Gaps between best evidence and practice: causes for concern

Buchan, Heather

doi:10.5694/j.1326-5377.2004.tb05944.x

Cited by 53 publications

(53 citation statements)

References 24 publications

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“…Passive dissemination of evidence via clinical practice guidelines and publications produce only small changes in clinical practice, and there is insufficient evidence to show that such strategies have any effect on patient outcomes [33]. Further, uptake of new evidence is inconsistent even when active implementation strategies are undertaken [4,34]. For example, one descriptive study examined the impact of the American Society of Clinical Oncology (ASCO) guidelines regarding use of hematopoietic colony-stimulating factors (CSF) on cancer care.…”

Section: Discussionmentioning

confidence: 99%

Examining and addressing evidence-practice gaps in cancer care: a systematic review

et al. 2014

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BackgroundThere is increasing recognition of gaps between best scientific evidence and clinical practice. This systematic review aimed to assess the volume and scope of peer-reviewed cancer research output in the years 2000, 2005, and 2010.MethodsEligible papers were published in English and reported on evidence-practice gaps in cancer care. The electronic database Medline was searched for three time periods using MeSH headings and keywords. Abstracts were assessed against eligibility criteria by one reviewer and checked by a second. Papers meeting eligibility criteria were coded as data-based or non-data-based, and by cancer type of focus. All data-based papers were then further classified as descriptive studies documenting the extent of, or barriers to addressing, the evidence-practice gap; or intervention studies examining the effectiveness of strategies to reduce the evidence-practice gap.ResultsA total of 176 eligible papers were identified. The number of publications significantly increased over time, from 25 in 2000 to 100 in 2010 (p < 0.001). Of the 176 identified papers, 160 were data-based. The majority of these (n = 150) reported descriptive studies. Only 10 studies examined the effectiveness of interventions designed to reduce discrepancies between evidence and clinical practice. Of these, only one was a randomized controlled trial. Of all data-based studies, almost one-third (n = 48) examined breast cancer care.ConclusionsWhile the number of publications investigating evidence-practice gaps in cancer care increased over a ten-year period, most studies continued to describe gaps between best evidence and clinical practice, rather than rigorously testing interventions to reduce the gap.

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Section: Discussionmentioning

confidence: 99%

Examining and addressing evidence-practice gaps in cancer care: a systematic review

et al. 2014

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“…Although difficult to quantify with accuracy, there is clear evidence that gaps exist between what is known to be effective and is from the best available evidence and research, and what happens in practice 1 , 2 …”

Section: How Common Is Variation In the Health System?mentioning

confidence: 99%

Clinical practice variation

Leathley

Hughes

2010

Medical Journal of Australia

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Although difficult to quantify, there is known widespread variation in the way that best available evidence is applied in clinical practice. The reasons for gaps between evidence and practice are complex, and efforts to improve uptake are unlikely to be successful if they are one‐dimensional or focus on individual health professionals. This article provides contextual reference for articles in this Supplement in addressing how and why clinical variation exists, the importance of reducing it and strategies to drive a more streamlined approach to evidence‐based care in Australian health care systems.

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“…They also value participation in activities in which there is a clear association with better patient outcomes. There is extensive published work pertaining to gaps in implementation of best evidence recommendations for care 27–29 . Organizational support for participation in initiatives that focus on improving clinical effectiveness or patient clinical outcomes review, together with provision of education about safety and quality improvement methods, may enhance understanding of a systems approach to patient safety and improve integration of information about patient safety issues into organizational safety frameworks.…”

Section: Discussionmentioning

confidence: 99%