Step Step Step Individual level Policy level Individual level Policy level
Identification Identification Identification Lipid-lowering medication (statin) used for primary prevention (performance gap) Introducing law on banning e-cigarettes smoking (opportunity) New home glucose monitoring program for diabetic patents (opportunity) Pre-marital genetic disease screening (performance gap)
Development
Development
Development
Determine multiple possible decisions using either: Search 1. Ready-made. For example, from research studies, Clinical Practice Guidelines, protocols, policy, or other sources Search and design (innovate) 2. Custom-made. For example, by task force, team discussions, experts’ or leaders’ opinions, or individually built options Determine multiple possible decisions using either: Search 1. Ready-made. For example, from research studies, Clinical Practice Guidelines, protocols, policy, or other sources Search and design (innovate) 2. Custom-made. For example, by task force, team discussions, experts’ or leaders’ opinions, or individually built options Determine multiple possible decisions using either: Search 1. Ready-made. For example, from research studies, Clinical Practice Guidelines, protocols, policy, or other sources Search and design (innovate) 2. Custom-made. For example, by task force, team discussions, experts’ or leaders’ opinions, or individually built options Determine multiple possible decisions using either: Search 1. Ready-made. For example, from research studies, Clinical Practice Guidelines, protocols, policy, or other sources Search and design (innovate) 2. Custom-made. For example, by task force, team discussions, experts’ or leaders’ opinions, or individually built options
Evaluation Rationalize: (Analysis and bargaining) Benefit
Decrease in cardiovascular (CVD) outcomes
Decrease in smoking, increase in community awareness
Decrease in hypoglycemia, better control, better CVD outcomes
Decrease in hereditary diseases
Harm
Evidence of reported and unreported harm
Economic impact.
Worse quality of life with frequent testing
Worse quality of life due to anxiety over tests results of uncertain significance, and risk of immediate decisions due to fear of consequences of positive results
Cost
High
Cost saving (decreases in smoking prevalence and related diseases)
High
High
Patient Experience:
Side effects acceptance, preventive proactive attitude
Community acceptance due to perception of coercion and affected patient autonomy
Variable either favorable or not.
Community acceptance due to perception of coercion and affected patient autonomy
Validation: Validation: To consider age, conditions’ severity, ethnicity, socio-economic state, Long- and short-term outcomes
To consider cultural and health long- and short-term outcomes
To consider diabetes control status, health literacy, age, medication type, long- and short-term outcomes. To consider genetic diseases’ epidemiology, socio-economic state, health literacy, long- and short-term outcomes
Judgment and decision-making Judgment and decision-making Judgment and decision-making Judgment and decision-making Judgment and decision-making Judgment and decision-making