Brown, Benjamin, Cheraghi-Sohi, Sudeh, Jaki, Thomas, Su, Ting-Li, Buchan, Iain ORCID: 0000-0003-3392-1650 and Sperrin, Matthew
(2016)
Understanding clinical prediction models as 'innovations': a mixed methods study in UK family practice.
BMC MEDICAL INFORMATICS AND DECISION MAKING, 16 (1).
106-.
Abstract
<h4>Background</h4>Well-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.<h4>Methods</h4>Mixed methods study in North West England that comprised an online survey and focus groups.<h4>Results</h4>One 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.<h4>Conclusions</h4>The 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.
Item Type: | Article |
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Uncontrolled 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 |
Depositing User: | Symplectic Admin |
Date Deposited: | 19 Mar 2019 16:02 |
Last Modified: | 19 Jan 2023 00:56 |
DOI: | 10.1186/s12911-016-0343-y |
Open Access URL: | https://doi.org/10.1186/s12911-016-0343-y |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3034519 |