Article type
Abstract
Background:Clinical practice guidelines play an important role in improving the quality of care. To assess the real effect, measuring its implementation situation is needed. The implementation situation can be reflected by testing the consistency between the actual clinical practice and the guideline. We constructed an instrument (Table 1) to measure the implementation situation of Traditional Chinese Medicine (TCM) guideline through consistency testing.
Objectives: The main objectives of this study were to validate the instrument and use it to explore the implementation situation by testing the consistency degree between the actual clinical practice and the menopause syndrome guideline of TCM.
Methods:Medical records of patients with menopause syndrome contain the gynaecologists’ diagnosis and treatment practices. Two groups of medical records were extracted from the electronic health record systems of five TCM hospitals in China. Then the evaluation staff used the instrument to assess the consistency degree between medical records and menopause syndrome guideline of TCM. Reliability and validity analyses were performed using Cronbach’s Alpha coefficient and exploratory factor analysis. Implementation situation were analysed using Mann-Whitney test and Kruskal-Wallis test.
Results: Data from 621 cases were included for analysis. The Cronbach’s Alpha coefficient of the instrument is 0.73. Four factors were extracted, which encompassed 92.69% of the total variance. Statistically significant improvement were found in the items of TCM diagnostic (P=0.001), modern medicine diagnostic (P=0.007), and recipe medicinal (P=0.006). Consistency scores of diagnostic dimension were significantly higher than the other dimensions (Syndrome differentiation and treatment, other therapeutic method, prevention).
Conclusions:The instrument for measuring the implementation situation of TCM guideline is of good reliability and validity. It is mainly used in the assessment of implementation situation of TCM guideline. The method of using consistency test to measure the implementation situation may provide a sample for evaluating the guideline implementation in other fields.
Objectives: The main objectives of this study were to validate the instrument and use it to explore the implementation situation by testing the consistency degree between the actual clinical practice and the menopause syndrome guideline of TCM.
Methods:Medical records of patients with menopause syndrome contain the gynaecologists’ diagnosis and treatment practices. Two groups of medical records were extracted from the electronic health record systems of five TCM hospitals in China. Then the evaluation staff used the instrument to assess the consistency degree between medical records and menopause syndrome guideline of TCM. Reliability and validity analyses were performed using Cronbach’s Alpha coefficient and exploratory factor analysis. Implementation situation were analysed using Mann-Whitney test and Kruskal-Wallis test.
Results: Data from 621 cases were included for analysis. The Cronbach’s Alpha coefficient of the instrument is 0.73. Four factors were extracted, which encompassed 92.69% of the total variance. Statistically significant improvement were found in the items of TCM diagnostic (P=0.001), modern medicine diagnostic (P=0.007), and recipe medicinal (P=0.006). Consistency scores of diagnostic dimension were significantly higher than the other dimensions (Syndrome differentiation and treatment, other therapeutic method, prevention).
Conclusions:The instrument for measuring the implementation situation of TCM guideline is of good reliability and validity. It is mainly used in the assessment of implementation situation of TCM guideline. The method of using consistency test to measure the implementation situation may provide a sample for evaluating the guideline implementation in other fields.