Skip to main content

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