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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
176 to 200 of 364 Research Studies DisplayedTrent SA, Johnson MA, Morse EA
Patient, provider, and environmental factors associated with adherence to cardiovascular and cerebrovascular clinical practice guidelines in the ED.
The primary objectives of this study were to estimate differences in emergency department (ED) adherence across coronary-related clinical practice guidelines (CPGs) and identify patient, provider, and environmental factors associated with adherence. The investigators found that adherence to ED CPGs for acute coronary syndrome, ST-elevation myocardial infarction, or acute ischemic stroke, differs significantly between cardiovascular and cerebrovascular diseases and is more likely to occur when the diagnosis is highly suggested by the patient's complaint and acknowledged as the primary diagnosis by the treating ED physician.
AHRQ-funded; HS022400.
Citation: Trent SA, Johnson MA, Morse EA .
Patient, provider, and environmental factors associated with adherence to cardiovascular and cerebrovascular clinical practice guidelines in the ED.
Am J Emerg Med 2018 Aug;36(8):1397-404. doi: 10.1016/j.ajem.2017.12.062..
Keywords: Cardiovascular Conditions, Emergency Department, Guidelines, Practice Patterns
Rhee C, Brown SR, Jones TM
Variability in determining sepsis time zero and bundle compliance rates for the Centers for Medicare and Medicaid services SEP-1 measure.
This study compared sepsis ‘time zero’ and CMS SEP-1 pass rates among 3 abstractors in 3 hospitals. Abstractors agreed on time zero in 29 out of 80 cases, and the perceived pass rates ranged from 9 to 19 out of 80 cases (23%). The authors conclude that this variability in time zero and perceived pass rates limits the utility of SEP-1 for measuring quality.
AHRQ-funded; HS025008.
Citation: Rhee C, Brown SR, Jones TM .
Variability in determining sepsis time zero and bundle compliance rates for the Centers for Medicare and Medicaid services SEP-1 measure.
Infect Control Hosp Epidemiol 2018 Aug;39(8):994-96. doi: 10.1017/ice.2018.134..
Keywords: Guidelines, Quality of Care, Quality Measures, Sepsis
Sittig DF, Salimi M, Aiyagari R
Adherence to recommended electronic health record safety practices across eight health care organizations.
The Safety Assurance Factors for EHR Resilience (SAFER) guides were released in 2014 to help health systems conduct proactive risk assessment of electronic health record (EHR)- safety related policies, processes, procedures, and configurations. This study examined the extent to which SAFER recommendations are followed. The study concluded that despite availability of recommendations on how to improve use of EHRs, most recommendations were not fully implemented. New national policy initiatives are needed to stimulate implementation of these best practices.
AHRQ-funded; HS024459; HS022087; HS023602.
Citation: Sittig DF, Salimi M, Aiyagari R .
Adherence to recommended electronic health record safety practices across eight health care organizations.
J Am Med Inform Assoc 2018 Jul;25(7):913-18. doi: 10.1093/jamia/ocy033..
Keywords: Electronic Health Records (EHRs), Guidelines, Health Information Technology (HIT), Patient Safety, Provider
Leyenaar JK, Shevenell M, Rizzo PA
Multi-stakeholder informed guidelines for direct admission of children to hospital.
The purpose of this study is to develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. The investigators concluded that these direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Shevenell M, Rizzo PA .
Multi-stakeholder informed guidelines for direct admission of children to hospital.
J Pediatr 2018 Jul;198:273-78.e7. doi: 10.1016/j.jpeds.2018.03.007..
Keywords: Children/Adolescents, Guidelines, Hospitalization, Hospitals, Patient Safety
Kanters AE, Morris AM, Albrahamse PH
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
AHRQ-funded; HS000053.
Citation: Kanters AE, Morris AM, Albrahamse PH .
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067..
Keywords: Cancer: Colorectal Cancer, Treatments, Guidelines, Medication, Patient Adherence/Compliance
Egan BM, Li J, Davis RA
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. This article discusses differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
AHRQ-funded; P30 HS021667.
Citation: Egan BM, Li J, Davis RA .
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
J Clin Hypertens 2018 Jun;20(6):991-1000. doi: 10.1111/jch.13314..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Guidelines, Blood Pressure, Medication, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Greenhawt M, Chan ES, Fleischer DM
Caregiver and expecting caregiver support for early peanut introduction guidelines.
This study investigates caregiver preferences for early peanut introduction (EPI) recommendations. The study concluded that among new and expecting caregivers, there is poor current willingness and questionable support for early allergenic solid food recommendations, including in-office allergy risk assessment before introduction. Willingness was better among expecting vs current caregivers.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Chan ES, Fleischer DM .
Caregiver and expecting caregiver support for early peanut introduction guidelines.
Ann Allergy Asthma Immunol 2018 Jun;120(6):620-25. doi: 10.1016/j.anai.2018.03.001..
Keywords: Caregiving, Children/Adolescents, Guidelines, Newborns/Infants, Patient-Centered Outcomes Research
Engelgau MM, Narayan KMV, Ezzati M
AHRQ Author: Meyers D
Implementation research to address the United States health disadvantage: report of a National Heart, Lung, and Blood Institute workshop.
This paper discusses the meeting of a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders, convened by the National Heart, Lung, and Blood Institute.
AHRQ-authored.
Citation: Engelgau MM, Narayan KMV, Ezzati M .
Implementation research to address the United States health disadvantage: report of a National Heart, Lung, and Blood Institute workshop.
Glob Heart 2018 Jun;13(2):65-72. doi: 10.1016/j.gheart.2018.03.003.
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Keywords: Cardiovascular Conditions, Guidelines, Research Methodologies
Villani J, Ngo-Metzger Q, Vincent IS
AHRQ Author: Ngo-Metzger Q
Sources of funding for research in evidence reviews that inform recommendations of the US Preventive Services Task Force.
This study characterizes the sources of funding for the scientific evidence base used by the USPSTF. One or more funding sources were identified for 79 percent of the 1,650 research articles. Government agencies provided support for 931 articles (56 percent). The remaining support came from nonprofits or universities (530 articles, 32 percent) and industry (282 articles, 17 percent).The sources of funding varied by recommendation topic.
AHRQ-authored.
Citation: Villani J, Ngo-Metzger Q, Vincent IS .
Sources of funding for research in evidence reviews that inform recommendations of the US Preventive Services Task Force.
JAMA 2018 May 22;319(20):2132-33. doi: 10.1001/jama.2018.5404.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Research Methodologies, U.S. Preventive Services Task Force (USPSTF)
Klara K, Kim J, Ross JS
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
Direct-to-consumer (DTC) advertisements for prescription drugs in the United States are regulated by the Food and Drug Administration (FDA). Off-label promotion, or the advertisement of a drug for an indication not approved by the FDA, is prohibited. The objective of this study was to examine the presence of off-label promotion in broadcast DTC ads and to assess their adherence to FDA guidelines mandating fair balance in presentation of risks and benefits and prohibiting misleading advertisement claims.
AHRQ-funded; HS022882.
Citation: Klara K, Kim J, Ross JS .
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
J Gen Intern Med 2018 May;33(5):651-58. doi: 10.1007/s11606-017-4274-9..
Keywords: Medication, Guidelines, Policy, Communication
Wiesenthal AC, Patel SP, LeBlanc TW
Top ten tips for palliative care clinicians caring for cancer patients receiving immunotherapies.
In this study, the investigators aim to further engage palliative care specialists in the active care of cancer patients receiving immunotherapeutics and use a "Top 10" tips format to concisely present practical learning points to busy clinicians.
AHRQ-funded; HS023681.
Citation: Wiesenthal AC, Patel SP, LeBlanc TW .
Top ten tips for palliative care clinicians caring for cancer patients receiving immunotherapies.
J Palliat Med 2018 May;21(5):694-99. doi: 10.1089/jpm.2018.0107..
Keywords: Palliative Care, Cancer, Guidelines
Gilmore-Bykovskyi A, Johnson R, Walljasper L
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. Findings suggested limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. In order to ensure NIH guideline compliance, shared investments from researchers, editors, and reviewers to make certain that group differences are systematically identified and reported are recommended.
AHRQ-funded; HS022548.
Citation: Gilmore-Bykovskyi A, Johnson R, Walljasper L .
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
Am J Alzheimers Dis Other Demen 2018 May;33(3):145-52. doi: 10.1177/1533317517749465..
Keywords: Caregiving, Sex Factors, Racial and Ethnic Minorities, Guidelines, Dementia, Disparities
Hoffman AS, Sepucha KR, Abhyankar P
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
This Explanation and Elaboration article expands on the 26 items in the SUNDAE guidelines, providing a rationale for each item, and including examples for how each item has been reported in published papers evaluating patient decision aids. Authors and reviewers may wish to use it broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.
AHRQ-funded; HS024250.
Citation: Hoffman AS, Sepucha KR, Abhyankar P .
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
BMJ Qual Saf 2018 May;27(5):389-412. doi: 10.1136/bmjqs-2017-006985..
Keywords: Decision Making, Guidelines, Patient-Centered Healthcare, Patient and Family Engagement, Quality of Care
Hoffman AS, Sepucha KR, Abhyankar P
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
This Explanation and Elaboration article expands on the 26 items in the SUNDAE guidelines, providing a rationale for each item, and including examples for how each item has been reported in published papers evaluating patient decision aids. Authors and reviewers may wish to use it broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.
AHRQ-funded; HS024250.
Citation: Hoffman AS, Sepucha KR, Abhyankar P .
Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.
BMJ Qual Saf 2018 May;27(5):389-412. doi: 10.1136/bmjqs-2017-006985..
Keywords: Decision Making, Guidelines, Patient-Centered Healthcare, Patient and Family Engagement, Quality of Care
MacLaughlin KL, Kessler ME, Komandur Elayavilli R
Impact of patient reminders on Papanicolaou test completion for high-risk patients identified by a clinical decision support system.
The researchers aimed to assess the effect of a complex clinical decision support system, incorporating national guidelines for high-risk patient screening and abnormal result management. They found that the average completion rate of recommended follow-up testing was significantly higher in the intervention group at 23.7 percent than the completion rate at 3.3 percent in the control group.
AHRQ-funded; HS022911.
Citation: MacLaughlin KL, Kessler ME, Komandur Elayavilli R .
Impact of patient reminders on Papanicolaou test completion for high-risk patients identified by a clinical decision support system.
J Womens Health 2018 May;27(5):569-74. doi: 10.1089/jwh.2017.6667.
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Keywords: Cancer, Clinical Decision Support (CDS), Guidelines, Health Information Technology (HIT)
Velopulos CG, Shihab HM, Lottenberg L
Prehospital spine immobilization/spinal motion restriction in penetrating trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma (EAST).
This study reviewed the published evidence on prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma in order to structure a practice management guideline. Using a Cochrane-style systematic review, 24 studies met inclusion criteria; five studies were used for the quantitative review. No study showed benefit to spine immobilization with regard to mortality and neurologic injury, even for patients with direct neck injuries. Increased mortality was associated with spine immobilization. The authors recommend that spine immobilization not be routinely used for adult patients with penetrating trauma.
AHRQ-funded; HS024547.
Citation: Velopulos CG, Shihab HM, Lottenberg L .
Prehospital spine immobilization/spinal motion restriction in penetrating trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma (EAST).
J Trauma Acute Care Surg 2018 May;84(5):736-44. doi: 10.1097/ta.0000000000001764..
Keywords: Care Management, Emergency Medical Services (EMS), Evidence-Based Practice, Guidelines, Trauma
Sepucha KR, Abhyankar P, Hoffman AS
Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.
This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating patient decision aids (PDAs). The study concluded that the SUNDAE (Standards for UNiversal reporting of patient Decision Aid Evaluations) Checklist will help ensure that reports of PDA evaluation studies are understandable, transparent and of high quality.
AHRQ-funded; HS024250.
Citation: Sepucha KR, Abhyankar P, Hoffman AS .
Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.
BMJ Qual Saf 2018 May;27(5):380-88. doi: 10.1136/bmjqs-2017-006986..
Keywords: Communication, Decision Making, Education: Patient and Caregiver, Evidence-Based Practice, Guidelines, Health Literacy, Patient-Centered Healthcare
Armstrong MJ, Mullins CD, Gronseth GS
Impact of patient involvement on clinical practice guideline development: a parallel group study.
The aim of this study was to investigate the effect of patient and public involvement (PPI) on guideline question formation and validate a conceptual model of patient and public contributions to guidelines. The qualitative analysis of the discussions occurring during guideline question development demonstrated key differences in group conduct and validated the proposed conceptual model of patient and public contributions to guidelines.
AHRQ-funded; HS024159; HS022135.
Citation: Armstrong MJ, Mullins CD, Gronseth GS .
Impact of patient involvement on clinical practice guideline development: a parallel group study.
Implement Sci 2018 Apr 16;13(1):55. doi: 10.1186/s13012-018-0745-6.
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Keywords: Evidence-Based Practice, Guidelines, Patient and Family Engagement, Patient-Centered Outcomes Research, Research Methodologies
Swaminathan L, Flanders S, Rogers M
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
This study tested whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve inappropriate peripherally inserted central catheter (PICC) use and patient outcomes. It concluded that, in a multihospital quality improvement project, implementation of MAGIC improved PICC appropriateness and reduced complications to a modest extent.
AHRQ-funded; HS022835.
Citation: Swaminathan L, Flanders S, Rogers M .
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
BMJ Qual Saf 2018 Apr;27(4):271-78. doi: 10.1136/bmjqs-2017-007342.
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Keywords: Adverse Events, Guidelines, Hospitalization, Patient-Centered Outcomes Research, Quality Improvement
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines
Henrikson NB, Morrison CC, Blasi PR
Behavioral counseling for skin cancer prevention: evidence report and systematic review for the US Preventive Services Task Force.
The authors systematically reviewed the evidence on the benefits and harms of behavioral counseling for skin cancer prevention to inform the US Preventive Services Task Force (USPSTF). They concluded that behavioral interventions can increase sun protection behavior, but there is no consistent evidence that interventions are associated with a reduction in the frequency of sunburn in children or adults and minimal evidence on skin cancer outcomes.
AHRQ-funded; 290201500007I.
Citation: Henrikson NB, Morrison CC, Blasi PR .
Behavioral counseling for skin cancer prevention: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Mar 20;319(11):1143-57. doi: 10.1001/jama.2017.21630.
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Keywords: Cancer, Cancer: Skin Cancer, Evidence-Based Practice, Guidelines, Prevention, U.S. Preventive Services Task Force (USPSTF)
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Howard R, Waljee J, Brummett C
Reduction in opioid prescribing through evidence-based prescribing guidelines.
The authors evaluated the effect of evidence-based postoperative prescribing guidelines in an effort to reduce overprescribing. The post-intervention group received opioid prescriptions for reduced dosages compared to the pre-intervention group. In the post-intervention group, 2.5% requested refills compared with 4.1% in the pre-intervention group. The authors indicated that this work will be used as a template for statewide practice transformation, which may serve as a platform for other states.
AHRQ-funded; HS023313.
Citation: Howard R, Waljee J, Brummett C .
Reduction in opioid prescribing through evidence-based prescribing guidelines.
JAMA Surg 2018 Mar;153(3):285-87. doi: 10.1001/jamasurg.2017.4436.
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Keywords: Evidence-Based Practice, Guidelines, Opioids, Practice Patterns, Surgery
Henderson JT, Webber EM, Sawaya GF
Screening for ovarian cancer: Updated evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed evidence on benefits and harms of ovarian cancer screening among average-risk women to inform the United States Preventive Services Task Force. They concluded that, in randomized trials conducted among average-risk, asymptomatic women, ovarian cancer mortality did not significantly differ between screened women and those with no screening or in usual care.
AHRQ-funded; 290201500007I.
Citation: Henderson JT, Webber EM, Sawaya GF .
Screening for ovarian cancer: Updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Feb 13;319(6):595-606. doi: 10.1001/jama.2017.21421.
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Keywords: Evidence-Based Practice, Guidelines, Cancer: Ovarian Cancer, Screening, U.S. Preventive Services Task Force (USPSTF)
Armstrong MJ, Gronseth GS
Approach to assessing and using clinical practice guidelines.
Knowing when to use guidelines in clinical practice requires neurologists to assess the rigor of published guidelines. This review briefly describes guideline definitions and the American Academy of Neurology process for guideline development, outlines key elements for assessing guideline quality, and details a practical approach for incorporating guideline recommendations when partnering with patients in shared decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS .
Approach to assessing and using clinical practice guidelines.
Neurol Clin Pract 2018 Feb;8(1):58-61. doi: 10.1212/cpj.0000000000000417.
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Keywords: Decision Making, Evidence-Based Practice, Guidelines, Patient and Family Engagement, Implementation