Centre for Outcomes Research and Effectiveness, Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Implement Sci. 2009 Aug 5;4:48. doi: 10.1186/1748-5908-4-48.
Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making.
A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis.
Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG.
This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.
多学科指南制定小组（GDG）对英国的医疗保健政策和实践有很大的影响，但先前的研究表明，研究证据对 GDG 建议的影响是可变的。设立证据到建议（EiR）研究的目的是记录对 GDG 决策有影响的社会心理因素。在本文中，我们旨在评估现有的定性方法对于 EiR 研究的相关性，并开发一种最适合捕捉 GDG 决策影响的方法。
一个由三名博士后研究员和一个多学科指导小组组成的研究团队评估了现有的定性方法对于编码 GDG 会议记录和与 GDG 成员进行半结构化访谈的有用性。开发了一种独特的技术配置，以允许数据减少和分析。
我们的方法结合了主题分析、扎根理论分析、内容分析和框架分析的技术。对 GDG 过程开始和结束时与小组成员进行的个别访谈的主题分析定义了离散的问题领域，以指导从 GDG 会议记录中提取数据。使用来自决策、社会影响和群体过程理论的概念，对数据片段进行归纳和演绎编码。这些代码为框架分析提供了信息，以描述和解释 GDG 会议中的事件。我们通过讨论国家卫生与临床优化研究所（NICE）急性身体健康 GDG 研究的一些初步发现来说明该方法的应用。
该方法目前正在应用于 NICE GDG 的三次会议研究。这些会议涵盖了急性身体健康、心理健康和公共卫生等主题，共包括 45 次全天会议。该方法有可能适用于其他医疗保健和决策群体。
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