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Understanding clinical prediction models as ‘innovations’: a mixed methods study in UK family practice

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Understanding clinical prediction models as ‘innovations’: a mixed methods study in UK family practice. / Brown, Benjamin; Cheraghi-Sohi, Sudeh; Jaki, Thomas Friedrich et al.
In: BMC Medical Informatics and Decision Making, Vol. 16, 106, 09.08.2016.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Brown, B, Cheraghi-Sohi, S, Jaki, TF, Su, T-L, Buchan, I & Sperrin, M 2016, 'Understanding clinical prediction models as ‘innovations’: a mixed methods study in UK family practice', BMC Medical Informatics and Decision Making, vol. 16, 106. https://doi.org/10.1186/s12911-016-0343-y

APA

Brown, B., Cheraghi-Sohi, S., Jaki, T. F., Su, T-L., Buchan, I., & Sperrin, M. (2016). Understanding clinical prediction models as ‘innovations’: a mixed methods study in UK family practice. BMC Medical Informatics and Decision Making, 16, Article 106. https://doi.org/10.1186/s12911-016-0343-y

Vancouver

Brown B, Cheraghi-Sohi S, Jaki TF, Su T-L, Buchan I, Sperrin M. Understanding clinical prediction models as ‘innovations’: a mixed methods study in UK family practice. BMC Medical Informatics and Decision Making. 2016 Aug 9;16:106. doi: 10.1186/s12911-016-0343-y

Author

Brown, Benjamin ; Cheraghi-Sohi, Sudeh ; Jaki, Thomas Friedrich et al. / Understanding clinical prediction models as ‘innovations’ : a mixed methods study in UK family practice. In: BMC Medical Informatics and Decision Making. 2016 ; Vol. 16.

Bibtex

@article{36825e7aefc741cebf0dab9a31a6cc7d,
title = "Understanding clinical prediction models as {\textquoteleft}innovations{\textquoteright}: a mixed methods study in UK family practice",
abstract = "BackgroundWell-designed clinical prediction models (CPMs) often out-perform clinicians at estimating probabilities of clinical outcomes, though their adoption by family physicians is variable. How family physicians interact with CPMs is poorly understood, therefore a better understanding and framing within a context-sensitive theoretical framework may improve CPM development and implementation. The aim of this study was to investigate why family physicians do or do not use CPMs, interpreting these findings within a theoretical framework to provide recommendations for the development and implementation of future CPMs.MethodsMixed methods study in North West England that comprised an online survey and focus groups.ResultsOne hundred thirty eight respondents completed the survey, which found the main perceived advantages to using CPMs were that they guided appropriate treatment (weighted rank [r] = 299; maximum r = 414 throughout), justified treatment decisions (r = 217), and incorporated a large body of evidence (r = 156). The most commonly reported barriers to using CPMs were lack of time (r = 163), irrelevance to some patients (r = 161), and poor integration with electronic health records (r = 147). Eighteen clinicians participated in two focus groups (i.e. nine in each), which revealed 13 interdependent themes affecting CPM use under three overarching domains: clinician factors, CPM factors and contextual factors. Themes were interdependent, indicating the tensions family physicians experience in providing evidence-based care for individual patients.ConclusionsThe survey and focus groups showed that CPMs were valued when they supported clinical decision making and were robust. Barriers to their use related to their being time-consuming, difficult to use and not always adding value. Therefore, to be successful, CPMs should offer a relative advantage to current working, be easy to implement, be supported by training, policy and guidelines, and fit within the organisational culture.",
keywords = "Clinical prediction models, Prognostic models, Risk stratification, Diagnostic models, Clinical decision support systems, Primary care information systems, Family physicians, Healthcare information technology adoption , Attitude of health personnel, Practice patterns, Clinicians",
author = "Benjamin Brown and Sudeh Cheraghi-Sohi and Jaki, {Thomas Friedrich} and Ting-Li Su and Iain Buchan and Matthew Sperrin",
year = "2016",
month = aug,
day = "9",
doi = "10.1186/s12911-016-0343-y",
language = "English",
volume = "16",
journal = "BMC Medical Informatics and Decision Making",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Understanding clinical prediction models as ‘innovations’

T2 - a mixed methods study in UK family practice

AU - Brown, Benjamin

AU - Cheraghi-Sohi, Sudeh

AU - Jaki, Thomas Friedrich

AU - Su, Ting-Li

AU - Buchan, Iain

AU - Sperrin, Matthew

PY - 2016/8/9

Y1 - 2016/8/9

N2 - BackgroundWell-designed clinical prediction models (CPMs) often out-perform clinicians at estimating probabilities of clinical outcomes, though their adoption by family physicians is variable. How family physicians interact with CPMs is poorly understood, therefore a better understanding and framing within a context-sensitive theoretical framework may improve CPM development and implementation. The aim of this study was to investigate why family physicians do or do not use CPMs, interpreting these findings within a theoretical framework to provide recommendations for the development and implementation of future CPMs.MethodsMixed methods study in North West England that comprised an online survey and focus groups.ResultsOne hundred thirty eight respondents completed the survey, which found the main perceived advantages to using CPMs were that they guided appropriate treatment (weighted rank [r] = 299; maximum r = 414 throughout), justified treatment decisions (r = 217), and incorporated a large body of evidence (r = 156). The most commonly reported barriers to using CPMs were lack of time (r = 163), irrelevance to some patients (r = 161), and poor integration with electronic health records (r = 147). Eighteen clinicians participated in two focus groups (i.e. nine in each), which revealed 13 interdependent themes affecting CPM use under three overarching domains: clinician factors, CPM factors and contextual factors. Themes were interdependent, indicating the tensions family physicians experience in providing evidence-based care for individual patients.ConclusionsThe survey and focus groups showed that CPMs were valued when they supported clinical decision making and were robust. Barriers to their use related to their being time-consuming, difficult to use and not always adding value. Therefore, to be successful, CPMs should offer a relative advantage to current working, be easy to implement, be supported by training, policy and guidelines, and fit within the organisational culture.

AB - BackgroundWell-designed clinical prediction models (CPMs) often out-perform clinicians at estimating probabilities of clinical outcomes, though their adoption by family physicians is variable. How family physicians interact with CPMs is poorly understood, therefore a better understanding and framing within a context-sensitive theoretical framework may improve CPM development and implementation. The aim of this study was to investigate why family physicians do or do not use CPMs, interpreting these findings within a theoretical framework to provide recommendations for the development and implementation of future CPMs.MethodsMixed methods study in North West England that comprised an online survey and focus groups.ResultsOne hundred thirty eight respondents completed the survey, which found the main perceived advantages to using CPMs were that they guided appropriate treatment (weighted rank [r] = 299; maximum r = 414 throughout), justified treatment decisions (r = 217), and incorporated a large body of evidence (r = 156). The most commonly reported barriers to using CPMs were lack of time (r = 163), irrelevance to some patients (r = 161), and poor integration with electronic health records (r = 147). Eighteen clinicians participated in two focus groups (i.e. nine in each), which revealed 13 interdependent themes affecting CPM use under three overarching domains: clinician factors, CPM factors and contextual factors. Themes were interdependent, indicating the tensions family physicians experience in providing evidence-based care for individual patients.ConclusionsThe survey and focus groups showed that CPMs were valued when they supported clinical decision making and were robust. Barriers to their use related to their being time-consuming, difficult to use and not always adding value. Therefore, to be successful, CPMs should offer a relative advantage to current working, be easy to implement, be supported by training, policy and guidelines, and fit within the organisational culture.

KW - Clinical prediction models

KW - Prognostic models

KW - Risk stratification

KW - Diagnostic models

KW - Clinical decision support systems

KW - Primary care information systems

KW - Family physicians

KW - Healthcare information technology adoption

KW - Attitude of health personnel

KW - Practice patterns

KW - Clinicians

U2 - 10.1186/s12911-016-0343-y

DO - 10.1186/s12911-016-0343-y

M3 - Journal article

VL - 16

JO - BMC Medical Informatics and Decision Making

JF - BMC Medical Informatics and Decision Making

M1 - 106

ER -