You are viewing the site in preview mode

Skip to main content

Advertisement

Table 4 Summary of findings and implications

From: Comparing the application of two theoretical frameworks to describe determinants of adverse medical device event reporting: secondary analysis of qualitative interview data

Finding Implication
All AMDE reporting themes mapped to both TDF and TICD Both theoretical frameworks were useful for systematically analyzing AMDE reporting determinant themes
Multiple TDF domains and TICD determinants were relevant Provide users with flexibility to choose and further prioritize from among the array of relevant domains/determinants but also raises uncertainty about how many to choose and with what precision
Several TDF domains and TICD determinants chosen by one or both mappers were conceptually similar though labelled differently Convergence across frameworks could be used to identify a core set of behavioural determinants
Selected TDF domains and TICD determinants chosen by one or both mappers applied to more than one AMDE reporting theme Convergence within frameworks could be used to identify a core set of behavioural determinants
Domains and determinants selected independently by two mappers often did not match; discrepancy rate similar for TDF and TICD Selection of TDF domains and TICD determinants may be subjective and influenced by mapper familiarity with a given theoretical framework. It is unclear if a process is needed to resolve discrepancies or, instead, if intervention design should be based on only domains/determinants selected by all independent mappers, or on a core set of domains/determinants most commonly selected by all mappers
Greater number of TICD determinants were applied across themes and mappers compared with TDF domains Compared with TDF, which focuses on individual level domains, TICD offers multilevel determinants, plus definitions and examples for each, and was thus easier to apply and could be applied with greater precision at a granular level
Numerous interventions corresponded to common TDF domains and TICD determinants selected by both mappers for each AMDE reporting theme It is unclear how to choose the intervention (s) that are most relevant from among the large number of options presented by the TDF and TICD
Additional interventions corresponded to TDF domains and TICD determinants selected by one mapper It is unclear if intervention (s) should be chosen based on only those associated with domains/determinants selected by all independent mappers, or with a core set of domains and determinants most commonly selected by all mappers
Given that similar TDF domains and TICD determinants were applied across AMDE reporting themes, corresponding interventions were also convergent Convergence within frameworks could be used to identify a core set of interventions corresponding to behavioural determinants
Some interventions recommended by TDF and TICD for the same AMDE reporting themes were conceptually similar though labelled differently Convergence across frameworks could be used to identify a core set of interventions corresponding to behavioural determinants
Although more TICD determinants were applied compared with TDF domains, TDF recommended a greater number of interventions compared with TICD It is unclear if and how interventions that are most relevant for a given context should be screened or prioritized from among the options recommended by either TDF or TICD
Even when themes mapped to conceptually similar TDF domains and TICD determinants, TDF and TICD often recommended conceptually different interventions It is unclear how to choose the intervention (s) that are most relevant when two rigorously developed theoretical frameworks differ in the interventions recommended for the same determinant
Some interventions recommended by TICD seemed more intuitively relevant compared with TDF Compared with TDF, which recommends interventions corresponding to broad domains, TICD recommends interventions corresponding to specific determinants, and may identify interventions that are more relevant. Following the mapping of themes to theoretical frameworks, consultation with stakeholders is likely needed to deliberate the relevance and feasibility of corresponding interventions for a given context.
Complex determinants involving interplay among factors were not well-addressed by TDF or TICD Domains and corresponding interventions in the TDF or TICD did not fully recognize the complex interplay of determinants inherent in some themes. It is unclear if this is because the frameworks are better suited to exploring determinants in some contexts (i.e. adherence with clinical guideline recommendations) and not others (i.e. reporting of AMDEs.
Neither TDF nor TICD prompt users to prioritize domains or interventions Neither the TDF nor the TICD prompt users to prioritize among the many potentially applicable domains or interventions as means of limiting or focusing the number and type of interventions