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https://www.readbyqxmd.com/read/29656532/of-lamp-posts-keys-and-fabled-drunkards-a-perspectival-tale-of-4-guidelines
#1
Trisha Greenhalgh
BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...
April 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29578574/time-to-challenge-the-spurious-hierarchy-of-systematic-over-narrative-reviews
#2
Trisha Greenhalgh, Sally Thorne, Kirsti Malterud
Systematic reviews are generally placed above narrative reviews in an assumed hierarchy of secondary research evidence. We argue that systematic reviews and narrative reviews serve different purposes and should be viewed as complementary. Conventional systematic reviews address narrowly focused questions; their key contribution is summarising data. Narrative reviews provide interpretation and critique; their key contribution is deepening understanding. This article is protected by copyright. All rights reserved...
March 26, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29508669/networks-as-systems
#3
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29396385/how-knowledge-is-constructed-and-exchanged-in-virtual-communities-of-physicians-qualitative-study-of-mindlines-online
#4
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trisha Greenhalgh
BACKGROUND: As a response to the criticisms evidence-based practice currently faces, groups of health care researchers and guideline makers have started to call for the appraisal and inclusion of different kinds of knowledge in guideline production (other than randomized controlled trials [RCTs]) to better link with the informal knowledge used in clinical practice. In an ethnographic study, Gabbay and Le May showed that clinicians in everyday practice situations do not explicitly or consciously use guidelines...
February 2, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29378576/economic-evaluation-of-type-2-diabetes-prevention-programmes-markov-model-of-low-and-high-intensity-lifestyle-programmes-and-metformin-in-participants-with-different-categories-of-intermediate-hyperglycaemia
#5
Samantha Roberts, Dawn Craig, Amanda Adler, Klim McPherson, Trisha Greenhalgh
BACKGROUND: National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia...
January 30, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29325407/the-bright-elusive-butterfly-of-value-in-health-technology-development-comment-on-providing-value-to-new-health-technology-the-early-contribution-of-entrepreneurs-investors-and-regulatory-agencies
#6
COMMENT
Trisha Greenhalgh, Nick Fahy, Sara Shaw
The current system of health technology development is characterised by multiple misalignments. The "supply" side (innovation policy-makers, entrepreneurs, investors) and the "demand" side (health policy-makers, regulators, health technology assessment, purchasers) operate under different - and conflicting - logics. The system is less a "pathway" than an unstable ecosystem of multiple interacting sub-systems. "Value" means different things to each of the numerous actors involved...
May 29, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29146638/preventing-type-2-diabetes-systematic-review-of-studies-of-cost-effectiveness-of-lifestyle-programmes-and-metformin-with-and-without-screening-for-pre-diabetes
#7
Samantha Roberts, Eleanor Barry, Dawn Craig, Mara Airoldi, Gwyn Bevan, Trisha Greenhalgh
OBJECTIVE: Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals. DESIGN: Systematic review of economic evaluations. DATA SOURCES AND ELIGIBILITY CRITERIA: Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29092808/beyond-adoption-a-new-framework-for-theorizing-and-evaluating-nonadoption-abandonment-and-challenges-to-the-scale-up-spread-and-sustainability-of-health-and-care-technologies
#8
Trisha Greenhalgh, Joseph Wherton, Chrysanthi Papoutsi, Jennifer Lynch, Gemma Hughes, Christine A'Court, Susan Hinder, Nick Fahy, Rob Procter, Sara Shaw
BACKGROUND: Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. OBJECTIVE: Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program...
November 1, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28931436/structural-analysis-of-health-relevant-policy-making-information-exchange-networks-in-canada
#9
Damien Contandriopoulos, François Benoît, Denise Bryant-Lukosius, Annie Carrier, Nancy Carter, Raisa Deber, Arnaud Duhoux, Trisha Greenhalgh, Catherine Larouche, Bernard-Simon Leclerc, Adrian Levy, Ruth Martin-Misener, Katerina Maximova, Kimberlyn McGrail, Candace Nykiforuk, Noralou Roos, Robert Schwartz, Thomas W Valente, Sabrina Wong, Evert Lindquist, Carolyn Pullen, Anne Lardeux, Melanie Perroux
BACKGROUND: Health systems worldwide struggle to identify, adopt, and implement in a timely and system-wide manner the best-evidence-informed-policy-level practices. Yet, there is still only limited evidence about individual and institutional best practices for fostering the use of scientific evidence in policy-making processes The present project is the first national-level attempt to (1) map and structurally analyze-quantitatively-health-relevant policy-making networks that connect evidence production, synthesis, interpretation, and use; (2) qualitatively investigate the interaction patterns of a subsample of actors with high centrality metrics within these networks to develop an in-depth understanding of evidence circulation processes; and (3) combine these findings in order to assess a policy network's "absorptive capacity" regarding scientific evidence and integrate them into a conceptually sound and empirically grounded framework...
September 20, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28806989/maximising-value-from-a-united-kingdom-biomedical-research-centre-study-protocol
#10
Trisha Greenhalgh, Pavel V Ovseiko, Nick Fahy, Sara Shaw, Polly Kerr, Alexander D Rushforth, Keith M Channon, Vasiliki Kiparoglou
BACKGROUND: Biomedical Research Centres (BRCs) are partnerships between healthcare organisations and universities in England. Their mission is to generate novel treatments, technologies, diagnostics and other interventions that increase the country's international competitiveness, to rapidly translate these innovations into benefits for patients, and to improve efficiency and reduce waste in healthcare. As NIHR Oxford BRC (Oxford BRC) enters its third 5-year funding period, we seek to (1) apply the evidence base on how best to support the various partnerships in this large, multi-stakeholder research system and (2) research how these partnerships play out in a new, ambitious programme of translational research...
August 14, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28801403/equipping-community-pharmacy-workers-as-agents-for-health-behaviour-change-developing-and-testing-a-theory-based-smoking-cessation-intervention
#11
Liz Steed, Ratna Sohanpal, Wai-Yee James, Carol Rivas, Sandra Jumbe, Angel Chater, Adam Todd, Elizabeth Edwards, Virginia Macneil, Fraser Macfarlane, Trisha Greenhalgh, Chris Griffiths, Sandra Eldridge, Stephanie Taylor, Robert Walton
OBJECTIVE: To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. DESIGN: Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. METHODS: Phase I : We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687532/studying-scale-up-and-spread-as-social-practice-theoretical-introduction-and-empirical-case-study
#12
James Shaw, Sara Shaw, Joseph Wherton, Gemma Hughes, Trisha Greenhalgh
BACKGROUND: Health and care technologies often succeed on a small scale but fail to achieve widespread use (scale-up) or become routine practice in other settings (spread). One reason for this is under-theorization of the process of scale-up and spread, for which a potentially fruitful theoretical approach is to consider the adoption and use of technologies as social practices. OBJECTIVE: This study aimed to use an in-depth case study of assisted living to explore the feasibility and usefulness of a social practice approach to explaining the scale-up of an assisted-living technology across a local system of health and social care...
July 7, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28663428/books-challenging-perspectives-on-organizational-change-in-health-care-change-in-the-right-way
#13
Trisha Greenhalgh
No abstract text is available yet for this article.
July 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28637744/group-clinics-for-young-adults-with-diabetes-in-an-ethnically-diverse-socioeconomically-deprived-setting-together-study-protocol-for-a-realist-review-co-design-and-mixed-methods-participatory-evaluation-of-a-new-care-model
#14
Chrysanthi Papoutsi, Dougal Hargreaves, Grainne Colligan, Ann Hagell, Anita Patel, Desirée Campbell-Richards, Russell M Viner, Shanti Vijayaraghavan, Martin Marshall, Trisha Greenhalgh, Sarah Finer
INTRODUCTION: Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#15
REVIEW
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28450337/books-evaluative-research-methods-managing-the-complexities-of-judgment-in-the-field-evaluation-for-social-justice
#16
Trisha Greenhalgh
No abstract text is available yet for this article.
May 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28369935/phase-2-of-catalise-a-multinational-and-multidisciplinary-delphi-consensus-study-of-problems-with-language-development-terminology
#17
Dorothy V M Bishop, Margaret J Snowling, Paul A Thompson, Trisha Greenhalgh
BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members...
October 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28351391/the-impact-on-healthcare-policy-and-practice-from-36-multi-project-research-programmes-findings-from-two-reviews
#18
REVIEW
Steve Hanney, Trisha Greenhalgh, Amanda Blatch-Jones, Matthew Glover, James Raftery
BACKGROUND: We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects. METHODS: We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared...
March 28, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28052845/efficacy-and-effectiveness-of-screen-and-treat-policies-in-prevention-of-type-2-diabetes-systematic-review-and-meta-analysis-of-screening-tests-and-interventions
#19
REVIEW
Eleanor Barry, Samantha Roberts, Jason Oke, Shanti Vijayaraghavan, Rebecca Normansell, Trisha Greenhalgh
OBJECTIVES:  To assess diagnostic accuracy of screening tests for pre-diabetes and efficacy of interventions (lifestyle or metformin) in preventing onset of type 2 diabetes in people with pre-diabetes. DESIGN:  Systematic review and meta-analysis. DATA SOURCES AND METHOD:  Medline, PreMedline, and Embase. Study protocols and seminal papers were citation-tracked in Google Scholar to identify definitive trials and additional publications...
January 4, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27978837/what-works-for-whom-in-pharmacist-led-smoking-cessation-support-realist-review
#20
REVIEW
Trisha Greenhalgh, Fraser Macfarlane, Liz Steed, Robert Walton
BACKGROUND: New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?" METHODS: This is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases...
December 16, 2016: BMC Medicine
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