@mcmaster.ca.
Implementing living guideline (LG) development frameworks in oncology faces challenges with evidence timeliness and resource demands. Stakeholders suggest AI tools and improved infrastructure for sustainable LG models.
Area of Science:
- Oncology
- Health Services Research
- Guideline Development
Background:
- Living guideline (LG) development frameworks offer methodological guidance for oncology.
- Practical implementation of these frameworks presents challenges.
Purpose of the Study:
- To explore stakeholder experiences with implementing LG development frameworks in oncology.
- To identify barriers, facilitators, and solutions for LG uptake and sustainability.
Main Methods:
- Exploratory sequential mixed methods design.
- Qualitative semi-structured interviews followed by a quantitative cross-sectional survey.
- Involved 9 interviewees and 45 survey participants from oncology guideline development programs.
Main Results:
- Seven themes identified as barriers (e.g., evidence timeliness, interpretation, publication delays).
- Six themes identified as facilitators (e.g., effective management, resource optimization, panel engagement).
- Nine themes proposed as solutions, with strong endorsement for AI-enhanced tools.
Conclusions:
- The LG framework is methodologically strong but faces practical challenges in resources and logistics.
- Successful adoption requires adequate infrastructure, expertise, and oversight.
- Findings offer critical considerations for sustainable LG models in oncology and beyond.
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