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30 Using an adapted version of the G-TRUST to reduce overuse and overdiagnosis through appropriate guideline selection
  1. René Wittmer1,2,
  2. Guylène Thériault3,
  3. Geneviève Bois4,
  4. Pascale Breault1
  1. 1Université de Montréal, Montreal, Canada
  2. 2Choisir avec soin Québec, Montreal, Canada
  3. 3McGill University, Gatineau, Canada
  4. 4Université de Montréal, Montreal, Canada


Clinicians are regularly faced with multiple and often conflicting guidelines. While clinicians may wish to reduce overuse in their practice, they may find doing so challenging when some guidelines regularly advocate or encourage low-value practices.

The G-TRUST tool can be used to compare clinical practice guidelines and select the most useful or appropriate one in a given context. While this tool has been validated in the past, its length may limit its use in daily practice. We suggest an adapted and shortened version of the G-TRUST tool with only 3 questions to facilitate its use.

Participants will be able to apply the tool in three different contexts presented by the facilitators (screening for dyslipidemia, screening for osteoporosis, and screening for diabetes) to appreciate how this tool can help select useful guidelines to reduce overuse and overdiagnosis. They will be invited to apply the tool to a domain or guideline of their choice and appreciate how it may facilitate discussion with colleagues and potentially reduce overuse and overdiagnosis.


  1. Appreciate how variation in different clinical practice guidelines may be a driver for overuse and Overdiagnosis.

  2. Familiarize themselves with the G-TRUST tool, as well as the author’s simplified version of the tool.

  3. Apply the simplified G-TRUST tool in different screening contexts suggested by the workshop facilitators to reduce overuse and Overdiagnosis.

  4. Apply the G-TRUST tool to compare two clinical practice guidelines on a topic of their choice to appreciate how it may be used to foster implementation of guidelines that reduce overuse and overdiagnosis at the consultation level.


  • Practical workshop.

  • Case studies in small groups where participants will be asked to compare clinical practice guidelines.

  • Small group discussions on how the tool may be helpful to select guidelines that reduce overuse and overdiagnosis.

Results In our experience, the modified G-TRUST allows selection of more appropriate clinical practice guidelines, that minimize overuse and overdiagnosis. This tool focuses on three major aspects of the G Trust and by simplifying the tool it allows to be possibly usable in clinical practice.

Conclusions The adapted version of the G-TRUST tool can help select useful guidelines to reduce overuse and overdiagnosis at the consultation level.

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