Wednesday, September 13, 2023

Journal Club: (1) Scenarios for Whole Genome Seq Adoption, (2) Scenarios for Any MedTech Adoption

This week I ran across two excellent papers on medtech adoption.  

One is recent, by van de Ven 2021, on adoption of whole genome sequencing.  The other (from a citation within Ven) turns out to be a classic, with 1200 citations to it, which is Greenhalgh 2017 on principles for the adoption of any med tech.

van de Ven 2021: 

Whole genome sequencing in oncology: Using scenario drafting to explore future developments.  BMC Cancer 2021.

The Van de Ven paper explores the use of scenario drafting and expert elicitation to anticipate future developments in the implementation of Whole Genome Sequencing (WGS) in clinical oncology. 

It identifies potential barriers and facilitators, highlighting the importance of factors such as price, clinical utility, and turnaround time in determining the likelihood of WGS adoption, offering valuable insights for policymakers and stakeholders in genomics.

Open access here.

For further reading see Ellis 2023 or Fleck 2023.

Greenhalgh 2017:

Beyond Adoption:  A new framework for theorizing and evaluating non adoption, abandonment, and challenges to scale-up, spread, and sustainability of healthcare technologies.  J Med Internet Res 2017.

The Greenhalgh paper introduces the NASSS framework, which offers a comprehensive and nuanced approach to understanding the adoption, scale-up, spread, and sustainability of complex medical technologies. The authors emphasize the importance of recognizing the non-linear and context-dependent nature of technology adoption and highlight the need to address factors related to the technology, the organization, the wider system, and the individual in healthcare settings.

Open access here.

For more about NASSS, see an implementation for a cardio health tracking device, open access, Abimbola 2019, here.  See a shorter overview of NASSS ("Cliff notes"), Greenhalgh & Abimbola 2019, here.  See a 2020 paper that introduces a "NASSS Toolkit" here.

Bonus 1:

There's a new 2023 paper by Greenhalgh et al. on the complexity of figuring out differences in values, among stakeholders in healthcare.   Find it open access at Milbank Quarterly, here.    

Bonus 2:

Greenhalgh et al. 2023 writes a letter to the editor of Annals of Internal Medicine about a review of N95 masks.   It contains this great quote:  

  • "Some members of the evidence-based medicine community seem to assume that a randomized controlled trial, however imperfectly and illogically designed, is necessarily superior to other forms of evidence. This is not the case."
  • Find it open access here.
  • See a lively video by Greenhalgh on flaws of evidence based medicine here.

AI Corner x 3

Find a ChatGPT discussion of Greenhalgh 2017, here.  For example, Chat applies the framework to genomics, and to digital pathology.

Find a ChatGPT discussion of van de Ven 2021, futurism in WGS, here.   

Find a ChatGPT discussion of Greenhalgh 2023, on complex values in healthcare, here.