Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 4, 2019
Date Accepted: May 14, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Impact of GRASP Framework on Clinicians and Healthcare Professionals’ Decisions in Selecting Clinical Predictive Tools
ABSTRACT
Background:
When selecting predictive tools, for implementation in clinical practice or for recommendation in clinical guidelines, clinicians and healthcare professionals are challenged with an overwhelming number of tools. Many of these tools have never been implemented or evaluated for comparative effectiveness. To overcome this challenge, the authors developed and validated an evidence-based framework for grading and assessment of predictive tools (The GRASP Framework), based on the critical appraisal of the published evidence on such tools.
Objective:
To examine the impact of using GRASP on clinicians and healthcare professionals’ decisions in selecting clinical predictive tools.
Methods:
A controlled experiment was conducted through an online survey. Through randomising two different groups of predictive tools and two scenarios; participants were asked to select the best tools; the most validated or implemented, with and without using the GRASP framework. A wide group of international clinicians and healthcare professionals were invited to take the survey. Task completion time, rate of correct decisions, rate of objective versus subjective decisions, and level of decisional conflict were measured.
Results:
Valid responses received were 194. Compared to not using GRASP, using the framework significantly increased correct decisions by 64% (T=8.53, p<0.001), increased objective decision making by 32% (T=9.24, p<0.001), and decreased subjective decision making; based on guessing and based on prior knowledge or experience, by 20% (T=-5.47, p<0.001) and 8% (T=-2.99, p=0.003) respectively. Using GRASP significantly decreased decisional conflict; increasing confidence and satisfaction of participants with their decisions by 11% (T=4.27, p<0.001) and 13% (T=4.89, p<0.001) respectively. Using GRASP decreased task completion time by 52% (T=-0.87, p=0.384). The average system usability scale of GRASP framework was very good; 72.5%, and 88% of participants found GRASP useful.
Conclusions:
Using GRASP has positively supported and significantly improved evidence-based decision making and increased accuracy and efficiency of selecting predictive tools. GRASP is not meant to be prescriptive; it represents a high-level approach and an effective, evidence-based, and comprehensive, yet simple and feasible, method to evaluate, compare, and select clinical predictive tools. Clinical Trial: Not Applicable
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