Making Clinical Practice Guidelines Pragmatic: How Big Data and Real World Evidence Can Close the Gap.

Making Clinical Practice Guidelines Pragmatic: How Big Data and Real World Evidence Can Close the Gap. Ann Acad Med Singapore. 2018 Dec;47(12):523-527 Authors: Chew SY, Koh MS, Loo CM, Thumboo J, Shantakumar S, Matchar DB Abstract Clinical practice guidelines (CPGs) have become ubiquitous in every field of medicine today but there has been limited success in implementation and improvement in health outcomes. Guidelines are largely based on the results of traditional randomised controlled trials (RCTs) which adopt a highly selective process to maximise the intervention's chance of demonstrating efficacy thus having high internal validity but lacking external validity. Therefore, guidelines based on these RCTs often suffer from a gap between trial efficacy and real world effectiveness and is one of the common reasons contributing to poor guideline adherence by physicians. "Real World Evidence" (RWE) can complement RCTs in CPG development. RWE-in the form of data from integrated electronic health records-represents the vast and varied collective experience of frontline doctors and patients. RWE has the potential to fill the gap in current guidelines by balancing information about whether a test or treatment works (efficacy) with data on how it works in real world practice (effectiveness). RWE can also advance the agenda of precision medicine in everyday practice by engaging frontline stakeholders in pragmatic biomarker studies. This wil...
Source: Annals of the Academy of Medicine, Singapore - Category: General Medicine Authors: Tags: Ann Acad Med Singapore Source Type: research