Causal Bayesian networks to quantify the interactions that influence implementation success
Bibliographic record
Abstract
Abstract Despite the potential of evidence-based medical innovations to improve patient outcomes, their integration remains difficult. Implementation science aims to assist by identifying and deploying effective implementation strategies within complex health care settings. Determinant frameworks, such as the Consolidated Framework for Implementation Research (CFIR), help identify factors influencing implementation success but do not specify mechanisms or methods for selecting optimal strategies. Selection methods are largely empirical, highlighting the need for objective, quantifiable approaches. We developed causal Bayesian networks (BNs) to model the interdependencies amongst contextual factors, determinants and outcomes with a specific example: the detection and management of chonic wet cough in Indigenous Australian children in primary health care settings. The BNs, informed by CFIR domains and prior qualitative research, quantifies the impact of barriers and enablers on implementation outcomes. The BNs enable predictions of intervention effects, and the assessment and quantification of potential implementation strategies, or a combination of strategies. The BNs are linked to a simple survey that allows implementation strategies to be tailored for each setting and that was administered at several sites across Australia to validate the models. The overall process, including the BNs and surveys, constitutes a generalisable structured workflow for selecting the most promising strategies. We describe the model development and validation, and the broader applicability of our BN-based workflow in implementation science.
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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 | 0.031 | 0.152 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 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".