Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
Implementation tools developed by guideline producers may improve guideline uptake
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Implementation tools developed by guideline producers may improve guideline uptake
How effective are implementation tools developed and disseminated by clinical practice guideline (CPG) producers in promoting guideline uptake?
Implementation tools developed by recognised CPG producers probably led to improved healthcare professionals' adherence to guidelines in the management of non-specific low back pain and ordering thyroid function tests. The clinical condition, type of healthcare professional and behaviour targeted by the CPG varied across studies. There were limited data on the relative costs of implementing these interventions. There were no studies evaluating the effectiveness of interventions targeting the organisation of care (eg, benchmarking tools, costing templates, etc) or for mass media interventions.
It was not possible to draw any conclusions about the comparative effectiveness of implementation tools, due to the small number of studies, the heterogeneity between interventions and the clinical conditions that were targeted.
The uptake of CPGs is inconsistent despite their potential to improve the quality of healthcare and patient outcomes. Some guideline producers have addressed this problem by developing tools to encourage faster adoption of new guidelines.
Flodgren G et al. Tools developed and disseminated by guideline producers to promote the uptake of their guidelines. Cochrane Reviews, 2016, Issue 8. Art. No.: CD010669.DOI: 10.1002/14651858. CD010669.pub2. This review contains 4 studies involving 4 different countries (Netherlands, France, US, Canada).