People With Lived Experience at the Centre of Canadian Stroke Best Practice Recommendations: A Model for Guideline Developers
Bibliographic record
Abstract
Abstract Background Actively engaging people with lived experience (PWLE) in stroke-related clinical practice guideline development has not previously been implemented and evaluated despite international efforts to incorporate patient and public engagement. The purpose of this pilot project was to evaluate the feasibility, perceived value and effectiveness of a new model, the Community Consultation and Review Panel, to actively engage PWLE in the writing and review of Canadian Stroke Best Practice Recommendations (CSBPR).Methods Members of the public with lived experience relevant to CSBPR module topics, including people with stroke, family members and caregivers, were recruited to participate in two CSBPR Community Consultation and Review Panels (CCRP). The CCRP ran in parallel to scientific writing groups updating two components of the CSBPR Rehabilitation, Recovery and Community Participation module – Rehabilitation and Recovery following Stroke and Transitions and Community Participation following Stroke . With the aid of an inter-group liaison, both the scientific writing group and CCRP reviewed the updated evidence and CCRP participants added insights and context based on their personal experiences. We utilized the Patient and Public Engagement Evaluation Tool (PPEET) to obtain CCRP participant feedback.Results This model was found to be feasible, requiring 3-4 hours of staff time per week. CCRP participants rated “strongly agree” or “agree” to 14 PPEET questions indicating that they perceived the CCRP to be a positive experience and effective process, and their participation had an impact. Responses to the open-ended questions revealed that CCRP participants felt that their input and recommendations on the CCSPR were acknowledged and would benefit stroke care in Canada.Conclusions The overall success of this pilot project established the feasibility and perceived benefit of employing a participatory and collaborative model to actively engage PWLE in stroke-related clinical practice guideline development. The values, experiences and recommendations of PWLE were able to be effectively incorporated into CSBPR content to enable lived experience specific context and considerations to augment the existing scientifically rigorous writing and review process. This model is now the standard practice for all future CSBPR module development and updates and could be adapted for guideline development across other disciplines.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.046 | 0.048 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.013 | 0.014 |
| Scholarly communication | 0.010 | 0.008 |
| Open science | 0.004 | 0.019 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".