Including practice data to improve evidence-based guidelines. Example of guidelines on the management of thyroid...

Area of Science:

• Endocrinology
• Medical Practice Improvement
• Health Services Research

Background:

• Clinical guidelines aim to improve patient care but face challenges in adoption.
• A gap often exists between guideline recommendations and healthcare professionals' expectations and practices.
• Understanding current practice is crucial for effective guideline implementation.

Purpose of the Study:

• To investigate the reasons for the gap between clinical guidelines and actual practice.
• To develop more effective clinical guidelines by incorporating physician expectations and current practices.
• To adapt guidelines for the management of thyroid nodules to better align with physician priorities.

Main Methods:

• Conducted three surveys: postal questionnaire on physician expectations/practice, expert opinion survey, and prospective patient management study.
• Analyzed physician expectations and current practices to inform guideline development.
• Evaluated guideline implementation in the management of 253 patients with thyroid nodules.

Main Results:

• Physician expectations and current practices were identified as key factors influencing guideline adoption.
• Survey results directly informed modifications to the thyroid nodule management guidelines.
• The adapted guidelines showed closer alignment with physicians' practices.

Conclusions:

• Incorporating physician perspectives and current practices is essential for developing effective clinical guidelines.
• Adapting guideline content to match professional expectations can improve their real-world application.
• This approach enhances the potential for clinical guidelines to change practice.