In reply: We thank Sturmberg and Martin1 for their thoughtful comments on our MJA research letter,2 which highlight the potential for an overly reductionist approach when using big data to examine the implementation of guidelines in real world general practice. As they note, there are many nuances and assumptions inherent in using general practitioner electronic medical record data and we agree that this does not provide a holistic account of the complex care practices that are jointly negotiated between care provider and patient.
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- 1. Sturmberg JP, Martin CM. Implementing cardiovascular disease preventive care guidelines in general practice: an opportunity missed [letter]. Med J Aust 2021; 215: 189.
- 2. Hespe CM, Campain A, Webster R, et al. Implementing cardiovascular disease preventive care guidelines in general practice: an opportunity missed. Med J Aust 2020; 213: 327–328. https://www.mja.com.au/journal/2020/213/7/implementing-cardiovascular-disease-preventive-care-guidelines-general-practice
- 3. Harris MF, Lloyd J, Krastev Y, et al. Routine use of clinical management guidelines in Australian general practice. Aust J Primary Health 2014; 20: 41–46.
- 4. Ivers N, Jamtvedt G, Flottorp S, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012; (6): CD000259.
- 5. Ivers NM, Sales A, Colquhoun H, et al. No more ‘business as usual’ with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implement Sci 2014; 9: 14.
- 6. Gachau S, Ayieko P, Gathara D, et al. Does audit and feedback improve the adoption of recommended practices? Evidence from a longitudinal observational study of an emerging clinical network in Kenya. BMJ Global Health 2017; 2: e000468.
- 7. Levesque J‐F, Sutherland K. Combining patient, clinical and system perspectives in assessing performance in healthcare: an integrated measurement framework. BMC Health Serv Res 2020; 20: 23.
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