Dataset Information

Tracking the impact of research on policy and practice: investigating the feasibility of using citations in clinical guidelines for research evaluation.

ABSTRACT:

Objectives

To investigate the feasibility of using research papers cited in clinical guidelines as a way to track the impact of particular funding streams or sources.

Setting

In recent years, medical research funders have made efforts to enhance the understanding of the impact of their funded research and to provide evidence of the 'value' of investments in particular areas of research. One of the most challenging areas of research evaluation is around impact on policy and practice. In the UK, the National Institute of Health and Clinical Excellence (NICE) provide clinical guidelines, which bring together current high-quality evidence on the diagnosis and treatment of clinical problems. Research referenced in these guidelines is an indication of its potential to have real impact on health policy and practice.

Design

This study is based on analysis of the authorship and funding attribution of research cited in two NICE clinical guidelines: dementia and chronic obstructive pulmonary disease.

Results

Analysis identified that around a third of papers cited in the two NICE guidelines had at least one author based in the UK. In both cases, about half of these UK attributed papers contained acknowledgements which allowed the source of funding for the research to be identified. The research cited in these guidelines was found to have been supported by a diverse set of funders from different sectors. The study also investigated the contribution of research groups based in universities, industry and the public sector.

Conclusions

The study found that there is great potential for guidelines to be used as sources of information on the quality of the research used in their development and that it is possible to track the source of the funding of the research. The challenge is in harnessing the relevant information to track this in an efficient way.

SUBMITTER: Kryl D

PROVIDER: S-EPMC3317168 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Tracking the impact of research on policy and practice: investigating the feasibility of using citations in clinical guidelines for research evaluation.

Kryl David D Allen Liz L Dolby Kevin K Sherbon Beverley B Viney Ian I

BMJ open 20120330 2

<h4>Objectives</h4>To investigate the feasibility of using research papers cited in clinical guidelines as a way to track the impact of particular funding streams or sources.<h4>Setting</h4>In recent years, medical research funders have made efforts to enhance the understanding of the impact of their funded research and to provide evidence of the 'value' of investments in particular areas of research. One of the most challenging areas of research evaluation is around impact on policy and practic ...[more]

PMID: 22466037

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Project description:IntroductionOver 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence.MethodsSystematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies.ResultsA total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent.ConclusionsEmergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality standards.

Project description:Medication adherence remains a difficult problem to both assess and improve in patients. It is a multifactorial problem that goes beyond the commonly cited reason of forgetfulness. To date, eHealth (also known as mHealth and telehealth) interventions to improve medication adherence have largely been successful in improving adherence. However, interventions to date have used time- and cost-intensive strategies or focused solely on medication reminding, leaving much room for improvement in using a modality as flexible as eHealth.Our objective was to develop and implement a fully automated short message service (SMS)-based medication adherence system, EpxMedTracking, that reminds patients to take their medications, explores reasons for missed doses, and alerts providers to help address problems of medication adherence in real time.EpxMedTracking is a fully automated bidirectional SMS-based messaging system with provider involvement that was developed and implemented through Epharmix, Inc. Researchers analyzed 11 weeks of de-identified data from patients cared for by multiple provider groups in routine community practice for feasibility and functionality. Patients included were those in the care of a provider purchasing the EpxMedTracking tool from Epharmix and were enrolled from a clinic by their providers. The primary outcomes assessed were the rate of engagement with the system, reasons for missing doses, and self-reported medication adherence.Of the 25 patients studied over the 11 weeks, 3 never responded and subsequently opted out or were deleted by their provider. No other patients opted out or were deleted during the study period. Across the 11 weeks of the study period, the overall weekly engagement rate was 85.9%. There were 109 total reported missed doses including "I forgot" at 33 events (30.3%), "I felt better" at 29 events (26.6%), "out of meds" at 20 events (18.4%), "I felt sick" at 19 events (17.4%), and "other" at 3 events (2.8%). We also noted an increase in self-reported medication adherence in patients using the EpxMedTracking system.EpxMedTracking is an effective tool for tracking self-reported medication adherence over time. It uniquely identifies actionable reasons for missing doses for subsequent provider intervention in real time based on patient feedback. Patients enrolled on EpxMedTracking also self-report higher rates of medication adherence over time while on the system.

Dataset Information

Tracking the impact of research on policy and practice: investigating the feasibility of using citations in clinical guidelines for research evaluation.

Objectives

Setting

Design

Results

Conclusions

Publications

Tracking the impact of research on policy and practice: investigating the feasibility of using citations in clinical guidelines for research evaluation.

Similar Datasets

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