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6. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials: A Short Report

Author

Weijer, Charles, Taljaard, Monica, Grimshaw, Jeremy M., Edwards, Sarah J. L., and Eccles, Martin P.

Abstract

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct, and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants.

Published
2015
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10. Implementing Clinical Guidelines: Current Evidence and Future Implications

Author

Grimshaw, Jeremy, Eccles, Martin, and Tetroe, Jacqueline

Abstract

One of the most common findings from health services research is a failure to routinely translate research findings into daily practice. Previous systematic reviews of strategies to promote the uptake of research findings suffered from a range of methodologic problems that have been addressed in a more recent systematic review of guideline dissemination and implementation strategies. Changes in practitioner behavior, in the desired direction, were reported in 86% of the comparisons made. The median effect size overall was approximately 10% improvement in absolute terms. The review suggests that interventions that were previously thought to be ineffective (e.g., dissemination of educational materials) may have modest but worthwhile benefits. Also, multifaceted interventions, previously thought to be more effective than single interventions, were found to be no more effective than single interventions. Overall, there is an imperfect evidence base for decision makers to work from. Many studies had methodologic weaknesses, and reporting of this kind of research is generally poor, making the generalizability of study findings frequently uncertain. A better theoretical underpinning of studies would make this body of research more useful.

Published
2004
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14. Changing Physicians' Behavior: What Works and Thoughts on Getting More Things to Work.

Author

Grimshaw, Jeremy M., Eccles, Martin P., Walker, Anne E., and Thomas, Ruth E.

Abstract

Efforts to address the information management problems of physicians include the Cochran reviews of the effectiveness of health care interventions and international clinical practice guidelines. A better theoretical base is needed to guide the choice of effective dissemination strategies. (Contains 18 references.) (SK)

Published
2002

18. Theory-based predictors of multiple clinician behaviors in the management of diabetes

Author

Presseau, Justin, Johnston, Marie, Francis, Jill J., Hrisos, Susan, Stamp, Elaine, Steen, Nick, Hawthorne, Gillian, Grimshaw, Jeremy M., Elovainio, Marko, Hunter, Margaret, and Eccles, Martin P.

Subjects
Self-efficacy (Psychology) -- Analysis, Psychology and mental health
Abstract

Behavioral theory is often tested on one behavior in isolation from other behaviors and theories. We aimed to test the predictive validity of constructs from motivation and action theories of behavior across six diabetes-related clinician behaviors, within the same sample of primary care clinicians. Physicians and nurses (n = 427 from 99 practices in the United Kingdom) completed questionnaires at baseline and 12 months. Primary outcomes: six self-reported clinician behaviors related to advising, prescribing and examining measured at 12 months; secondary outcomes: baseline intention and patient-scenario-based simulated behavior. Across six behaviors, each theory accounted for a medium amount of variance for 12-month behavior (median [R.sup.2.sub.adj] = 0.15), large and medium amount of variance for two intention measures (median [R.sup.2.sub.adj] = 0.66; 0.34), and small amount of variance for simulated behavior (median [R.sup.2.sub.adj] = 0.05). Intention/proximal goals, self-efficacy, and habit predicted all behaviors. Constructs from social cognitive theory (self-efficacy), learning theory (habit) and action and coping planning consistently predicted multiple clinician behaviors and should be targeted by quality improvement interventions. Keywords Clinician behavior * Intention * Habit * Multiple behaviors * Planning * Self-efficacy, Introduction There is enduring clinical and policy interest in promoting evidence-based health care. However, the production and dissemination of evidence of clinical best practice does not automatically lead to implementation. [...]

Published
2014
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22. Nice Clinical Guidelines

Author

Littlejohns, Peter, Leng, Gillian, Culyer, Tony, Drummond, Mike, Pilling, Stephen, Eccles, Martin, Wailoo, Allan, Roberts, Jennifer, Brazier, John, and McCabe, Chris

Published
2004

25. Effect Of Computerised Evidence Based Guidelines

Author

Emery, Jon D., Purves, Ian N., Beaumont, Robin, Fahey, Tom, Mitchell, Liz, Sullivan, Frank, Montgomery, Alan, Gregor, Peter, van Wyk, Jacobus T., Moorman, Peter W., van Wijk, Marc A. M., Eccles, Martin P., McColl, Elaine, Steen, Nick, Rousseau, Nikki, Grimshaw, Jeremy, and Parkin, David

Published
2003

38. Guideline for Primary Care Management of Dementia

Author

Marshall, Tom, Eastley, Rebecca, Haworth, Judy, Wilcock, Gordon, Sharp, Deborah, Tapsfield, William G., Jelley, Diana M., Matthews, H., Wilkinson, D., Holmes, C., Eccles, Martin, Clarke, Julie, Livingstone, Moira, Freemantle, Nick, and Mason, James

Published
1999

44. Aspirin Prophylaxis for Vascular Disease

Author

Fitzmaurice, D., Thomas, C. P., Chant, Harvey, Fearn, Shirley, McCollum, Charles, Eccles, Martin, Freemantle, Nick, and Mason, James

Published
1998

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