The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

/pdf/cochrane-handbook-for-systematic-reviews-of-interventions-1xbdy6uvru.pdf

Cochrane Handbook for Systematic Reviews of Interventions

Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.

/pdf/fostering-implementation-of-health-services-research-4xghpqk7rh.pdf

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

BIOE 402. Medical Technology Assessment. 2 or 3 hours. Bioentrepreneur course. Assessment of medical technology in the context of commercialization. Objectives, competition, market share, funding, pricing, manufacturing, growth, and intellectual property; many issues unique to biomedical products. Course Information: 2 undergraduate hours. 3 graduate hours. Prerequisite(s): Junior standing or above and consent of the instructor.

“Bioinformatics” 특집을 내면서

The protocol of a clinical trial serves as the foundation for study planning, conduct, reporting, and appraisal. However, trial protocols and existing protocol guidelines vary greatly in content and quality. This article describes the systematic development and scope of SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013, a guideline for the minimum content of a clinical trial protocol.The 33-item SPIRIT checklist applies to protocols for all clinical trials and focuses on content rather than format. The checklist recommends a full description of what is planned; it does not prescribe how to design or conduct a trial. By providing guidance for key content, the SPIRIT recommendations aim to facilitate the drafting of high-quality protocols. Adherence to SPIRIT would also enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, sponsors, funders, research ethics committees or institutional review boards, peer reviewers, journals, trial registries, policymakers, regulators, and other key stakeholders.

/pdf/spirit-2013-statement-defining-standard-protocol-items-for-45mhqcz9e0.pdf

SPIRIT 2013 statement: defining standard protocol items for clinical trials.

High quality protocols facilitate proper conduct, reporting, and external review
 of clinical trials. However, the completeness of trial protocols is often
 inadequate. To help improve the content and quality of protocols, an
 international group of stakeholders developed the SPIRIT 2013 Statement
 (Standard Protocol Items: Recommendations for Interventional Trials). The SPIRIT
 Statement provides guidance in the form of a checklist of recommended items to
 include in a clinical trial protocol. This SPIRIT 2013 Explanation and Elaboration paper provides important
 information to promote full understanding of the checklist recommendations. For
 each checklist item, we provide a rationale and detailed description; a model
 example from an actual protocol; and relevant references supporting its
 importance. We strongly recommend that this explanatory paper be used in
 conjunction with the SPIRIT Statement. A website of resources is also available
 (www.spirit-statement.org). The SPIRIT 2013 Explanation and Elaboration paper, together with the Statement,
 should help with the drafting of trial protocols. Complete documentation of key
 trial elements can facilitate transparency and protocol review for the benefit
 of all stakeholders.

https://www.bmj.com/content/bmj/346/bmj.e7586.full.pdf

SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials

The electronic medical record (EMR) is an enabling technology that allows physician practices to pursue more powerful quality improvement programs than is possible with paper-based records. However, achieving quality improvement through EMR use is neither low-cost nor easy. Based on a qualitative study of physician practices that had implemented an EMR, we found that quality improvement depends heavily on physicians’ use of the EMR—and not paper—for most of their daily tasks. We identified key barriers to physicians’ use of EMRs. We then suggest policy interventions to overcome these barriers, including providing work/practice support systems, improving electronic clinical data exchange, and providing financial rewards for quality improvement.

http://www.wpmassociates.com/healthcare/articles/physician_use_EMR.pdf

Physicians' use of electronic medical records: barriers and solutions

Clinical decision support systems for the practice of evidence-based medicine.

Chronic diseases like diabetes, asthma, and obesity account for 46% of global disease burden ( 1 ). The traditional model of episodic care in clinic and hospital-based settings is suboptimal for improving chronic disease outcomes ( 2 ). Mobile communication devices, in conjunction with Internet and social media, present opportunities to enhance disease prevention and management by extending health interventions beyond the reach of traditional care—an approach referred to as mHealth ( 3 ). However, mHealth is emerging as a patchwork of incompatible applications (“apps”) serving narrow, albeit valuable, needs, and thus could benefit from more coordinated development ( 4 ). A public-private partnership to define and instantiate an “open” mHealth architecture (described below), in the context of economic incentives and enabling policies, could support medical discovery and evidence-based practice about managing and preventing chronic disease.

https://science.sciencemag.org/content/sci/330/6005/759.full.pdf

Open mHealth Architecture: An Engine for Health Care Innovation

Mobile Devices and Health Mobile health involves sensors, mobile apps, social media, and location-tracking technology used in disease diagnosis, prevention, and management. This article provides an...

https://www.nejm.org/doi/pdf/10.1056/NEJMra1806949

Mobile Devices and Health.

We conducted case studies of fourteen solo or small-group primary care prac- tices using electronic health record (EHR) software from two vendors. Initial EHR costs aver- aged $44,000 per full-time-equivalent (FTE) provider, and ongoing costs averaged $8,500 per provider per year. The average practice paid for its EHR costs in 2.5 years and profited handsomely after that; however, some practices could not cover costs quickly, most provid- ers spent more time at work initially, and some practices experienced substantial financial risks. Policies should be designed to provide incentives and support services to help prac- tices improve the quality of their care by using EHRs.

Ida Sim

Papers

Physicians' use of electronic medical records: barriers and solutions

Clinical decision support systems for the practice of evidence-based medicine.

Open mHealth Architecture: An Engine for Health Care Innovation

Mobile Devices and Health.

The Value Of Electronic Health Records In Solo Or Small Group