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Fig. 1 | Implementation Science

Fig. 1

From: Studying de-implementation in health: an analysis of funded research grants

Fig. 1

Flow diagram of identification, screening, eligibility, and inclusion of grants for portfolio analysis on de-implementation of health services and practices. Flow diagram adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. aSearch includes the following: National Institutes of Health and Agency for Healthcare Research and Quality; years 2000–2017; all awarded and funded grants; activity codes for all research grants (R series) and career development awards (K series); free text search in abstract, specific aims, title, and summary statement: disinvest%, medical reversal, de-implement%, de-adopt%, exnovat%, low value, undiffus%, “decrease use,” disincentiv%, “choosing wisely,” and de-prescrib% (combined with “or” and % searching all tenses of the base word). FOA query includes the following: all funded grants from the Dissemination and Implementation Research in Health (DIRH) FOAs, PAR-06-039, PAR-07-086, PAR-06-520, PAR-06-521, PAR-10-038, PAR-10-039, PAR-10-040, PAR-13-055, PAR-13-056, PAR-13-054, PAR-16-238, PAR-16-236, and PAR-16-237. RFA query includes funded grants from the Provocative Questions RFAs, CA-13-024 and CA-13-025 (group E, question 3), CA-15-008, and CA-15-009 (question 12). bNumber of unique projects, after removing duplicates (included amended applications, duplicate entries due to multiple principal investigators, etc.). cFirst found of quality control: examined grant titles and study sections of grants. dSecond round of quality control: examined abstract and specific aims of grants. eExclusion reasons: broad focus on variation in patient outcomes, quality of care, or cost; no specific focus on decreasing or stopping use of health services or practices; and examination of impact of health policy or reimbursement changes on utilization of health services or patient outcomes (e.g., reduction in hospital-associated infections) not specific to de-implementation

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