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Open research questions in Clinical practice guidelines implementation

202 gap statements mined from Clinical practice guidelines implementation papers in our 7.9M-paper local library, which holds 1,173 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • The evidence-practice gap in stroke rehabilitation is clinically important because many guideline-recommended processes are linked to timely identification and management of potentially modifiable post-stroke impairments and complications. Cognitive and mood screening can identify impairments that affect engagement with rehabilitation, safety, discharge planning, caregiver burden, 8).

    Delivery of selected guideline-based care processes in adult stroke rehabilitation: a systematic review and meta-analysis · 2026 · DOI

  • Despite the availability of these guidelines, translation into routine rehabilitation practice remains inconsistent. Guideline recommendations may be present at the policy level but incompletely implemented at the bedside, in outpatient clinics, or during community follow-up.

    Delivery of selected guideline-based care processes in adult stroke rehabilitation: a systematic review and meta-analysis · 2026 · DOI

  • Limited awareness, knowledge, and training of nurses may be a challenge to the use of evidence-based clinical guidelines and standardized nursing documentation. Workload, complex guideline formats, and weak organizational support may also be challenges.

    Reported Use of Clinical Guidelines and Nursing Documentation Checklists Among Nurses in Kazakhstan: A Cross-Sectional Online Survey · 2026 · DOI

  • Future studies are required to address this issue of the validity in implementing and maintaining quality assessment systems as a tool with a real impact on improving patients’ clinical outcomes and epidemiological indicators.

    The Impact of Implementing Indicators of Quality of Oncological Care on Improving Patient Outcomes: A Cross-Sectional Review of Experiences from Countries Using Indicators in the Quality Assessment Process · 2025 · DOI

  • However, their association with comprehensive objective measures of overall guideline adherence remains unclear.

    Association of Self‐Reported Clinical Behavior With Guideline Adherence in Schizophrenia and Major Depressive Disorder After Guideline Education · 2026 · DOI

  • While adherence is critical for optimal healthcare, it has not been studied in men's health.

    Examining adherence to American Urological Association (AUA) guidelines in men’s health: Insights from the New York section AUA survey · 2025 · DOI

  • Despite its inclusion in international guidelines, formal protocols for developing acupuncture-specific clinical recommendations remain insufficient.

    Developing Guideline Recommendations and Treatment Regimens for Acupuncture: An Example from the Clinical Practice Guideline · 2025 · DOI

  • In Colombia, studies associated with CPGs and medical professions are scarce; the few available have considered CPGs as a tool for standardization, improving health care efficiency, and quality, and have identified barriers against their implementation.

    Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia · 2025 · DOI

  • However, no studies have been done to develop a clinical pathway for cesarean sections (CS) in the INA-CBG system that is both effective and efficient.

    Development of an Efficient and Effective Clinical Pathway for Cesarean Section in West Sumatra (Indonesia) · 2024 · DOI

  • However, the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.

    Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines · 2024 · DOI

  • Additionally, it highlights emerging topics that have the potential to impact pregnancy care in the future and identifies gaps in the literature that warrant further research.

    Synopsis of the 2023 U.S. Department of VA and U.S. DoD Clinical Practice Guideline for the Management of Pregnancy · 2024 · DOI

  • 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 · DOI

  • There 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 · DOI

  • Little 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.

    PROMIS in routine clinical care: a scoping review of implementation and use · 2026 · DOI

  • The study highlights the challenge of developing transferable or theoretically transferable findings that can enhance the relevance of qualitative research in global guidance. The study notes the challenge of balancing the need for rigorous and timely systematic reviews with the need for qualitative research to inform guideline development.

    Expert stakeholders on the role of qualitative research in World Health Organisation guidelines · 2026 · DOI

  • If there are no guidelines on the topic, the second step involves a search and evaluation of systematic reviews.

    Protocol for the development of NHMRC-endorsed guidelines for extracorporeal membrane oxygenation using GRADE methodology · 2025 · DOI

  • The narrow focus of many clinical and public health guidelines might overlook important aspects of the social context examined by qualitative research. Developing transferable or theoretically transferable findings can enhance the relevance of qualitative research in global guidance.

    Expert stakeholders on the role of qualitative research in World Health Organisation guidelines · 2026 · DOI

  • Although two rounds were planned, all items reached the consensus threshold in round 1, so the Delphi was completed in a single round under the predefined early-stopping rule. The panel was evenly split by sex in their 40s.

    An external peer review instrument for Korean Medicine clinical practice guideline drafts (KM-EPRI): development and content validation · 2026 · DOI

  • Patients and the public were not involved in the development, conducting and analysis of this review, - The search was limited to organisations from the GIN directory and additional searches in other databases, - The review was limited to guidance documents regarding guideline development, - Data were extracted by one reviewer and verified by a second, - The review did not assess the quality of the guidance…

    Prediction models in clinical guidelines: a scoping review of clinical guideline guidance development documents · 2026 · DOI

  • The role of education, organizational support, and electronic documentation should be examined, - The causes of variability in guideline utilization should be…

    Reported Use of Clinical Guidelines and Nursing Documentation Checklists Among Nurses in Kazakhstan: A Cross-Sectional Online Survey · 2026 · DOI

  • Further research is needed to develop guidance on how to assess and incorporate prediction models in clinical guidelines, - Research is needed to develop a consensus on how to synthesise evidence from studies on prediction models, - Studies are needed to evaluate the effectiveness of prediction models in clinical practice, - Research is needed to develop methods for selecting between competing prediction…

    Prediction models in clinical guidelines: a scoping review of clinical guideline guidance development documents · 2026 · DOI

  • Recommendations vary widely across guidelines, and the main reasons included different emphases on the diagnosis of hyperthyroidism, different target populations, irrational selection of evidence and geographic variation.

    Quality of guidelines for hyperthyroidism: systematic quality assessment using the AGREE II tool · 2025 · DOI

  • Limited participation from Indian cardiac surgeons - Difficulty in collecting and analyzing data from multiple sources - Need for standardized data collection…

    Guidelines do not come out of thin air · 2026 · DOI

  • The database currently only reflects the practice of units prepared to contribute, - '50,000 operations' is still only a very small minority of Indian cardiac surgical volume, - The database needs more participation from Indian…

    Guidelines do not come out of thin air · 2026 · DOI

  • The need for trusted sources to summarise and disseminate current clinical evidence - The lack of evidence-based guidelines for radiological practice - The need for a systematic and transparent approach to creating…

    The ESR Guide to Guidelines initiative: from art to evidence · 2026 · DOI

Most-cited papers in Clinical practice guidelines implementation

Most recent work

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Open questions raised by papers listed on this page include: (1) Their association with comprehensive objective measures of overall guideline adherence remains unclear (“Association of Self‐Reported Clinical Behavior With Guideline Adherence in…”, 2026); (2) There is a need to understand who is using PROMIS in routine clinical care and how (“PROMIS in routine clinical care: a scoping review of implementation and use”, 2026); (3) Future studies are required to address this issue of the validity in implementing and maintaining quality assessment systems as a tool with a real impact on improving patients’ clinical outcomes and epidemiological indicators (“The Impact of Implementing Indicators of Quality of Oncological Care on…”, 2025); (4) While adherence is critical for optimal healthcare, it has not been studied in men's health (“Examining adherence to American Urological Association (AUA) guidelines in…”, 2025); (5) If there are no guidelines on the topic, the second step involves a search and evaluation of systematic reviews (“Protocol for the development of NHMRC-endorsed guidelines for extracorporeal…”, 2025). 202 gap statements have been mined from Clinical practice guidelines implementation papers in our 7.9M-paper local library, which holds 1,173 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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