FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4230304840> ?p ?o ?g. }

• W4230304840 abstract "Clinical practice is not always evidence-based and, therefore, may not optimise patient outcomes. Local opinion leaders (OLs) are individuals perceived as credible and trustworthy, who disseminate and implement best evidence, for instance through informal one-to-one teaching or community outreach education visits. The use of OLs is a promising strategy to bridge evidence-practice gaps. This is an update of a Cochrane review published in 2011.To assess the effectiveness of local opinion leaders to improve healthcare professionals' compliance with evidence-based practice and patient outcomes.We searched CENTRAL, MEDLINE, Embase, three other databases and two trials registers on 3 July 2018, together with searching reference lists of included studies and contacting experts in the field.We considered randomised studies comparing the effects of local opinion leaders, either alone or with a single or more intervention(s) to disseminate evidence-based practice, with no intervention, a single intervention, or the same single or more intervention(s). Eligible studies were those reporting objective measures of professional performance, for example, the percentage of patients being prescribed a specific drug or health outcomes, or both. We included all studies independently of the method used to identify OLs.We used standard Cochrane procedures in this review. The main comparison was (i) between any intervention involving OLs (OLs alone, OLs with a single or more intervention(s)) versus any comparison intervention (no intervention, a single intervention, or the same single or more intervention(s)). We also made four secondary comparisons: ii) OLs alone versus no intervention, iii) OLs alone versus a single intervention, iv) OLs, with a single or more intervention(s) versus the same single or more intervention(s), and v) OLs with a single or more intervention(s) versus no intervention.We included 24 studies, involving more than 337 hospitals, 350 primary care practices, 3005 healthcare professionals, and 29,167 patients (not all studies reported this information). A majority of studies were from North America, and all were conducted in high-income countries. Eighteen of these studies (21 comparisons, 71 compliance outcomes) contributed to the median adjusted risk difference (RD) for the main comparison. The median duration of follow-up was 12 months (range 2 to 30 months). The results suggested that the OL interventions probably improve healthcare professionals' compliance with evidence-based practice (10.8% absolute improvement in compliance, interquartile range (IQR): 3.5% to 14.6%; moderate-certainty evidence).Results for the secondary comparisons also suggested that OLs probably improve compliance with evidence-based practice (moderate-certainty evidence): i) OLs alone versus no intervention: RD (IQR): 9.15% (-0.3% to 15%); ii) OLs alone versus a single intervention: RD (range): 13.8% (12% to 15.5%); iii) OLs, with a single or more intervention(s) versus the same single or more intervention(s): RD (IQR): 7.1% (-1.4% to 19%); iv) OLs with a single or more intervention(s) versus no intervention: RD (IQR):10.25% (0.6% to 15.75%).It is uncertain if OLs alone, or in combination with other intervention(s), may lead to improved patient outcomes (3 studies; 5 dichotomous outcomes) since the certainty of evidence was very low. For two of the secondary comparisons, the IQR included the possibility of a small negative effect of the OL intervention. Possible explanations for the occasional negative effects are, for example, the possibility that the OLs may have prioritised some outcomes, at the expense of others, or that an unaccounted outcome difference at baseline, may have given a faulty impression of a negative effect of the intervention at follow-up. No study reported on costs or cost-effectiveness.We were unable to determine the comparative effectiveness of different approaches to identifying OLs, as most studies used the sociometric method. Nor could we determine which methods used by OLs to educate their peers were most effective, as the methods were poorly described in most studies. In addition, we could not determine whether OL teams were more effective than single OLs.Local opinion leaders alone, or in combination with other interventions, can be effective in promoting evidence-based practice, but the effectiveness varies both within and between studies.The effect on patient outcomes is uncertain. The costs and the cost-effectiveness of the intervention(s) is unknown. These results are based on heterogeneous studies differing in types of intervention, setting, and outcomes. In most studies, the role and actions of the OL were not clearly described, and we cannot, therefore, comment on strategies to enhance their effectiveness. It is also not clear whether the methods used to identify OLs are important for their effectiveness, or whether the effect differs if education is delivered by single OLs or by multidisciplinary OL teams. Further research may help us to understand how these factors affect the effectiveness of OLs." @default.
• W4230304840 created "2022-05-11" @default.
• W4230304840 creator A5021732017 @default.
• W4230304840 creator A5036700381 @default.
• W4230304840 creator A5054403907 @default.
• W4230304840 creator A5061092775 @default.
• W4230304840 date "2019-06-24" @default.
• W4230304840 modified "2023-10-16" @default.
• W4230304840 title "Local opinion leaders: effects on professional practice and healthcare outcomes" @default.
• W4230304840 cites W1482945686 @default.
• W4230304840 cites W1503806335 @default.
• W4230304840 cites W1510361671 @default.
• W4230304840 cites W1526588184 @default.
• W4230304840 cites W1540055596 @default.
• W4230304840 cites W1554040650 @default.
• W4230304840 cites W1557414191 @default.
• W4230304840 cites W1599819026 @default.
• W4230304840 cites W161312970 @default.
• W4230304840 cites W1656816330 @default.
• W4230304840 cites W1681426172 @default.
• W4230304840 cites W1766218069 @default.
• W4230304840 cites W1955119530 @default.
• W4230304840 cites W1963561122 @default.
• W4230304840 cites W1966165541 @default.
• W4230304840 cites W1966560725 @default.
• W4230304840 cites W1967535974 @default.
• W4230304840 cites W1972600468 @default.
• W4230304840 cites W1975034993 @default.
• W4230304840 cites W1980716696 @default.
• W4230304840 cites W1989007791 @default.
• W4230304840 cites W1989065277 @default.
• W4230304840 cites W1995192377 @default.
• W4230304840 cites W1997145769 @default.
• W4230304840 cites W1998162855 @default.
• W4230304840 cites W2000465062 @default.
• W4230304840 cites W2002421485 @default.
• W4230304840 cites W2002689588 @default.
• W4230304840 cites W2005507374 @default.
• W4230304840 cites W2007805366 @default.
• W4230304840 cites W2016184074 @default.
• W4230304840 cites W2019917555 @default.
• W4230304840 cites W2021956474 @default.
• W4230304840 cites W2023548214 @default.
• W4230304840 cites W2024969156 @default.
• W4230304840 cites W2027114552 @default.
• W4230304840 cites W2028208439 @default.
• W4230304840 cites W2029072497 @default.
• W4230304840 cites W2029853326 @default.
• W4230304840 cites W2036369627 @default.
• W4230304840 cites W2038028146 @default.
• W4230304840 cites W2041480924 @default.
• W4230304840 cites W2045194019 @default.
• W4230304840 cites W2046839105 @default.
• W4230304840 cites W2046997364 @default.
• W4230304840 cites W2050437615 @default.
• W4230304840 cites W2052012471 @default.
• W4230304840 cites W2052964932 @default.
• W4230304840 cites W2054273968 @default.
• W4230304840 cites W2055877249 @default.
• W4230304840 cites W2058681112 @default.
• W4230304840 cites W2058788916 @default.
• W4230304840 cites W2060534090 @default.
• W4230304840 cites W2066974146 @default.
• W4230304840 cites W2069612613 @default.
• W4230304840 cites W2071344904 @default.
• W4230304840 cites W2074985728 @default.
• W4230304840 cites W2075986339 @default.
• W4230304840 cites W2076810064 @default.
• W4230304840 cites W2077160739 @default.
• W4230304840 cites W2081243369 @default.
• W4230304840 cites W2082371264 @default.
• W4230304840 cites W2082391887 @default.
• W4230304840 cites W2092364837 @default.
• W4230304840 cites W2093641991 @default.
• W4230304840 cites W2093947496 @default.
• W4230304840 cites W2098871492 @default.
• W4230304840 cites W2098923148 @default.
• W4230304840 cites W2100402441 @default.
• W4230304840 cites W2104481453 @default.
• W4230304840 cites W2105501846 @default.
• W4230304840 cites W2107709347 @default.
• W4230304840 cites W2108628735 @default.
• W4230304840 cites W2108660596 @default.
• W4230304840 cites W2108930654 @default.
• W4230304840 cites W2110237364 @default.
• W4230304840 cites W2112488537 @default.
• W4230304840 cites W2112790162 @default.
• W4230304840 cites W2113235638 @default.
• W4230304840 cites W2119417456 @default.
• W4230304840 cites W2123722128 @default.
• W4230304840 cites W2124136628 @default.
• W4230304840 cites W2126260477 @default.
• W4230304840 cites W2128121045 @default.
• W4230304840 cites W2131908953 @default.
• W4230304840 cites W2135826537 @default.
• W4230304840 cites W2138687551 @default.
• W4230304840 cites W2139350388 @default.
• W4230304840 cites W2140144472 @default.
• W4230304840 cites W2140191362 @default.
• W4230304840 cites W2142149055 @default.

• next