Dissemination and implementation analysis of the Ross procedure in adults: time to update the guidelines?
Dissemination and implementation analysis of the Ross procedure in adults: time to update the guidelines?
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DOI：
10.1186/s43057-023-00119-5
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发表时间：
2023
影响因子：
--
通讯作者：
Burke CR
中科院分区：
文献类型：
--
作者：
Bilodeau KS;Mauchley DC;DeRoo S;Burke CR
传播与实施科学（D&I）旨在通过解决将研究和循证实践纳入常规临床实践的挑战，提高护理的质量和有效性。D&I的这一视角对数据的解释和整合提出了挑战，指出特定治疗的失败可能并不反映缺乏疗效，而是反映了实施的不完善。本文的目的是回顾罗斯程序的历史背景对其D&I的影响。Ross手术的背景基线是从该手术在文献中的原始描述到自2017年瓣膜病指南以来的主要出版物中定义的。D&I评估使用实施研究统一框架（CFIR）进行，使用来自五个各自领域的结构来定义主要决定因素。五个CFIR领域中的每一个似乎都与影响Ross手术热情和接受程度的不同历史的因素相关。Ross的复杂性需要适应优化，中心体积与结果有很强的相关性，在非当代研究中没有考虑到这一点。这些研究后来发表的结果影响了主动脉外科社区的社会和文化背景，并导致进一步的组织不确定性，导致指南纳入缓慢。Ross手术的D&I是由于对技术复杂性、患者选择的影响和复杂的主动脉手术经验的认识不足，导致由于对有效性的误解而忽视了有效的手术。
The science of dissemination and implementation (D&I) aims to improve the quality and effectiveness of care by addressing the challenges of incorporating research and evidence-based practice into routine clinical practice. This lens of D&I has challenged the interpretation and incorporation of data, noting that failure of a given therapy may not reflect lack of efficacy, but instead reflect an imperfect implementation. The aim of this manuscript is to review the influence of the Ross procedure’s historical context on its D&I. A contextual baseline of the Ross procedure was defined from the procedure’s original description in the literature to major publications since the 2017 valvular heart disease guidelines. D&I evaluation was conducted using the Consolidated Framework for Implementation Research (CFIR), using constructs from each of the five respective domains to define the main determinants. Each of the five CFIR domains appears to be correlated with a factor influencing the Ross procedure’s varied history of enthusiasm and acceptance. The complex nature of Ross required adaptation for optimization, with a strong correlation of center volume on outcomes that were not considered in non-contemporary studies. Outcomes later published from those studies influenced social and cultural contexts within the aortic surgery community, and led to further organizational uncertainty, resulting in slow guideline incorporation. The D&I of the Ross procedure was a result of inadequate appreciation of technical complexity, effect of patient selection, and complex aortic surgery experience, resulting in dismissal of an efficacious procedure due to a misunderstanding of effectiveness.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
5.7
作者：
Oxenham, H;Bloomfield, P;Miller, HC
通讯作者：
Miller, HC
影响因子：
6.2
作者：
Appoo, Jehangir J.;Bozinovski, John;Boodhwani, Munir
通讯作者：
Boodhwani, Munir
影响因子：
12.7
作者：
Glasgow, Russell E.;Vinson, Cynthia;Hunter, Christine
通讯作者：
Hunter, Christine
影响因子：
158.5
作者：
Goldstone, Andrew B.;Chiu, Peter;Woo, Y. Joseph
通讯作者：
Woo, Y. Joseph