Article type
Abstract
Background: In the development and adaptation of practice guidelines, considering contextual information (e.g., cost, acceptability, and feasibility of interventions) is as important as that of evidence about health effects.
Objectives: To describe our team’s experiences and lessons learnt from conducting studies on contextual factors to inform practice guidelines.
Methods: Our team conducted both primary research (quantitative studies, qualitative studies, mixed methods studies) and systematic reviews to inform different clinical, public health, and health systems guidelines developed by the World Health Organization. These studies focused on valuation of outcomes, as well as resource use, acceptability, feasibility, and impact on equity of interventions. They sought the views of a range of stakeholders including health professionals, patients, and policymakers.
Results: Advantages of primary research are the generation of contextual information directly relevant to the questions of interest, ensuring the quality of information, and stakeholder engagement. Its limitations include reliance on a single study, and time and resource requirements. While systematic reviews address some of these shortcomings, they might not directly address all questions of interest. Also, the quality of the information depends on that of the published research. Quantitative research reflects views across a large sample, but might not uncover in-depth details and nuances, which could be better explored using a qualitative approach. A key consideration is ensuring good participant understanding of the outcomes and interventions assessed (e.g., through using outcome and intervention descriptors), and of the aspects to consider when assessing contextual factors (e.g., impact of the outcome on quality of life for valuation of outcomes). Another consideration relates to the target population (e.g., having received an intervention vs not). Lastly, based on our experience, we developed a generic protocol that can be used in the planning of quantitative and qualitative studies addressing contextual factors.
Conclusions: Different study designs are available to gather contextual information to inform practice guidelines, each with unique considerations. Nonetheless, there are some common aspects to be considered by the researchers including clarity, as well as selection of participants.
Relevance and importance to patients: Gathering contextual information improves guideline relevance, enhancing utilization and impact on patient health outcomes.
Objectives: To describe our team’s experiences and lessons learnt from conducting studies on contextual factors to inform practice guidelines.
Methods: Our team conducted both primary research (quantitative studies, qualitative studies, mixed methods studies) and systematic reviews to inform different clinical, public health, and health systems guidelines developed by the World Health Organization. These studies focused on valuation of outcomes, as well as resource use, acceptability, feasibility, and impact on equity of interventions. They sought the views of a range of stakeholders including health professionals, patients, and policymakers.
Results: Advantages of primary research are the generation of contextual information directly relevant to the questions of interest, ensuring the quality of information, and stakeholder engagement. Its limitations include reliance on a single study, and time and resource requirements. While systematic reviews address some of these shortcomings, they might not directly address all questions of interest. Also, the quality of the information depends on that of the published research. Quantitative research reflects views across a large sample, but might not uncover in-depth details and nuances, which could be better explored using a qualitative approach. A key consideration is ensuring good participant understanding of the outcomes and interventions assessed (e.g., through using outcome and intervention descriptors), and of the aspects to consider when assessing contextual factors (e.g., impact of the outcome on quality of life for valuation of outcomes). Another consideration relates to the target population (e.g., having received an intervention vs not). Lastly, based on our experience, we developed a generic protocol that can be used in the planning of quantitative and qualitative studies addressing contextual factors.
Conclusions: Different study designs are available to gather contextual information to inform practice guidelines, each with unique considerations. Nonetheless, there are some common aspects to be considered by the researchers including clarity, as well as selection of participants.
Relevance and importance to patients: Gathering contextual information improves guideline relevance, enhancing utilization and impact on patient health outcomes.