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Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems
In the past decades, extensive research has been performed on the phenomenon of unwarranted clinical variation in clinical practice. Many studies have been performed on signaling, describing and visualizing clinical variation. We argue that it is time for next steps in practice variation research. I...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270826/ https://www.ncbi.nlm.nih.gov/pubmed/32319525 http://dx.doi.org/10.1093/intqhc/mzaa023 |
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author | Atsma, Femke Elwyn, Glyn Westert, Gert |
author_facet | Atsma, Femke Elwyn, Glyn Westert, Gert |
author_sort | Atsma, Femke |
collection | PubMed |
description | In the past decades, extensive research has been performed on the phenomenon of unwarranted clinical variation in clinical practice. Many studies have been performed on signaling, describing and visualizing clinical variation. We argue that it is time for next steps in practice variation research. In addition to describing and signaling variation patterns, we argue that a better understanding of causes of variation should be gained. Moreover, target points for improving and decreasing clinical variation should be created. Key elements in this new focus should be research on the complex interaction of networks, reflective medicine, patient beliefs and objective criteria for treatment choices. By combining these different concepts, alternative research objectives and new targets for improving and reducing unwarranted variation may be defined. In this perspective, we reflect on these concepts and propose target points for future research. |
format | Online Article Text |
id | pubmed-7270826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72708262020-06-09 Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems Atsma, Femke Elwyn, Glyn Westert, Gert Int J Qual Health Care Frontiers of Improvement In the past decades, extensive research has been performed on the phenomenon of unwarranted clinical variation in clinical practice. Many studies have been performed on signaling, describing and visualizing clinical variation. We argue that it is time for next steps in practice variation research. In addition to describing and signaling variation patterns, we argue that a better understanding of causes of variation should be gained. Moreover, target points for improving and decreasing clinical variation should be created. Key elements in this new focus should be research on the complex interaction of networks, reflective medicine, patient beliefs and objective criteria for treatment choices. By combining these different concepts, alternative research objectives and new targets for improving and reducing unwarranted variation may be defined. In this perspective, we reflect on these concepts and propose target points for future research. Oxford University Press 2020-06 2020-04-18 /pmc/articles/PMC7270826/ /pubmed/32319525 http://dx.doi.org/10.1093/intqhc/mzaa023 Text en © The Author(s) 2020. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Frontiers of Improvement Atsma, Femke Elwyn, Glyn Westert, Gert Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title | Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title_full | Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title_fullStr | Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title_full_unstemmed | Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title_short | Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
title_sort | understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems |
topic | Frontiers of Improvement |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270826/ https://www.ncbi.nlm.nih.gov/pubmed/32319525 http://dx.doi.org/10.1093/intqhc/mzaa023 |
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