Optimised guidelines and tools for better healthcare decisions
Guidelines produced for healthcare decision-makers often pose a problem for those called on to implement them. The quality of evidence used to back guideline development is often unclear, and what may apply in one instance is not necessarily right in another. The GRADE Working Group has made efforts to address challenges in this area by focusing on assessment and communication of the quality of evidence and the strength of recommendations. The EU-funded project DECIDE (Developing and evaluating communication strategies to support informed decisions and practice based on evidence) built on such initiatives for increased application of evidence-based interventions and reduced their use in cases where benefits are uncertain. Project partners worked on innovative ways to present research evidence in guidelines specifically tailored to meet the various needs of key users such as health professionals, policymakers and patients. The DECIDE team gathered stakeholder input from advisory groups, consultations and user testing across a broad range of European health systems. Using these results as a basis, it developed targeted dissemination strategies that were then assessed in randomised trials, and then improved and re-evaluated. To address current shortcomings in communicating practice recommendations and supporting evidence, researchers developed an electronic, multilayered approach that enhances the usability of clinical practice guidelines for health professionals. They also contributed to a toolkit on patient and public involvement in guidelines. Peer-reviewed papers present the findings of systematic analyses on grading systems for medical tests, and public attitudes to and awareness of guidelines. A methodical and transparent approach to support panels in making well-informed healthcare choices was created, as was a tool to present interactive versions of evidence summaries enabling users to tailor a presentation to their own needs. Project outcomes were fed into a web-based tool that supports the entire guideline production process. It has over 11 000 registered users. DECIDE generated information needed to successfully address the challenges of applying intervention guidelines in real-world clinical systems.
Keywords
Healthcare, DECIDE, communication strategies, evidence-based interventions