“Entrenched practices and other biases”: unpacking the historical, economic, professional, and social resistance to de-implementation

@article{Montini2015EntrenchedPA,
  title={“Entrenched practices and other biases”: unpacking the historical, economic, professional, and social resistance to de-implementation},
  author={Theresa Montini and Ian D. Graham},
  journal={Implementation Science : IS},
  year={2015},
  volume={10}
}
  • T. Montini, I. Graham
  • Published 13 February 2015
  • Medicine, Political Science
  • Implementation Science : IS
BackgroundIn their article on “Evidence-based de-implementation for contradicted, unproven, and aspiring healthcare practices,” Prasad and Ioannidis (IS 9:1, 2014) referred to extra-scientific “entrenched practices and other biases” that hinder evidence-based de-implementation.DiscussionUsing the case example of the de-implementation of radical mastectomy, we disaggregated “entrenched practices and other biases” and analyzed the historical, economic, professional, and social forces that… 
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References

SHOWING 1-10 OF 69 REFERENCES
Evidence-based de-implementation for contradicted, unproven, and aspiring healthcare practices
TLDR
A conceptual framework is proposed to guide and prioritize this process of abandoning ineffective medical practices, shifting emphasis toward the principles of evidence-based medicine, acknowledging that evidence may still be misinterpreted or distorted by recalcitrant proponents of entrenched practices and other biases.
Barriers to Implementing the DSM-5 Cultural Formulation Interview: A Qualitative Study
TLDR
Perceived barriers to CFI implementation in clinical practice reported by patients and clinicians at the New York site within the DSM-5 international field trial are presented.
Impure Science: AIDS, Activism, and the Politics of Knowledge
  • S. Epstein
  • Political Science, Medicine
    Nature Medicine
  • 1997
In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history.
Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings
TLDR
Systematic reviews of rigorous studies provide the best evidence on the effectiveness of different strategies to promote the implementation of research findings and to assess the quality of the systematic reviews.
The practice of medical technology.
TLDR
It is argued that the logical next step of this paradigm is to move beyond criticism and influence the creation and implementation of medical technologies.
Changing the use of electronic fetal monitoring and labor support: a case study of barriers and facilitators.
TLDR
Investigating factors influencing the successful (and unsuccessful) introduction of an evidence-based fetal health surveillance guideline found that the physical setting, adopter concerns, and the medicolegal issues surrounding the guideline played critical roles in uptake.
Evolution and Translation of Research Findings: From Bench to Where?
TLDR
Some of the evidence (or lack thereof) for the process of evolution and translation of research findings, with emphasis on the biomedical sciences are discussed.
Policy makers' perspectives on tobacco control advocates' roles in regulation development
TLDR
There is an important role for tobacco control advocates in the policy development process in regulatory agencies and policy makers suggested that Tobacco control advocates should present science in a format that is well organised and easily absorbed.
Practice-based Evidence for Healthcare: Clinical Mindlines
TLDR
Evidence in practice: evidence in practice and growing mindlines: laying the foundations for clinical thinking and knowledge in practice.
Technology as an occasion for structuring: evidence from observations of CT scanners and the social order of radiology departments.
  • S. Barley
  • Medicine
    Administrative science quarterly
  • 1986
TLDR
A theory of how technology might occasion different organizational structures by altering institutionalized roles and patterns of interaction is outlined, showing how identical CT scanners occasioned similar structuring processes in two radiology departments and yet led to divergent forms of organization.
...
...