Arduous implementation: Does the Normalisation Process Model explain why it's so difficult to embed decision support technologies for patients in routine clinical practice
Open accessAbstract
BACKGROUND: Decision support technologies (DSTs, also known as decision aids) help patients and professionals take part in collaborative decision-making processes. Trials have shown favorable impacts on patient knowledge, satisfaction, decisional conflict and confidence. However, they have not become routinely embedded in health care settings. Few studies have approached this issue using a theoretical framework. We explained problems of implementing DSTs using the Normalization Process Model, a conceptual model that focuses attention on how complex interventions become routinely embedded in practice. METHODS: The Normalization Process Model was used as the basis of conceptual analysis of the outcomes of previous primary research and reviews. Using a virtual working environment we applied the model and its main concepts to examine: the 'workability' of DSTs in professional-patient interactions; how DSTs affect knowledge relations between their users; how DSTs impact on users' skills and performance; and the impact of DSTs on the allocation of organizational resources. RESULTS: A conceptual analysis using the Normalization Process Model provided insight on implementation problems for DSTs in routine settings. Current research focuses mainly on the interactional workability of these technologies, but factors related to divisions of labor and health care, and the organizational contexts in which DSTs are used, are poorly described and understood. CONCLUSION: The model successfully provided a framework for helping to identify factors that promote and inhibit the implementation of DSTs in healthcare and gave us insights into factors influencing the introduction of new technologies into contexts where negotiations are characterized by asymmetries of power and knowledge. Future research and development on the deployment of DSTs needs to take a more holistic approach and give emphasis to the structural conditions and social norms in which these technologies are enacted.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
NPT has been used to explain the success or failure of a range of eHealth implementations.
“NPT has been used to explain the success or failure of a range of eHealth implementations [115-117]”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [115]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Rogers, E. M., Singhal, A., & Quinlan, M. M. (2019) · Routledge eBooks · doi:10.4324/9780203710753-35 · Cited by 37,557 · see citing works
The Discovery of Grounded Theory: Strategies for Qualitative Research
Glaser, B. G., & Strauss, A. L. (2017) · Aldine (Routledge reprint) · doi:10.4324/9780203793206 · Cited by 25,789 · see citing works
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
GREENHALGH, T., ROBERT, G., MACFARLANE, F., BATE, P., & KYRIAKIDOU, O. (2004) · The Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00325.x · Cited by 7,448 · see citing works
Decision aids for people facing health treatment or screening decisions
Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001431.pub5 · Cited by 6,685 · see citing works
Self-citationA meta-analysis of the technology acceptance model
King, W. R., & He, J. (2006) · Information & Management · doi:10.1016/j.im.2006.05.003 · Cited by 2,906 · see citing works
Elwyn, G. (2006) · BMJ · doi:10.1136/bmj.38926.629329.ae · Cited by 1,824 · see citing works
Self-citationValidation of a Decision Regret Scale
Brehaut, J., O'Connor, A. M. C., Wood, T. J., Hack, T. F., Siminoff, L. A., Gordon, E. J., & Feldman‐Stewart, D. (2003) · Medical Decision Making · doi:10.1177/0272989x03256005 · Cited by 1,465 · see citing works
Medical Innovation: A Diffusion Study.
Mechanic, D., Coleman, J. S., Katz, E., & Menzel, H. (1967) · American Sociological Review · doi:10.2307/2091036 · Cited by 1,383 · see citing works
A Review of the Predictors, Linkages, and Biases in IT Innovation Adoption Research
Jeyaraj, A., Rottman, J. W., & Lacity, M. C. (2006) · Journal of Information Technology · doi:10.1057/palgrave.jit.2000056 · Cited by 1,136 · see citing works
Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives
GROL, R. P. T. M., BOSCH, M. C., HULSCHER, M. E. J. L., ECCLES, M. P., & WENSING, M. (2007) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2007.00478.x · Cited by 943 · see citing works
May, C., Finch, T., Mair, F., Ballini, L., Dowrick, C., Eccles, M., Gask, L., MacFarlane, A., Murray, E., Rapley, T., et al. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-148 · Cited by 768 · see citing works
Self-citationGravel, K., Légaré, F., & Graham, I. D. (2006) · Implementation Science · doi:10.1186/1748-5908-1-16 · Cited by 755 · see citing works
Self-citation(2000) · Europe PMC (PubMed Central) · Cited by 737 · see citing works
Decision aids for people facing health treatment or screening decisions
O'Connor, A. M. C., Bennett, C. L., Stacey, D., Barry, M. J., Col, N. F., Eden, K., Entwistle, V. A., Fiset, V., Holmes-Rovner, M. M., Khangura, S. D., et al. (2003) · doi:10.1002/14651858.cd001431 · Cited by 662 · see citing works
Patient Satisfaction with Health Care Decisions
Holmes-Rovner, M. M., Kroll, J., Schmitt, N., Rovner, D. R., Breer, M. L., Rothert, M. L., Padonu, G., & Talarczyk, G. (1996) · Medical Decision Making · doi:10.1177/0272989x9601600114 · Cited by 612 · see citing works
The OPTION scale: measuring the extent that clinicians involve patients in decision‐making tasks
Elwyn, G. J., Hutchings, H. A., Edwards, A., Rapport, F., Wensing, M., Cheung, W., & Grol, R. P. T. M. (2005) · Health Expectations · doi:10.1111/j.1369-7625.2004.00311.x · Cited by 494 · see citing works
Self-citationA rational model for assessing and evaluating complex interventions in health care
May, C. (2006) · BMC Health Services Research · doi:10.1186/1472-6963-6-86 · Cited by 447 · see citing works
Self-citationProblems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research
Heritage, J. C., & Maynard, D. W. (2006) · Annual Review of Sociology · doi:10.1146/annurev.soc.32.082905.093959 · Cited by 347 · see citing works
The Economic Sociology of Conventions: Habit, Custom, Practice, and Routine in Market Order
Biggart, N. W., & Beamish, T. D. (2003) · Annual Review of Sociology · doi:10.1146/annurev.soc.29.010202.100051 · Cited by 345 · see citing works
McKinstry, B. (2000) · BMJ · doi:10.1136/bmj.321.7265.867 · Cited by 344 · see citing works
Profit and loss analysis for an intensive care unit (ICU) in Japan: a tool for strategic management
Cao, P., Toyabe, S., Abe, T., & Akazawa, K. (2006) · BMC Health Services Research · doi:10.1186/1472-6963-6-1 · Cited by 320 · see citing works
The laboratory of the mind: thought experiments in the natural sciences
(1992) · Choice Reviews Online · doi:10.5860/choice.29-4469 · Cited by 317 · see citing works
Support for self care for patients with chronic disease
Kennedy, A. P., Rogers, A. E., & Bower, P. (2007) · BMJ · doi:10.1136/bmj.39372.540903.94 · Cited by 307 · see citing works
Clinical autonomy, individual and collective: the problem of changing doctors’ behaviour
Armstrong, D. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(01)00309-4 · Cited by 295 · see citing works
Rethinking Informed Consent: The Case for Shared Medical Decision-Making
King, J. S., & Moulton, B. W. (2006) · American Journal of Law & Medicine · doi:10.1177/009885880603200401 · Cited by 277 · see citing works
Nonabandonment: A Central Obligation for Physicians
Quill, T. E., & Cassel, C. K. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-5-199503010-00008 · Cited by 256 · see citing works
Implementing shared decision‐making in routine practice: barriers and opportunities
Holmes-Rovner, M. M., Valade, D., Orlowski, C., Draus, C., Nabozny‐Valerio, B., & Keiser, S. (2000) · Health Expectations · doi:10.1046/j.1369-6513.2000.00093.x · Cited by 241 · see citing works
Légaré, F., O'Connor, A. M. C., Graham, I. D., Wells, G. A., & Tremblay, S. (2006) · Medical Decision Making · doi:10.1177/0272989x06290492 · Cited by 184 · see citing works
Self-citationEdwards, A., Elwyn, G. J., Hood, K., Robling, M. R., Atwell, C., Holmes-Rovner, M. M., Kinnersley, P., Houston, H., & Russell, I. T. (2003) · Patient Education and Counseling · doi:10.1016/s0738-3991(03)00055-7 · Cited by 177 · see citing works
Self-citationCharles, C. A., Gafni, A., & Whelan, T. J. (2004) · Health Expectations · doi:10.1111/j.1369-7625.2004.00299.x · Cited by 162 · see citing works
An approach to measuring the quality of breast cancer decisions
Sepucha, K., Ozanne, E. M., Silvia, K. A., Partridge, A. H., & Mulley, A. G. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2006.08.007 · Cited by 148 · see citing works
Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine
May, C. R., Rapley, T., Moreira, T., Finch, T. L., & Heaven, B. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.07.003 · Cited by 144 · see citing works
Self-citationMach, E., & Hiebert, E. N. (1976) · Springer eBooks · doi:10.1007/978-94-010-1428-1 · Cited by 144 · see citing works
Checkland, K., Harrison, S., & Marshall, M. (2007) · Journal of Health Services Research & Policy · doi:10.1258/135581907780279657 · Cited by 133 · see citing works
Durand, M., Stiel, M., Boivin, J., & Elwyn, G. J. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2007.12.004 · Cited by 116 · see citing works
Self-citationTreatment decision aids: conceptual issues and future directions
Charles, C. A., Gafni, A., Whelan, T. J., & O’Brien, M. A. (2005) · Health Expectations · doi:10.1111/j.1369-7625.2005.00325.x · Cited by 102 · see citing works
Back to Norms! on the Scope and Dynamics of Norms and Normative Action
Therborn, G. (2002) · Current Sociology · doi:10.1177/0011392102050006006 · Cited by 100 · see citing works
Respecting the subjective: quality measurement from the patient's perspective
Elwyn, G. J., Buetow, S., Hibbard, J. H., et al. (2007) · BMJ · doi:10.1136/bmj.39339.490301.ad · Cited by 95 · see citing works
Self-citationPatient centredness in the MRCGP video examination: analysis of large cohort
Campion, P., Foulkes, J., Neighbour, R., et al. (2002) · BMJ · doi:10.1136/bmj.325.7366.691 · Cited by 92 · see citing works
Teledermatology in the U.K.: lessons in service innovation
Finch, T. L., Mair, F. S., & May, C. R. (2007) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2006.07608.x · Cited by 84 · see citing works
Self-citationLégaré, F., O'Connor, A. M. C., Graham, I. D., Saucier, D., Côté, L., Blais, J., Cauchon, M., & Paré, L. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2006.04.011 · Cited by 83 · see citing works
Self-citationIntegrating Decision Making and Mental Health Interventions Research: Research Directions.
Wills, C. E., & Holmes-Rovner, M. M. (2006) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2006.00002.x · Cited by 80 · see citing works
Cooper, R. (2005) · Metaphilosophy · doi:10.1111/j.1467-9973.2005.00372.x · Cited by 75 · see citing works
Stacey, D., Graham, I., O'Connor, A., & Pomey, M. (2005) · Worldviews on Evidence-Based Nursing · doi:10.1111/j.1741-6787.2005.00035.x · Cited by 74 · see citing works
Stacey, D., Pomey, M., O'Connor, A. M. C., & Graham, I. D. (2006) · Implementation Science · doi:10.1186/1748-5908-1-17 · Cited by 63 · see citing works
Légaré, F., O'Connor, A. M. C., Graham, I. D., Wells, G. A., Jacobsen, M. J., Elmslie, T., & Drake, E. R. (2003) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00129-5 · Cited by 63 · see citing works
Self-citationEdwards, A., Evans, R. M., & Elwyn, G. J. (2003) · Patient Education and Counseling · doi:10.1016/s0738-3991(03)00077-6 · Cited by 60 · see citing works
Self-citationMach, E., & Hiebert, E. N. (1976) · Springer eBooks · doi:10.1007/978-94-010-1428-1_11 · Cited by 57 · see citing works
Beyond the limits of clinical governance? The case of mental health in English primary care
Gask, L. L., Rogers, A. E., Campbell, S., & Sheaff, R. (2008) · BMC Health Services Research · doi:10.1186/1472-6963-8-63 · Cited by 55 · see citing works
Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study
King, G., Richards, H., & Godden, D. (2007) · Journal of Telemedicine and Telecare · doi:10.1258/135763307783064430 · Cited by 48 · see citing works
Understanding treatment decision making: Contexts, commonalities, complexities, and challenges
Blank, T., Graves, K. D., Sepucha, K., & Llewellyn‐Thomas, H. A. (2006) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3203_6 · Cited by 46 · see citing works
Kaner, E., Heaven, B., Rapley, T., Murtagh, M. J., Graham, R. H., Thomson, R., & May, C. R. (2007) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-7-2 · Cited by 45 · see citing works
Self-citationAdvocating Mandatory Patient ‘Autonomy’ in Healthcare: Adverse Reactions and Side Effects
Davies, M., & Elwyn, G. J. (2007) · Health Care Analysis · doi:10.1007/s10728-007-0075-3 · Cited by 44 · see citing works
Self-citationEvans, R. M., Elwyn, G. J., Edwards, A., Watson, E. K., Austoker, J., & Grol, R. P. T. M. (2007) · Journal of Medical Internet Research · doi:10.2196/jmir.9.3.e21 · Cited by 36 · see citing works
Self-citationEssential psychotherapies : theory and practice
Gurman, A. S., & Messer, S. (2011) · Choice Reviews Online · doi:10.5860/choice.33-5386 · Cited by 34 · see citing works
Godolphin, W. J., Towle, A., & McKendry, R. (2001) · Europe PMC (PubMed Central) · Cited by 32 · see citing works
Doctor–patient interaction in a randomised controlled trial of decision-support tools
Rapley, T., May, C. R., Heaven, B., et al. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.10.011 · Cited by 31 · see citing works
Self-citationPowerlessness, Control, and Complexity: The Experience of Family Physicians in a Group Model HMO
Gask, L. (2004) · The Annals of Family Medicine · doi:10.1370/afm.58 · Cited by 26 · see citing works
Pierce, D., & Gunn, J. M. (2007) · BMC Family Practice · doi:10.1186/1471-2296-8-24 · Cited by 24 · see citing works
The person-centered psychotherapies.
Bohart, A. C. (1995) · Cited by 21 · see citing works
Shared decision-making in the Netherlands – current state and future perspectives
van der Weijden, T., van Veenendaal, H., & Timmermans, D. R. M. (2007) · Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen - German Journal for Quality in Health Care · doi:10.1016/j.zgesun.2007.02.022 · Cited by 20 · see citing works
Self-citationInformed Decision Making in Outpatient Practice: Time to Get Back to Basics
Braddock III, C. H., Edwards, K. A., Hasenberg, N. M., Laidley, T. L., & Levinson, W. (1999) · JAMA · doi:10.1001/jama.282.24.2313 · Cited by 19 · see citing works
Evans, R. M., Edwards, A., Coulter, A., et al. (2007) · Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen - German Journal for Quality in Health Care · doi:10.1016/j.zgesun.2007.02.027 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 4
- Rogers EM The diffusion of innovation 1995 New York: Free Press
- Greenhalgh T Robert G Macfarlane F Bate P Kyriakidou O Diffusion of innovations in service organizations: Systematic review and recommendations Milbank Quarterly 2004 82 581 629 15595944 10.1111/j.0887-378X.2004.00325.x PMC2690184 · DOI · Paper page
- May C Finch T Normalizing Health Technologies London, Palgrave
- Gravel K Legare F Graham I Barriers and facilitators to implementing shared decision-making in clinical practice: a systematic review of health professionals' perceptions Implementation Science 2006 1 16 16899124 10.1186/1748-5908-1-16 PMC1586024 · DOI · Paper page
Cited by
Sorted by citations
Implementing, Embedding, and Integrating Practices: An Outline of Normalization Process Theory
May, C., & Finch, T. (2009) · Sociology · doi:10.1177/0038038509103208 · Cited by 2,115 · see citing works
Self-citationDevelopment of a theory of implementation and integration: Normalization Process Theory
May, C. R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., Rapley, T., Ballini, L., Ong, B. N., Rogers, A., et al. (2009) · Implementation Science · doi:10.1186/1748-5908-4-29 · Cited by 1,409 · see citing works
“Elwyn et al. [ 31 ] concluded that the NPM offered stable explanations of the collective work involved in shared decision-making processes and operationalizing decisionmaking tools.”
Self-citationMay, C. R., Cummings, A., Girling, M., Bracher, M., Mair, F. S., May, C. M., Murray, E., Myall, M., Rapley, T., & Finch, T. (2018) · Implementation Science · doi:10.1186/s13012-018-0758-1 · Cited by 683 · see citing works
Self-citationMair, F. S., May, C., O’Donnell, C., Finch, T., Sullivan, F., & Murray, E. (2012) · Bulletin of the World Health Organization · doi:10.2471/blt.11.099424 · Cited by 553 · see citing works
Self-citationMcEvoy, R., Ballini, L., Maltoni, S., O’Donnell, C. A., Mair, F. S., & MacFarlane, A. (2014) · Implementation Science · doi:10.1186/1748-5908-9-2 · Cited by 413 · see citing works
Finch, T. L., Girling, M., May, C. R., Mair, F. S., Murray, E., Treweek, S., McColl, E., Steen, I. N., Cook, C., Vernazza, C. R., et al. (2018) · BMC Medical Research Methodology · doi:10.1186/s12874-018-0591-x · Cited by 337 · see citing works
Self-citationLund, S., Richardson, A., & May, C. (2015) · PLOS ONE · doi:10.1371/journal.pone.0116629 · Cited by 325 · see citing works
Self-citationWeb-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress
Murray, E. (2012) · Medicine 2.0 · doi:10.2196/med20.1741 · Cited by 219 · see citing works
Agency and implementation: Understanding the embedding of healthcare innovations in practice
May, C. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.11.021 · Cited by 189 · see citing works
Self-citationRapley, T., Girling, M., Mair, F. S., Murray, E., Treweek, S., McColl, E., Steen, I. N., May, C. R., & Finch, T. L. (2018) · BMC Medical Research Methodology · doi:10.1186/s12874-018-0590-y · Cited by 193 · see citing works
Self-citationFinch, T. L., Rapley, T., Girling, M., Mair, F. S., Murray, E., Treweek, S., McColl, E., Steen, I. N., & May, C. R. (2013) · Implementation Science · doi:10.1186/1748-5908-8-43 · Cited by 177 · see citing works
Self-citationFinch, T. L., Mair, F. S., O’Donnell, C., Murray, E., & May, C. R. (2012) · BMC Medical Research Methodology · doi:10.1186/1471-2288-12-69 · Cited by 127 · see citing works
Self-citationvan der Weijden, T., Légaré, F., Boivin, A., Burgers, J. S., van Veenendaal, H., Stiggelbout, A. M., Faber, M., & Elwyn, G. (2010) · Implementation Science · doi:10.1186/1748-5908-5-10 · Cited by 130 · see citing works
Self-citationKennedy, A., Rogers, A., Bowen, R., Lee, V., Blakeman, T., Gardner, C., Morris, R., Protheroe, J., & Chew-Graham, C. (2014) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2013.11.008 · Cited by 97 · see citing works
Shared Decision Making for Atrial Fibrillation (SDM4AFib) Trial Investigators, Spencer-Bonilla, G., Thota, A., Organick, P., Ponce, O. J., Kunneman, M., Giblon, R., Branda, M. E., Sivly, A. L., Behnken, E., et al. (2020) · Trials · doi:10.1186/s13063-020-04305-2 · Cited by 17 · see citing works
Self-citationFeasibility Evaluation of an Interpersonal and Social Rhythm Therapy Group Delivery Model
Hoberg, A. A., Vickers, K. S., Ericksen, J., Bauer, G., Kung, S., Stone, R., Williams, M., Moore, M. J., & Frye, M. A. (2013) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2013.08.002 · Cited by 9 · see citing works
May, C. R., Finch, T., Ballini, L., MacFarlane, A., Mair, F., Murray, E., Treweek, S., & Rapley, T. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-245 · Cited by 3 · see citing works
Self-citation
- Authors
- Elwyn, G., Légaré, F., Weijden, T. V. D., Edwards, A., & May, C.
- Affiliations
- Cardiff University (GB)
- Centre hospitalier universitaire de Québec (CA)
- Maastricht University (NL)
- Newcastle University (GB)
- Corresponding author
- Elwyn, Glyn
- Venue
- Implementation Science
- Published
- 2008-12
- Volume
- 3
- Issue
- 1
- Pages
- 57-57
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC2631595
- OpenAlex
- W2013687146
- Cited by
- 159
- References
- 64
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 12 · 2020: 15 · 2019: 8 · 2018: 13 · 2017: 14 · 2016: 12 · 2015: 8 · 2014: 8 · 2013: 13 · 2012: 15
- FWCI
- 14.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Implementation Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Keywords
- decision support technology, decision aids, implementation barriers, routine clinical practice, professional-patient interaction, workability, organizational resources, power imbalance, social norms, collaborative decision-making
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
