Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 25;13(1):86.
doi: 10.1186/s13012-018-0772-3.

The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support

Stijn Van de Velde  1 , Ilkka Kunnamo  2 , Pavel Roshanov  3 , Tiina Kortteisto  4 , Bert Aertgeerts  5 , Per Olav Vandvik  6   7 , Signe Flottorp  8   7 ; GUIDES expert panel
Collaborators, Affiliations

The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support

Stijn Van de Velde et al. Implement Sci. .

Abstract

Background: Computerised decision support (CDS) based on trustworthy clinical guidelines is a key component of a learning healthcare system. Research shows that the effectiveness of CDS is mixed. Multifaceted context, system, recommendation and implementation factors may potentially affect the success of CDS interventions. This paper describes the development of a checklist that is intended to support professionals to implement CDS successfully.

Methods: We developed the checklist through an iterative process that involved a systematic review of evidence and frameworks, a synthesis of the success factors identified in the review, feedback from an international expert panel that evaluated the checklist in relation to a list of desirable framework attributes, consultations with patients and healthcare consumers and pilot testing of the checklist.

Results: We screened 5347 papers and selected 71 papers with relevant information on success factors for guideline-based CDS. From the selected papers, we developed a 16-factor checklist that is divided in four domains, i.e. the CDS context, content, system and implementation domains. The panel of experts evaluated the checklist positively as an instrument that could support people implementing guideline-based CDS across a wide range of settings globally. Patients and healthcare consumers identified guideline-based CDS as an important quality improvement intervention and perceived the GUIDES checklist as a suitable and useful strategy.

Conclusions: The GUIDES checklist can support professionals in considering the factors that affect the success of CDS interventions. It may facilitate a deeper and more accurate understanding of the factors shaping CDS effectiveness. Relying on a structured approach may prevent that important factors are missed.

Keywords: Clinical computerised decision support systems; Evidence-based medicine; Guideline adherence; Implementation; Practice Guidelines.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable

Competing interests

Ilkka Kunnamo, Per Olav Vandvik, Blackford Middleton, David Bates, Jerome Osheroff, Kensaku Kawamoto, Lorenzo Moja, Nard Schreurs, Nicolas Delvaux and Smisha Agarwal declared financial relationships that present or might present a potential conflict of interest. Other relationships that present or might present a potential conflict of interest were declared by Linn Brandt (doing research about a specific type of CDS), Nard Schreurs (relationships with software vendors) and Mieke Vermandere (implementation of a specific type of CDS). The other authors had no potential conflict of interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diagram presenting the four domains that are important for successful implementation of guideline-based CDS. This diagram is adapted from the formula by Fixsen on successful uses of evidence-based programs in human service settings [100]
Fig. 2
Fig. 2
Screenshot of the electronic version of the GUIDES checklist illustrating the domains and factors
See this image and copyright information in PMC

References

    1. Saini V, Brownlee S, Elshaug AG, Glasziou P, Heath I. Addressing overuse and underuse around the world. Lancet. 2017;390(10090):105–107. doi: 10.1016/S0140-6736(16)32573-9. - DOI - PubMed
    1. Brownlee S, Chalkidou K, Doust J, Elshaug AG, Glasziou P, Heath I, et al. Evidence for overuse of medical services around the world. Lancet. 2017;390:156. doi: 10.1016/S0140-6736(16)32585-5. - DOI - PMC - PubMed
    1. Elshaug AG, Rosenthal MB, Lavis JN, Brownlee S, Schmidt H, Nagpal S, et al. Levers for addressing medical underuse and overuse: achieving high-value health care. Lancet. 2017;390(10090):191–202. doi: 10.1016/S0140-6736(16)32586-7. - DOI - PubMed
    1. Glasziou P, Straus S, Brownlee S, Trevena L, Dans L, Guyatt G, et al. Evidence for underuse of effective medical services around the world. Lancet. 2017;390:169. doi: 10.1016/S0140-6736(16)30946-1. - DOI - PubMed
    1. Saini V, Garcia-Armesto S, Klemperer D, Paris V, Elshaug AG, Brownlee S, et al. Drivers of poor medical care. Lancet. 2017;390(10090):178–190. doi: 10.1016/S0140-6736(16)30947-3. - DOI - PubMed

Publication types