CLICK-IT

Introduction

The abstract below is submitted to the GIN conference 2013 in San Francisco and outlines how we will move forward with research in MAGIC and DECIDE WP1 to determine optimal presentation formats of the multilayered guidelines we have developed through user-testing. In CLICK-IT we will integrate a randomized trial in an educational session to both teach and research conceptual understanding of evidence-based clinical practice and guideline methodology and improved guideline presentation formats.

How do clinicians like and understand trustworthy guidelines?

Randomized controlled trial using Clickers in educational sessions

Background

Clinical practice guidelines (CPG) often have shortcomings in presentation formats that limit dissemination at the point of care. As part of the DECIDE project (1) we have developed multilayered CPG presentation formats. Comprehensive user-testing of the formats has provided us with alternative presentation formats now ready for randomized trials but also an important insight: Insufficient conceptual understanding of guideline methodology (e.g. strength of recommendations and quality of evidence) may hamper application of CPG recommendations in practice.

Objective

To determine physicians´understanding, attitudes and preferences concerning trustworthy guidelines in traditional and new presentation formats (DECIDE A and B).

Methods

In this randomized controlled trial we will recruit 100 physicians attending a standardized lecture with 3 components: 1) presentation of clinical scenario, 2) explanations

of key concepts of trustworthy CPG (e.g. GRADE, AGREE II) and 3) presentationof a current trustworthy CPG relevant to the scenario, displayed

in traditional PDF format and DECIDE A and B formats. Throughout the lecture participants will answer questions with “Clickers” and be randomly assigned to alternative presentation formats by concealed allocation and blinding, through the use of eyepatches.

Results

We will present results from the trial at the conference.

Discussion

If our approach of integrating randomised trials into educational sessions is feasible and provides valid results we will conduct multiple such trials in DECIDE.

Implications for guideline developers and users

Optimized GL presentation formats and sufficient conceptual understanding, as researched in this trial, should facilitate the uptake of trustworthy CPG and application of research evidence in practice.

Treweek S, Oxman AO, Alderson P, Bossuyt P, Davoli M, Flottorp S, Harbour R, Hill S, Liberati A, Liira H, Schünemann HJ, Rosenbaum S, Thornton J, Vandvik PO, Alonso-Coello and the DECIDE Consortium.

Title: Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): Protocol and preliminary results. Implementation Science. 2013,8, Early Online January 2013.