Journal of evaluation in clinical practice
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As big data becomes more publicly accessible, artificial intelligence (AI) is increasingly available and applicable to problems around clinical decision-making. Yet the adoption of AI technology in healthcare lags well behind other industries. The gap between what technology could do, and what technology is actually being used for is rapidly widening. ⋯ To aid with change, we propose facilitating clinician decisions through technology by seamlessly weaving what we call 'invisible AI' into existing clinician workflows, rather than sequencing new steps into clinical processes. We explore evidence from the change management and human factors literature to conceptualize a new approach to AI implementation in health organizations. We discuss challenges and provide recommendations for organizations to employ this strategy.
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The physiotherapy profession strives to be a leader in providing quality care and strongly recognizes the value of research to guide clinical practice. Adherence to guidelines for research reporting and conduct is a significant step towards high-quality, transparent and reproducible research. ⋯ Most RCTs/SRs were registered; the majority had discrepancies between preregistration and publication, potentially influencing the outcomes and interpretations of findings. Journals should require preregistration and compare the submission with the registration information when assessing publication suitability. Readers should be aware of these inconsistencies and their implications when interpreting and translating results into practice.
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Our goal is to describe the association between total quantitative blood loss (QBL) and risk of obstetric haemorrhage-related morbidity (OBH-M) to assess the utility of the current definition of obstetric haemorrhage (OBH). ⋯ Our findings suggest that a higher QBL threshold than the currently accepted definition of OBH is more predictive of OBH-M.
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Preoperative patient education through 'joint class' has potential to improve quality of care for total joint replacement (TJR). However, no formal guidance exists regarding curriculum content, potentially resulting in inter-institutional variation. ⋯ Our synthesis identified core common topics included in pre-TJR education but also highlighted variation across institutions, supporting opportunities for standardization. Clinicians and researchers can use our preliminary model to systematically develop and evaluate 'joint classes,' with the goal of establishing a standard of care for TJR preoperative education.
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Exercise stress echocardiograms (stress echos) are overused, whereas exercise stress electrocardiograms (stress ECGs) can be an appropriate, lower-cost substitute. In this post hoc, mixed methods evaluation, we assessed an initiative promoting value-based, guideline-concordant ordering practices in primary care (PC) and cardiology clinics. ⋯ This initiative influenced ordering behaviour in PC and cardiology clinics. However, clinicians' perceptions of the initiative varied between specialties and did not always align with the observed behaviour change.