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The European society of human reproduction and embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal

Lotte JEW van Dijk, Willianne LDM Nelen, Thomas M D'Hooghe, Gerard AJ Dunselman, Rosella PMG Hermens, Christina Bergh, Karl G Nygren, Arnold HM Simons, Petra De Sutter UGent, Catherine Marshall, et al. (2011) IMPLEMENTATION SCIENCE. 6.
abstract
Background: Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological quality has been assessed. To improve the impact of the ESHRE guidelines and to improve European subfertility care, it is important to optimise the implementability of guidelines. We therefore investigated the implementation barriers of the ESHRE guideline with the best methodological quality and evaluated the used instrument for usability and feasibility. Methods: We reviewed the ESHRE guideline for the diagnosis and treatment of endometriosis to assess its implementability. We used an electronic version of the guideline implementability appraisal (eGLIA) instrument. This eGLIA tool consists of 31 questions grouped into 10 dimensions. Seven items address the guideline as a whole, and 24 items assess the individual recommendations in the guideline. The eGLIA instrument identifies factors that influence the implementability of the guideline recommendations. These factors can be divided into facilitators that promote implementation and barriers that oppose implementation. A panel of 10 experts from three European countries appraised all 36 recommendations of the guideline. They discussed discrepancies in a teleconference and completed a questionnaire to evaluate the ease of use and overall utility of the eGLIA instrument. Results: Two of the 36 guideline recommendations were straightforward to implement. Five recommendations were considered simply statements because they contained no actions. The remaining 29 recommendations were implementable with some adjustments. We found facilitators of the guideline implementability in the quality of decidability, presentation and formatting, apparent validity, and novelty or innovation of the recommendations. Vaguely defined actions, lack of facilities, immeasurable outcomes, and inflexibility within the recommendations formed barriers to implementation. The eGLIA instrument was generally useful and easy to use. However, assessment with the eGLIA instrument is very time-consuming. Conclusions: The ESHRE guideline for the diagnosis and treatment of endometriosis could be improved to facilitate its implementation in daily practice. The eGLIA instrument is a helpful tool for identifying obstacles to implementation of a guideline. However, we recommend a concise version of this instrument.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
SUBFERTILITY, INTERVENTIONS, CARE, QUALITY, CLINICAL-PRACTICE GUIDELINES, SYSTEMATIC REVIEWS, MANAGEMENT, ESHRE, GAP
journal title
IMPLEMENTATION SCIENCE
Implement. Sci.
volume
6
article number
7
pages
8 pages
Web of Science type
Article
Web of Science id
000287140200001
JCR category
HEALTH POLICY & SERVICES
JCR impact factor
3.1 (2011)
JCR rank
4/61 (2011)
JCR quartile
1 (2011)
ISSN
1748-5908
DOI
10.1186/1748-5908-6-7
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1246393
handle
http://hdl.handle.net/1854/LU-1246393
date created
2011-05-29 16:29:41
date last changed
2016-12-21 15:42:20
@article{1246393,
  abstract     = {Background: Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological quality has been assessed. To improve the impact of the ESHRE guidelines and to improve European subfertility care, it is important to optimise the implementability of guidelines. We therefore investigated the implementation barriers of the ESHRE guideline with the best methodological quality and evaluated the used instrument for usability and feasibility. Methods: We reviewed the ESHRE guideline for the diagnosis and treatment of endometriosis to assess its implementability. We used an electronic version of the guideline implementability appraisal (eGLIA) instrument. This eGLIA tool consists of 31 questions grouped into 10 dimensions. Seven items address the guideline as a whole, and 24 items assess the individual recommendations in the guideline. The eGLIA instrument identifies factors that influence the implementability of the guideline recommendations. These factors can be divided into facilitators that promote implementation and barriers that oppose implementation. A panel of 10 experts from three European countries appraised all 36 recommendations of the guideline. They discussed discrepancies in a teleconference and completed a questionnaire to evaluate the ease of use and overall utility of the eGLIA instrument. Results: Two of the 36 guideline recommendations were straightforward to implement. Five recommendations were considered simply statements because they contained no actions. The remaining 29 recommendations were implementable with some adjustments. We found facilitators of the guideline implementability in the quality of decidability, presentation and formatting, apparent validity, and novelty or innovation of the recommendations. Vaguely defined actions, lack of facilities, immeasurable outcomes, and inflexibility within the recommendations formed barriers to implementation. The eGLIA instrument was generally useful and easy to use. However, assessment with the eGLIA instrument is very time-consuming. Conclusions: The ESHRE guideline for the diagnosis and treatment of endometriosis could be improved to facilitate its implementation in daily practice. The eGLIA instrument is a helpful tool for identifying obstacles to implementation of a guideline. However, we recommend a concise version of this instrument.},
  articleno    = {7},
  author       = {van Dijk, Lotte JEW and Nelen, Willianne LDM and D'Hooghe, Thomas M and Dunselman, Gerard AJ and Hermens, Rosella PMG and Bergh, Christina and Nygren, Karl G and Simons, Arnold HM and De Sutter, Petra and Marshall, Catherine and Burgers, Jako S and Kremer, Jan AM},
  issn         = {1748-5908},
  journal      = {IMPLEMENTATION SCIENCE},
  keyword      = {SUBFERTILITY,INTERVENTIONS,CARE,QUALITY,CLINICAL-PRACTICE GUIDELINES,SYSTEMATIC REVIEWS,MANAGEMENT,ESHRE,GAP},
  language     = {eng},
  pages        = {8},
  title        = {The European society of human reproduction and embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal},
  url          = {http://dx.doi.org/10.1186/1748-5908-6-7},
  volume       = {6},
  year         = {2011},
}

Chicago
van Dijk, Lotte JEW, Willianne LDM Nelen, Thomas M D’Hooghe, Gerard AJ Dunselman, Rosella PMG Hermens, Christina Bergh, Karl G Nygren, et al. 2011. “The European Society of Human Reproduction and Embryology Guideline for the Diagnosis and Treatment of Endometriosis: An Electronic Guideline Implementability Appraisal.” Implementation Science 6.
APA
van Dijk, L. J., Nelen, W. L., D’Hooghe, T. M., Dunselman, G. A., Hermens, R. P., Bergh, C., Nygren, K. G., et al. (2011). The European society of human reproduction and embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal. IMPLEMENTATION SCIENCE, 6.
Vancouver
1.
van Dijk LJ, Nelen WL, D’Hooghe TM, Dunselman GA, Hermens RP, Bergh C, et al. The European society of human reproduction and embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal. IMPLEMENTATION SCIENCE. 2011;6.
MLA
van Dijk, Lotte JEW, Willianne LDM Nelen, Thomas M D’Hooghe, et al. “The European Society of Human Reproduction and Embryology Guideline for the Diagnosis and Treatment of Endometriosis: An Electronic Guideline Implementability Appraisal.” IMPLEMENTATION SCIENCE 6 (2011): n. pag. Print.