Applying Realist Retroduction to EHR-Based Clinical Decision Support Tool Development
Bibliographic Data
| ID | 2411923 |
|---|---|
| Authors | Suzanne E Morrissey (0000-0002-3166-8391, OCHIN, Inc., Portland, OR, USA), Arwen Bunce (0000-0003-2243-972X, OCHIN, Inc., Portland, OR, USA), Jenna Donovan (0000-0002-2793-0457, OCHIN, Inc., Portland, OR, USA), Brenda Mcgrath (0000-0003-4456-461X, OCHIN, Inc., Portland, OR, USA), Ryan Mcgrath (0000-0003-4208-1059, Ochin), Laura Gottlieb, Laura M Gottlieb (0000-0003-2669-4066), Maura Pisciotta (0000-0003-3120-798X, OCHIN, Inc., Portland, OR, USA), Susan Watkins (0000-0002-0187-1639, Ochin), Shelby Watkins (OCHIN, Inc., Portland, OR, USA), Rachel Gold (0000-0001-6326-5012) |
| Year | 2025 |
| Volume | 24 |
| Publication date | 2025-03-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Qualitative Methods (JOURNAL) |
| Journal identifiers | ISSN: 1609-4069 • E-ISSN: 1609-4069 |
| Publisher | SAGE Publications Inc (PUBLISHER) |
| DOI | 10.1177/16094069251326415 |
| PMID | 40873693 |
| OpenAlex | W4408937923 |
| Language | EN |
| Citations received | 1 |
| References cited | 46 |
The application of realist-informed approaches to implementation research can produce answers to why, for whom and under what circumstances social determinants of health interventions work. In the context of a study to develop and test EHR-based clinical decision support tools that suggest adjusting care plans in response to patient-reported financial, housing, food, transportation, and utilities insecurity, the authors applied an innovative use of realist principles in a bounded, mid-study task. This paper demonstrates how realist retroduction can be applied in intervention development processes. Retroduction proved useful in identifying the often intangible clinical needs and preferences that affected decision support tool desirability and use, which then guided the revision of five tools prior to a formal trial. This paper illustrates how data from the study development phases were put in service of retroductive steps that, through the identification of tentative program theories, guided revision of the pilot electronic tools to better meet clinic needs in the study trial phase. Applying retroductive thinking to establish what may be more or less effective under real-world conditions before participants are recruited is a productive, pragmatic form of researcher/stakeholder co-design that seeks to achieve results without wasting clinical teams' time
Clinical decision support system · Decision support system · Computer Science · Health Sciences Research and Education · Machine Learning in Healthcare · Medicine · Meta-analysis and systematic reviews · Artificial Intelligence
The Sage Encyclopedia of Social Science Research Methods
Health disparities across the lifespan
Realist Synthesis for Public Health
Uncovering the Benefits of Participatory Research
Development of a theory of implementation and integration
Rameses II reporting standards for realist evaluations
Using Realist Evaluation to Understand Process Outcomes in a Covid-19-Impacted Yoga Intervention Trial
A realist evaluation of community-based participatory research
How to develop a realist programme theory using Margaret Archer’s structure–agency–culture framework
Critical realism in empirical research
A Realist Theory of Science
Codebook Development for Team-Based Qualitative Analysis
Examining the Application of Retroductive Theorizing in Realist-Informed Studies
Building Realist Program Theory for Large Complex and Messy Interventions
Implementing, Embedding, and Integrating Practices
| Citations per year | 1 |
|---|---|
| Citation span | 2025 - 2025 (1) |
| Highly cited | No |