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Table 8 Family physicians’ perceptions, cognition, and agreement with 3 draft recommendations, and their suggestions for overcoming identified problems

From: The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

Category Identified problem (Number of respondents) Suggestions to improve (Number of respondents) How to do it
Perception Disorganized (N = 8) Visually separate (N = 5), organize (N = 4) Create organized lists, groups, tables; Create flowchart
Wordy (N = 6) Simplify, shorten (N = 2), visually separate (N = 5) Point form, tables
Long (N = 4) Simplify, shorten (N = 2); visually separate (N = 5) Lists, tables
Cognition Do not understand grading of evidence quality (N = 6) Define grading system of evidence quality (N = 6) Use footnotes to explain grading of evidence; Hyperlink to more information about how grading is defined
Confusing/complex (N = 4) Visually separate (N = 5); organize (N = 4); match the system with the real world (N = 3) Create organized lists, groups, tables; create flowchart; use terms familiar to physicians
Lacking information (N = 4) Define terms and phrases (N = 4) Define acronyms; define vague terms
Agreement Not practical (lacking necessary resources, incongruent with provider and patient values) (N = 11) Individualize (N = 4) When formulating recommendations, consider costs, human resources, & provider & patient values
Poor evidence (N = 6) If the evidence is poor, simplify the recommendation (N = 4) Do not give detailed and specific recommendations when there is weak evidence to support it
Does not make clinical sense (no clear direction, missing information) (N = 6) Clear and actionable language; provide more background information (N = 4) Use active voice; include clear targets; include information about benefits and harms
Too aggressive (i.e., targets, intervention, monitoring) (N = 4) Provide background information for the recommendation (N = 8) Acknowledge that it is a change from current practice and underscore the rationale