Open research questions in Clinical practice guidelines implementation
107 unresolved questions extracted from the limitations and future-work sections of 397 Clinical practice guidelines implementation papers in our library. Each links back to the study that raised it.
What the literature leaves open
Although its benefits are recognized, little is known about how nurses experience and adapt to this organizational innovation.
Emergency Department Nurses’ Experiences with the Early Care Pathway (ECP) Model: An Interpretative Phenomenological Study · 2026 · DOIIts effect on review quality and inter-rater reliability remains to be evaluated in practice.
An external peer review instrument for Korean Medicine clinical practice guideline drafts (KM-EPRI): development and content validation · 2026 · DOIThe complexity of therapeutic options for T2D management. The need for tailored treatment to individual patient preferences. The absence of high-quality decision aids in CPGs.
Shared Decision Making: Aids and Promotion in Clinical Practice Guidelines for Type 2 Diabetes Treatment · 2026 · DOIThere is a persistent gap between the theoretical recognition of SDM and its operational integration into CPGs. The absence of high-quality decision aids in CPGs is concerning. The development of high-quality decision aids is necessary for informed choice among therapeutic options.
Shared Decision Making: Aids and Promotion in Clinical Practice Guidelines for Type 2 Diabetes Treatment · 2026 · DOIDeveloping rigorous and unconflicted clinical guidelines is difficult. Differences in opinions, lack of methodological rigour, and conflicted interests can turn guidelines into promotion of interpretations and beliefs. The presence of large clinical guidelines with hundreds of recommendations may not guarantee improved clinical care.
Clinical practice guidelines in sport and exercise medicine: time for capacity building · 2026 · DOIThe lack of clinical guidelines and standardization of care in sport and exercise medicine. The need for capacity building to develop relevant and rigorous clinical guidelines.
Clinical practice guidelines in sport and exercise medicine: time for capacity building · 2026 · DOIThe scientific basis for the decisions offered by decision support systems is often not explicitly stated. There is a need for a systematic examination of the literature to map the current state of clinical decision support systems.
Effectiveness of Guideline-Based Clinical Decision Support Systems: Protocol for a Systematic Review · 2026 · DOILittle is known about the use of PROMIS in clinical care. There is a need to understand who is using PROMIS in routine clinical care and how.
CONCLUSIONS: The rigour of development and editorial independence of WHO-supported guidelines require improvement, particularly for diseases where comprehensive guidelines are lacking.
Appraisal of World Health Organization guidelines for priority infectious diseases with potential to cause public health emergencies · 2025 · DOIFurther research on the connections between various organs via hormones, cytokines, and neural networks. Further research on the impact of immune checkpoint inhibitors as a treatment for advanced malignancies. Further research on the development of clinical endocrinology and endocrinological research in Japan.
Reflections and expectations of an endocrinologist and diabetologist on the launch of a new, board-certified Endocrinology, Diabetes and Metabolism specialist system pioneered by the JES and the JDS · 2024 · DOIThe need for close collaboration between endocrinologists and diabetologists. The lack of interdisciplinary approaches in endocrinology. The need for a new board-certified specialist system to promote interdisciplinary approaches.
Reflections and expectations of an endocrinologist and diabetologist on the launch of a new, board-certified Endocrinology, Diabetes and Metabolism specialist system pioneered by the JES and the JDS · 2024 · DOIEvidence and rationale Hypertensive patients with onset age ≤35 years, abnormal blood potassium, a low plasma renin level, and common secondary hypertension excluded are recommended for genetic testing to screen for monogenic hypertension (2D).
CPAP during sleep is suggested for hypertensive patients with moderate to severe OSA (2C). Mineral corticoid receptor antagonists are suggested for patients with moderate to severe OSA complicated with resistant hypertension (2C).
The gap the paper identifies is the lack of consideration of who gets to decide how to redefine a disease. The influence of industry on the re-drawing of disease boundaries is a concern that is not being adequately addressed.
The aim of this study was to explore the attitudes, barriers and limitations to the development and implementation of guidelines for lower limb open fractures METHODS: Twelve renowned orthopaedic and plastic surgeons, based in countries with no guidelines at present, underwent semi-structured interviews.
Avoiding “a piece of paper on the wall that everyone ignores”: A qualitative study on the barriers for implementing open fracture guidelines · 2024 · DOIProblem At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, reliable, globally applicable recommendations for safe and continuous school operations were lacking.
The need for clear communication and documentation during patient care transfer is not always met, leading to patient safety issues and medicolegal risk.
Few attempts have been made to summarize and analyze the findings of empirical studies comparing individual and group treatment. There is a lack of clear guidelines for practitioners to decide between individual and group treatment.
When to Recommend Group Treatment: A Review of the Clinical and the Research Literature · 1986 · DOIThe increasing number of child support cases is creating a demand for an alternative mechanism to the use of limited judicial resources. The current system is inconsistent and unfair. The use of different formulas and guidelines in different states can create confusion and inconsistency.
The lack of guidelines for helping standard-setting groups address issues and technical matters. The need for a systematic approach to standard setting.
and cautions In this final chapter we will briefly review and summarize the rea- sons for more intensive scrutiny of departmental operations and budgets and the factors that have prevented such study. We will then list the means and procedures for such review, closing with comments and cautions about putting these procedures into opera- tion. need for intensive scrutiny In a period of continuing growth in which new resources were scarcely adequate and usually lagged a year or two behind the rapidly expanding need, most departments were heavily loaded. There was no apparent necessity for intensive scrutiny. Quite reasonably the emphasis was on allocation of new resources. Even if there had been some disposition toward planning (other than pro- jections of increases), detailed planning was ruled out by the recur- rent and even overlapping exigencies of dealing with budget acquisi- tion and allocation every year. The emphasis was on catching up rather than on looking ahead to the implications of current deci- sions. Enrollment and student credit hours became the major means of demonstrating needs. This scenario has been vastly altered. At best the university now faces at least temporarily stable enrollments and probably de- clining ones in the near future. Likewise, in many cases state budget 107 108 allocations are stable or actually declining if inflationary factors are taken into account. A further complication-not always fully recog- that increases previously tended to be on an actual-cost nized-is basis per student, whereas departmental budgets were often ex- panded on a marginal-cost basis. This permitted the allocation of funds for the development of new, often costly, and sometimes dubious programs. As budgets are stabilized, the expansion brings stresses that are not easily met. It is easier to add than to discard programs. Liberalization of requirements and various external pressures have also contributed to enrollment shifts leading to inequities in departmental and college staffing relative to current loads. Without additional new funding, only internal reallocation can correct these inequities. Internal reallocation does not come easily and can sel- dom be accomplished t o any significant extent in one year. And, even then, reallocation requires much closer attention to depart- mental needs and operations across the entire university than has been generally exercised. To this must be added the external de- mands for accountability, which require increasingly detailed infor- mation about colleges and departments. At that point the excesses and inequities in loads and resource allocation resulting from de- partmental autonomy become painfull
Reducing pressures and concerns about minute differences in ranks. Providing a stable and effective base from which to judge future academic progress.
The need for guidelines for school and college use of GPA and RiC. The lack of compromise and flexibility in the use of GPA and RiC.
The significant F ratio for interaction limited the analysis. The study only analyzed the reactions of school counselors, counselor-educators, and administrators.
BRUCE SEIERTZER, ALLAN DYE, and ROBERT WALSH uring the past five years, several D guidance policy statements and recommendations have been made by diverse groups and individuals. This study sought to evaluate the recom- mendations of Conant [ 21, Wrenn [ 3 ] , and the APGA 111 with regard to acceptance by those involved in guid- ance. and The reactions of school counselors, counselor-educators, adminis- trators to selected major recommenda- tions of these policy statements were obtained to determine the degree of acceptance of the recommendations held b y these three groups, independ- ently and collectively. The investi- gators were interested in ascertaining (1) in general, which set of recom- mendations (Conant’s, Wrenn’s, or APGA’s) was most acceptable, (2) whether there was any between-group (counselors, counselor-educators, and administrators) difference as to which set was most acceptable, and ( 3 ) the particular recommendations which ob- tained the most communality among the three groups. BHUCE SHERTZER and ALLAN DYE are Counselor-Educators, Purdue University, and ROBERT WALSH is a School Counse- lor. hlonticello School, New York.
Most-cited papers in Clinical practice guidelines implementation
- Why Don't Physicians Follow Clinical Practice Guidelines? · JAMA · 1999 · 5,138 citations
- Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations · The Lancet · 1993 · 1,996 citations
- Classification and regression tree analysis in public health: Methodological review and comparison with logistic regression · Annals of Behavioral Medicine · 2003 · 718 citations
- Evidential reasoning rule for evidence combination · Artificial Intelligence · 2013 · 691 citations
- Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise · Canadian Medical Association Journal · 2013 · 555 citations
- Development of the AGREE II, part 1: performance, usefulness and areas for improvement · Canadian Medical Association Journal · 2010 · 402 citations
- Practice Guidelines, a New Reality in Medicine · Archives of Internal Medicine · 1992 · 387 citations
- The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory? · Social Science & Medicine · 2004 · 355 citations
- AGREE II: Advancing guideline development, reporting, and evaluation in health care · Preventive Medicine · 2010 · 331 citations
- Failure of Clinical Practice Guidelines to Meet Institute of Medicine Standards · Archives of Internal Medicine · 2012 · 254 citations
Most recent work
- Operationalizing Equity: A Methodologic Framework for Revising Pediatric Clinical Guidance · PEDIATRICS · 2026
- A step forward for patient‐centred fasting guidelines · Anaesthesia · 2026
- Aligning the Clinical Judgment Management Model With Clinical Concept Mapping · Nurse Educator · 2026
- Understanding the Content and Purpose of S3 Clinical Practice Guidelines in Dentistry · International Endodontic Journal · 2026
- PI-QUAL in Clinical Practice: Rationale and a Step-by-Step Approach to Implementation · American Journal of Roentgenology · 2026
- MAKING CLINICAL PRACTICE GUIDELINES FOR DENTISTRY MORE PATIENT-CENTERED THROUGH PATIENT-REPORTED OUTCOME INTEGRATION · Journal of Evidence Based Dental Practice · 2026
- Shared Decision Making: Aids and Promotion in Clinical Practice Guidelines for Type 2 Diabetes Treatment · Journal of Evaluation in Clinical Practice · 2026
- Development, implementation, and evaluation of clinical practice guidelines, protocols, and pathways used in rural and remote Australia, Canada, and Aotearoa New Zealand: a scoping review · JBI Evidence Synthesis · 2026
- Clinical practice guidelines in sport and exercise medicine: time for capacity building · 2026
- Ensuring Clinical Practice Guidelines Meet the Needs of the End-User: a Prioritization Survey for Guideline Topics for Behavioural and Psychological Symptoms of Dementia. · Canadian Geriatrics Journal · 2026
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