A multi-dimensional model of clinical utility.

Clinical utility is an increasingly used concept in health care, but one that lacks an agreed formal definition or conceptualization. In this article, I show that the term is commonly used as a synonym for studies of clinical effectiveness and/or economic evaluations and argue that further factors relating to everyday working practice should be included under its auspices. I go on to develop a multi-dimensional model that outlines four factors in practitioners' judgements about clinical utility: appropriateness, accessibility, practicability, and acceptability.

[1]  Sue Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.

[2]  Geoff Payne,et al.  Generalization in Qualitative Research , 2005 .

[3]  N. Rosenberg,et al.  The dynamics of technological change in medicine. , 1994, Health affairs.

[4]  J. Storey,et al.  Managers' Theories About the Process of Innovation , 2004 .

[5]  Louise Fitzgerald,et al.  Innovation in healthcare: how does credible evidence influence professionals? , 2003, Health & social care in the community.

[6]  Luke Vale,et al.  Evidence-based health economics , 2002 .

[7]  J. Gabbay,et al.  Evidence based guidelines or collectively constructed “mindlines?” Ethnographic study of knowledge management in primary care , 2004, BMJ : British Medical Journal.

[8]  A. V. D. Ven,et al.  Central problems in the management of innovation , 1986 .

[9]  E. Ferlie,et al.  Interlocking Interactions, the Diffusion of Innovations in Health Care , 2002 .

[10]  Malcolm Williams.  Interpretivism and Generalisation , 2000 .

[11]  S. Dopson,et al.  Changing clinical practice: views about the management of adult asthma. , 1999, Quality in health care : QHC.

[12]  Robert F. Rich,et al.  Measuring knowledge utilization: Processes and outcomes , 1997 .

[13]  S. Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.

[14]  P. Liamputtong.  Qualitative Research Methods , 2005 .

[15]  R. Kendell,et al.  Distinguishing between the validity and utility of psychiatric diagnoses. , 2003, The American journal of psychiatry.

[16]  K. Malterud.  Qualitative research: standards, challenges, and guidelines , 2001, The Lancet.

[17]  T. Schermer,et al.  Evidence-based health economics: from effectiveness to efficiency in systematic review. , 2003 .

[18]  F. Damanpour.  Organizational Innovation: A Meta-Analysis Of Effects Of Determinants and Moderators , 1991 .

[19]  H. Pincus,et al.  Clinical utility as a criterion for revising psychiatric diagnoses. , 2004, The American journal of psychiatry.

[20]  E. Murphy,et al.  Qualitative research methods in health technology assessment: a review of the literature. , 1998, Health technology assessment.

[21]  E Morgan,et al.  Clinical effectiveness. , 1997, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[22]  Louise Locock,et al.  No magic targets! Changing clinical practice to become more evidence based. , 2002, Health care management review.