Implementing Implementation Science; A Bibliometric Study of Qualitative Research in Clinical Artificial Intelligence

Abstract Background Implementation science is a pragmatic and multidisciplinary field, centred on the application of a wide range of theoretical approaches to close ‘know-do’ gaps in healthcare. The implementation science community is made of individuals on a continuum between academia and practice, but it is unclear to what extent the theoretical deliberations of implementation academics are translated into the work of implementation practitioners and on to patient benefit. This bibliometric study aims to use the field of clinical artificial intelligence(AI) implementation to sample the prevalence and character of theoretically informed implementation practices. Methods Qualitative research of key stakeholder perspectives on clinical AI published between 2014-2021 was systematically identified. Following title, abstract and full-text screening eligible articles were characterised in terms of their publication, AI tool and context studied, the theoretical approach if any and the research methods and quality. Descriptive, comparative and regression statistics were applied. Results One-hundred-and-eleven studies met the eligibility criteria, with monthly eligible publication rate increasing from 0.7-4.0 between 2014-2021. Eligible studies represented 23 different nations and 25 different clinical specialities. A theoretical approach was explicitly employed in 39(35.1%) studies though 6 of these described novel theoretical approaches(15.1%) and the most frequently used theoretical approach was only used 3 times. There was no statistically significant trend in the prevalence of theoretically informed research within the study period. Of the 25 theoretically informed studies conducted in Europe or North America 19(76%) used theories that originated in the same continent. Conclusions The theoretical approaches which characterise implementation science are not being put to use as often as they could, and the means by which they are selected also seems suboptimal. The field may facilitate a greater synergy between theory and practice if the focus shifts from unifying implementation theories on to unifying and expanding the implementation community. By making more theoretical approaches accessible to practitioners and supporting their selection and application, theory could be more effectively harnessed to close healthcare’s ‘know-do gaps’. Protocol registration PROSPERO ID 248025