Decision-to-Implement Worksheet for Evidence-based Interventions: From the WWAMI Region Practice and Research Network

Johnson, Karin; Tuzzio, Leah; Renz, Anne; Baldwin, Laura Mae; Parchman, Michael L.

doi:10.3122/jabfm.2016.05.150327

Cited by 3 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, sustainability cannot be an afterthought. From the outset, researchers need to consider the contextual factors that can support or impede the uptake of successful interventions 70,71 . Thinking through—and documenting—the financial, technical, political, and sociocultural barriers and facilitators as interventions are deployed can support eventual scale‐up and accelerated learning.…”

Section: Aiming For Sustainability: Short‐term Projects or Ongoing In...mentioning

confidence: 99%

“…From the outset, researchers need to consider the contextual factors that can support or impede the uptake of successful interventions. 70 , 71 Thinking through—and documenting—the financial, technical, political, and sociocultural barriers and facilitators as interventions are deployed can support eventual scale‐up and accelerated learning. The creation of sustainable infrastructures ensure that scientists and health system operators can respond to longer term and evolving needs.…”

Section: Aiming For Sustainability: Short‐term Projects or Ongoing In...mentioning

confidence: 99%

See 1 more Smart Citation

Gathering speed and countering tensions in the rapid learning health system

Reid

Greene

2023

Learning Health Systems

View full text Add to dashboard Cite

The vision of the learning health system (LHS), conceptualized 15 years ago, is for the rapid generation, use, and spread of high-quality evidence that yields better health experiences, outcomes, efficiencies, and equity in everyday practice settings across communities. However, despite the emergence of many useful LHS frameworks and examples to guide adoption, large gaps remain in the speed and consistency with which evidence is generated and used across the range of settings from the bedside to the policy table. Gaps in progress are not surprising, however, given the tensions that predictably arise when key stakeholders-researchers, health systems, and funders-comingle in these efforts. This commentary examines eight core tensions that naturally arise and offers practical actions that stakeholders can take to address these tensions and speed LHS adoption. The urgency for attenuating these tensions and accelerating health system improvements has never been higher. Timeliness, rigor, and prioritization can be aligned across stakeholders, but only if all partners are intentional about the operational and cultural challenges that exist.collaboration, health care economics and organizations, health system, learning health system The sluggishness and inconsistency with which high-quality evidence is created, taken up, and spread to achieve benefit across populations continue to frustrate policymakers, government payers, clinicians, and patients. 1 COVID-19 has shone a bright spotlight on the evidence gaps occurring from the bedside to the policy table and the need for locally meaningful, high-value evidence under very short timelines. 2 The learning health system (LHS), conceived in 2007, 3,4 envisions a union of care delivery and research enterprises with a goal of rapidly generating and using evidence to improve health, care experiences, efficiencies, and equity within and across populations. 5 Many useful LHS conceptual frameworks, lexicons, logic models, taxonomies, and examples 3,[5][6][7][8][9][10][11][12][13] have emerged, all built on learning cycles where data are generated in usual care settings, knowledge is rapidly generated from these data and then widely used, refined, and scaled to advance policy and practice. 10,12,14 While there is scant disagreement with the LHS ideal, a recent Global Evidence Commission report 2 signals that the LHS vision remains unfulfilled across the world from its inception 15 years ago. Health research remains largely disconnected from health systems; deficiencies persist in the creation of intermediary evidence generation, implementation, and learning supports. While disappointing, these conclusions are not surprising given the real-world tensions that often impede-singly or in combination-the rapid learning process. Recently conducted scoping and other reviews have articulated the range of organizational and sociocultural complexities and challenges 15-18 that may be eased or aggravated by financial, technical, or operational barriers to change.Because health systems are not...

show abstract

Section: Aiming For Sustainability: Short‐term Projects or Ongoing In...mentioning

confidence: 99%

Section: Aiming For Sustainability: Short‐term Projects or Ongoing In...mentioning

confidence: 99%

Gathering speed and countering tensions in the rapid learning health system

Reid

Greene

2023

Learning Health Systems

View full text Add to dashboard Cite

show abstract

“…Dal-Ré et al’s [ 10 ] suggestion to provide PRECIS-2 ratings and supporting documents could help decision-makers assess the degree to which study proposals and research findings are appropriately characterized. Further, detailed information on how and why studies are pragmatic in different domains helps to understand the applicability of evidence in particular settings and patient populations, for example, such as when a clinic is deciding to implement a new finding in their practice [ 14 ].…”

Section: Challenges and Opportunitiesmentioning

confidence: 99%

Informing real-world practice with real-world evidence: the value of PRECIS-2

Neta¹,

Johnson

2018

BMC Med

View full text Add to dashboard Cite

Real-world evidence is needed to inform real-world practice. Pragmatic controlled trials are intended to provide such evidence by assessing the effectiveness of medicines and other interventions in real-world settings, as opposed to explanatory trials that assess efficacy in highly controlled settings. Dal-Ré and colleagues (BMC Med 16:49, 2018) recently performed a literature review of studies published between 2014 and 2017 to assess the degree to which studies that self-identified as pragmatic were truly so. The authors found that over one-third of randomized controlled trials of drugs and biologics that were self-labeled as pragmatic used placebo controls (as opposed to usual care), tested medicines before licensing, or were conducted in a single site. Further, they proposed that, in order to improve the reliability of the ‘pragmatic’ label, investigators should assess their trials using the PRECIS-2 tool upon submission to funders, ethics boards, or journals. We appreciate the value of PRECIS-2 as an indicator to assess the pragmatic versus explanatory features in a trial, and we herein highlight the potential challenges and opportunities that may arise with its systematic and widespread use.

show abstract

Evidence, Engagement, and Technology: Themes of and the State of Primary Care Practice-based Network Research

Nease

2016

J Am Board Fam Med

View full text Add to dashboard Cite

Practice-based research supported by practice-based research network (PBRN) infrastructure has historically provided an important method for challenging guidelines and evidence arising from secondary and tertiary care settings. This sample of current practice-based research in this issue of the JABFM provides an opportunity to ask whether practice-based research continues to address questions relevant to primary care practices and clinicians and whether a PBRN infrastructure is instrumental to maintaining the relevance and feasibility of practice-based research. Based on this issue's articles, the current state of practice-based research seems to be good, at face value addressing relevant issues for primary care practices. Less clear is the degree to which PBRN infrastructures and relationships informed the questions asked and facilitated the implementation of the studies presented. Practice-based research-related articles that routinely report about how study questions arose-from practices and their clinicians, staff and communities, or elsewhere-could help directly answer questions of relevance. In addition, reporting how practices are recruited to practice-based research studies could inform the degree to which ongoing relationships central to PBRNs facilitate the recruitment and conduct of practice-based research. (J Am Board Fam Med 2016;29:521-524.)

show abstract

Decision-to-Implement Worksheet for Evidence-based Interventions: From the WWAMI Region Practice and Research Network

Cited by 3 publications

References 21 publications

Gathering speed and countering tensions in the rapid learning health system

Gathering speed and countering tensions in the rapid learning health system

Informing real-world practice with real-world evidence: the value of PRECIS-2

Evidence, Engagement, and Technology: Themes of and the State of Primary Care Practice-based Network Research

Contact Info

Product

Resources

About