Cargando…

Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices

The use of relevant guidelines is critical in psychiatric clinical practice to ensure the homogeneity of the global care provided. Consequently, it is important to identify whether they are utilized successfully and, if not, why. This would enable pragmatic solutions to be agreed to improve the orga...

Descripción completa

Detalles Bibliográficos
Autores principales: Cases, Cécile, Gallini, Adeline, Lafont Rapnouil, Stéphanie, Bougon, Emmanuelle, Mathur, Anjali, Brismontier, Ariane, Taib, Simon, Sporer, Marie, Arbus, Christophe, Salles, Juliette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044516/
https://www.ncbi.nlm.nih.gov/pubmed/33868036
http://dx.doi.org/10.3389/fpsyt.2021.581449
_version_ 1783678503552548864
author Cases, Cécile
Gallini, Adeline
Lafont Rapnouil, Stéphanie
Bougon, Emmanuelle
Mathur, Anjali
Brismontier, Ariane
Taib, Simon
Sporer, Marie
Arbus, Christophe
Salles, Juliette
author_facet Cases, Cécile
Gallini, Adeline
Lafont Rapnouil, Stéphanie
Bougon, Emmanuelle
Mathur, Anjali
Brismontier, Ariane
Taib, Simon
Sporer, Marie
Arbus, Christophe
Salles, Juliette
author_sort Cases, Cécile
collection PubMed
description The use of relevant guidelines is critical in psychiatric clinical practice to ensure the homogeneity of the global care provided. Consequently, it is important to identify whether they are utilized successfully and, if not, why. This would enable pragmatic solutions to be agreed to improve the organization of care and the removal of any barriers to the guidelines' implementation. The first step in this process, before any exploration of the limitations of the guidelines themselves, involves a determination of whether they are actually applied in clinical practice. We therefore evaluated discrepancies between the guidelines relating to patients with borderline personality disorder and current practices in the psychiatric Emergency Department at Toulouse University Hospital. This was achieved using a reading process involving a panel of eight local experts who analyzed relevant medical files extracted from a database. They were guided by, and instructed to answer, six standardized questions in relation to each file to determine the method's feasibility. A total of 333 files were analyzed to determine whether, in the local experts' judgment, the care provided reflected current guidance. This reading process revealed substantial agreement (0.85%; Fleiss Kappa −0.69), which is a promising outcome and suggests that such methods could be used in future protocols. Moreover, the process is practical and reliable and requires very few materials.
format Online
Article
Text
id pubmed-8044516
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-80445162021-04-15 Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices Cases, Cécile Gallini, Adeline Lafont Rapnouil, Stéphanie Bougon, Emmanuelle Mathur, Anjali Brismontier, Ariane Taib, Simon Sporer, Marie Arbus, Christophe Salles, Juliette Front Psychiatry Psychiatry The use of relevant guidelines is critical in psychiatric clinical practice to ensure the homogeneity of the global care provided. Consequently, it is important to identify whether they are utilized successfully and, if not, why. This would enable pragmatic solutions to be agreed to improve the organization of care and the removal of any barriers to the guidelines' implementation. The first step in this process, before any exploration of the limitations of the guidelines themselves, involves a determination of whether they are actually applied in clinical practice. We therefore evaluated discrepancies between the guidelines relating to patients with borderline personality disorder and current practices in the psychiatric Emergency Department at Toulouse University Hospital. This was achieved using a reading process involving a panel of eight local experts who analyzed relevant medical files extracted from a database. They were guided by, and instructed to answer, six standardized questions in relation to each file to determine the method's feasibility. A total of 333 files were analyzed to determine whether, in the local experts' judgment, the care provided reflected current guidance. This reading process revealed substantial agreement (0.85%; Fleiss Kappa −0.69), which is a promising outcome and suggests that such methods could be used in future protocols. Moreover, the process is practical and reliable and requires very few materials. Frontiers Media S.A. 2021-03-31 /pmc/articles/PMC8044516/ /pubmed/33868036 http://dx.doi.org/10.3389/fpsyt.2021.581449 Text en Copyright © 2021 Cases, Gallini, Lafont Rapnouil, Bougon, Mathur, Brismontier, Taib, Sporer, Arbus and Salles. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Cases, Cécile
Gallini, Adeline
Lafont Rapnouil, Stéphanie
Bougon, Emmanuelle
Mathur, Anjali
Brismontier, Ariane
Taib, Simon
Sporer, Marie
Arbus, Christophe
Salles, Juliette
Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title_full Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title_fullStr Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title_full_unstemmed Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title_short Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices
title_sort developing and testing a local expert-based reading process for use to examine discrepancies between guidelines and current clinical practices
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044516/
https://www.ncbi.nlm.nih.gov/pubmed/33868036
http://dx.doi.org/10.3389/fpsyt.2021.581449
work_keys_str_mv AT casescecile developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT galliniadeline developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT lafontrapnouilstephanie developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT bougonemmanuelle developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT mathuranjali developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT brismontierariane developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT taibsimon developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT sporermarie developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT arbuschristophe developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices
AT sallesjuliette developingandtestingalocalexpertbasedreadingprocessforusetoexaminediscrepanciesbetweenguidelinesandcurrentclinicalpractices