title: Framework for the impact analysis and implementation of Clinical Prediction Rules (CPRs).
abstract: Clinical Prediction Rules (CPRs) are tools that quantify the contribution of symptoms, clinical signs and available diagnostic tests, and in doing so stratify patients according to the probability of having a target outcome or need for a specified treatment. Most focus on the derivation stage with only a minority progressing to validation and very few undergoing impact analysis. Impact analysis studies remain the most efficient way of assessing whether incorporating CPRs into a decision making process improves patient care. However there is a lack of clear methodology for the design of high quality impact analysis studies.We have developed a sequential four-phased framework based on the literature and the collective experience of our international working group to help researchers identify and overcome the specific challenges in designing and conducting an impact analysis of a CPR.There is a need to shift emphasis from deriving new CPRs to validating and implementing existing CPRs. The proposed framework provides a structured approach to this topical and complex area of research.
authors: Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. emmawallace@rcsi.ie
authors: Emma
authors: E
authors: Wallace
authors: Susan M
authors: SM
authors: Smith
authors: Rafael
authors: R
authors: Perera-Salazar
authors: Paul
authors: P
authors: Vaucher
authors: Colin
authors: C
authors: McCowan
authors: Gary
authors: G
authors: Collins
authors: Jan
authors: J
authors: Verbakel
authors: Monica
authors: M
authors: Lakhanpaul
authors: Tom
authors: T
authors: Fahey
mesh_terms: D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006801:Humans; D010818:Practice Patterns, Physicians'; D012107:Research Design