Generalised framework for multi-criteria method selection: Rule set database and exemplary decision support system implementation blueprints.
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SUBMITTER: Watrobski J
PROVIDER: S-EPMC6327857 | biostudies-other | 2019 Feb
REPOSITORIES: biostudies-other
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Generalised framework for multi-criteria method selection: Rule set database and exemplary decision support system implementation blueprints.
Wątróbski Jarosław J Jankowski Jarosław J Ziemba Paweł P Karczmarczyk Artur A Zioło Magdalena M
Data in brief 20181212
This data article describes the analysis of 56 MCDA (Multi-Criteria Decision Analysis) methods in regards to 9 decision-making problem characteristics structured into 3 levels. The impact of uncertainty in decision-making problem description on MCDA method selection is studied. 450,000 possible descriptions of a decision problem were studied, resulting in sets of rules which can serve as input to uncertainty-aware MCDA method selection decision support systems. Comprehensive analyses of the obta ...[more]
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Project description:BackgroundUnderstanding how to implement innovations in primary care practices is key to improve primary health care. Aiming to contribute to this understanding, we investigate the implementation of a clinical decision support system (CDSS) as part of the innovation fund project AdAM (01NVF16006). Originating from complexity theory, the practice change and development model (PCD) proposes several interdependent factors that enable organizational-level change and thus accounts for the complex settings of primary care practices. Leveraging the PCD, we seek to answer the following research questions: Which combinations of internal and external factors based on the PCD contribute to successful implementation in primary care practices? Given these results, how can implementation in the primary care setting be improved?MethodsWe analyzed the joint contributions of internal and external factors on implementation success using qualitative comparative analysis (QCA). QCA is a set-theoretic approach that allows to identify configurations of multiple factors that lead to one outcome (here: successful implementation of a CDSS in primary care practices). Using survey data, we conducted our analysis based on a sample of 224 primary care practices.ResultsWe identified two configurations of internal and external factors that likewise enable successful implementation. The first configuration enables implementation based on a combination of Strong Inside Motivation, High Capability for Development, and Strong Outside Motivation; the second configuration based on a combination of Strong Inside Motivators, Many Options for Development and the absence of High Capability for Development.ConclusionIn line with the PCD, our results demonstrate the importance of the combination of internal and external factors for implementation outcomes. Moreover, the two identified configurations show that different ways exist to achieve successful implementation in primary care practices.Trial registrationAdAM was registered on ClinicalTrials.gov ( NCT03430336 ) on February 6, 2018.
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Project description:ObjectivesTo illustrate key contextual factors that may have effects on clinical decision support (CDS) adoption and, ultimately, success.Materials and methodsWe conducted a qualitative evaluation of 2 similar radiology CDS innovations for near-term endpoints affecting adoption and present the findings using an evaluation framework. We identified key contextual factors between these 2 innovations and determined important adoption differences between them.ResultsDegree of electronic health record integration, approach to education and training, key drivers of adoption, and tailoring of the CDS to the clinical context were handled differently between the 2 innovations, contributing to variation in their relative degrees of adoption and use. Attention to these factors had impacts on both near and later-term measures of success (eg, patient outcomes).DiscussionCDS adoption is a well-studied early-term measure of CDS success that directly impacts outcomes. Adoption requires attention throughout the design phases of an intervention especially to key factors directly affecting it, including how implementation across multiple sites and systems complicates adoption, which prior experience with CDS matters, and that practice guidelines invariably require tailoring to the clinical context.ConclusionWith better planning for the capture of early-term measures of successful CDS implementation, especially adoption, critical adjustments may be made to ensure that the CDS is effectively implemented to be successful.
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