Acceptability, feasibility and effectiveness of two methods of involving patients with disability in developing clinical guidelines: A single blind crossover trial (Preprint)
Bibliographic record
Abstract
BACKGROUND There is a lack of robust knowledge about the best method to involve patients and population in clinical practice guidelines (CPG) development. This lack of evidence is a potential threat to the the quality of CPG in general and might have an impact on the adhesion of patients and providers to the guidelines and ultimately to the quality of care provided from them. OBJECTIVE The goal of this pilot trial is to document the acceptability, feasibility and effectiveness of two methods of involving patients in CPG development. METHODS A single-blind crossover pragmatic trial was performed with patients with traumatic brain injury (TBI). The patients experimented two alternative methods of producing clinical practice recommendations, i.e. a discussion group (control intervention) and a Wiki (experimental intervention). The participants rated the acceptability of the two methods, and feasibility was assessed using indicators such as the number of participants who completed the two methods and the number of support interventions required. Twenty experts, blinded to the method of producing the recommendations, independently rated the recommendations produced by the participants for clarity, accuracy, appropriateness and usefulness. RESULTS Twenty participants with TBI were recruited and sixteen completed the study. The acceptability of the two methods were found to be similar, despite qualitative comments indicate small preference for focus groups social characteristics. Both methods appeared highly feasible to involve patients in CPG development, and the experts’ perceived effectiveness was similar, despite the recommendation produced through focus group was deemed as more relevant to support the clinical practice. CONCLUSIONS Our results confirms previous observations about the acceptability and feasibility of focus group and wiki to allow patient and population to participate in clinical practice guideline production. It adds to the scientific literature establishing the similarity in effectiveness of the two methods. CLINICALTRIAL Clinical trial KT Canada 87776.
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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 | 0.032 | 0.053 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 0.002 |
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".