Article type
Year
Abstract
Background
Cochrane Sustainable Healthcare is a new Cochrane field focused on tackling medical excess. Choosing Wisely is an international, clinician-led campaign that seeks to advance a dialogue on reducing overuse by developing evidence-based recommendations of unnecessary tests, treatments and procedures. Choosing Wisely campaigns are present or planned in 25 countries globally. Campaigns are shifting from awareness of overuse towards deimplementation of unnecessary medical care identified by recommendations. However, there is a need for evidence to support deimplementation efforts. The objectives of these two groups align and a collaboration offers potential for synergistic effects to promote evidence-informed approaches to reduce overuse.
Objectives
To analyze potential mismatches between Cochrane Reviews and Choosing Wisely recommendations, and through this identify how these two organizations can contribute to each other’s collective goals of reducing medical excess and overuse.
Methods
In accordance with a pre-specified protocol, two authors independently assessed the evidence underpinning the Choosing Wisely International top 10 recommendations as well as the available Cochrane reviews relevant for each of these recommendations. We analyzed mismatches between the recommendations and the reviews. We also identified potential gaps in the Cochrane reviews. For example; differences in questions asked or outcomes reported compared to those needed to support recommendations about deimplementation. The analysis included both evidence-based approaches to deimplementation, as well as evidence on measuring outcomes and impact of deimplementation.
Results
We aim to arrive at a framework for the pathway between recommendations and evidence of overuse to evidence-based deimplementation approaches. This framework can help guide the work and collaboration between Cochrane Sustainable Healthcare and Choosing Wisely, and identify and prioritize knowledge gaps for deimplementation research.
Conclusions
The primary goals of Cochrane Sustainable Healthcare are to enhance the relevance of primary research and evidence synthesis to tackle medical excess, and to increase the use of that evidence to enable more sustainable healthcare for individual patients and societies. Crucial in this is a close collaboration with stakeholders. The collaboration with Choosing Wisely offers a model of how partnership with aligned organizations can advance collective goals, in this case improving knowledge on deimplementation.
Cochrane Sustainable Healthcare is a new Cochrane field focused on tackling medical excess. Choosing Wisely is an international, clinician-led campaign that seeks to advance a dialogue on reducing overuse by developing evidence-based recommendations of unnecessary tests, treatments and procedures. Choosing Wisely campaigns are present or planned in 25 countries globally. Campaigns are shifting from awareness of overuse towards deimplementation of unnecessary medical care identified by recommendations. However, there is a need for evidence to support deimplementation efforts. The objectives of these two groups align and a collaboration offers potential for synergistic effects to promote evidence-informed approaches to reduce overuse.
Objectives
To analyze potential mismatches between Cochrane Reviews and Choosing Wisely recommendations, and through this identify how these two organizations can contribute to each other’s collective goals of reducing medical excess and overuse.
Methods
In accordance with a pre-specified protocol, two authors independently assessed the evidence underpinning the Choosing Wisely International top 10 recommendations as well as the available Cochrane reviews relevant for each of these recommendations. We analyzed mismatches between the recommendations and the reviews. We also identified potential gaps in the Cochrane reviews. For example; differences in questions asked or outcomes reported compared to those needed to support recommendations about deimplementation. The analysis included both evidence-based approaches to deimplementation, as well as evidence on measuring outcomes and impact of deimplementation.
Results
We aim to arrive at a framework for the pathway between recommendations and evidence of overuse to evidence-based deimplementation approaches. This framework can help guide the work and collaboration between Cochrane Sustainable Healthcare and Choosing Wisely, and identify and prioritize knowledge gaps for deimplementation research.
Conclusions
The primary goals of Cochrane Sustainable Healthcare are to enhance the relevance of primary research and evidence synthesis to tackle medical excess, and to increase the use of that evidence to enable more sustainable healthcare for individual patients and societies. Crucial in this is a close collaboration with stakeholders. The collaboration with Choosing Wisely offers a model of how partnership with aligned organizations can advance collective goals, in this case improving knowledge on deimplementation.