Medical journals and effective dissemination of health research

Abstract

Clinical medical journals have not been effective in meeting the information needs of practitioners and bridging the gap between clinical research and practice. The slow adoption of results of clinical research is at least partly due to the failure of clinical journals to disseminate information in a way that would motivate practitioners to change practice. Although implementation is primarily a local process, medical journals are in a unique position to advance implementation by modifying their focus and adjusting their contents. Strategies that may be useful include publication of pre-appraised evidence summaries and 'clinical bottom-lines' and giving importance to systematic reviews and large evaluative research articles as they represent higher levels of evidence and have greater potential to change practice. Clinical journals should encourage researchers to consider how and by whom the findings will be used and provide information on implications for implementation such as possible strategies that may work, cost-effectiveness, side-effects and potential barriers to implementation. Medical journal publishers should explore ways to cooperate so that findings of landmark clinical trials could be shared thus reducing the 'scatter' of medical information. Electronic media offers numerous advantages such as quick accessibility and linking of information, and medical journals should capitalize on such innovations. There is a paradigm shift in health care practice as evidence is consciously and explicitly incorporated into individual patient care. Medical journals need to change to reflect this change in practice and provide practitioners with valid and relevant information.

The information sources and journals consulted or read by UK paediatricians to inform their clinical practice and those which they consider important: a questionnaire survey

“…Despite some doubts [9], journals continue to be considered an important information source by many clinicians. Journals are also still the principal medium used to publish research findings.…”

Bridging Research, Practice, and Policy

“…1 Educational opportunities that expose providers and practitioners to current research findings may increase use of evidence-based practices. 2 Likewise, opportunities that expose investigators to local practice environments may increase production of more relevant research.…”

“…2 Likewise, opportunities that expose investigators to local practice environments may increase production of more relevant research. 3 Current research dissemination strategies, including professional meetings, continuing medical education 4 , and peer-reviewed publications 1 tend to be unidirectional (researcher to audience) and fail to address tensions between scientifically rigorous protocols and real-world application. While knowledge transfer may occur, translation of evidence into practice also requires feasible local implementation strategies.…”

Reporting of MMR evidence in professional publications: 1988-2007

“…However there is debate about how effective such outlets are in bridging the gap between evidence and practice,1 2 3 4 and practice often lags behind the evidence. Evidence-based practice can be fostered by encouraging journals to disseminate information in a way that would motivate practitioners to change practice,4 including using editorials and commentary columns of journals and other publications for health professionals, particularly when there is uncertainty about the evidence base.…”

“…However there is debate about how effective such outlets are in bridging the gap between evidence and practice,1 2 3 4 and practice often lags behind the evidence. Evidence-based practice can be fostered by encouraging journals to disseminate information in a way that would motivate practitioners to change practice,4 including using editorials and commentary columns of journals and other publications for health professionals, particularly when there is uncertainty about the evidence base. Journals themselves identify supporting practitioners as their role; the BMJ identifies “Helping doctors make better decisions” as one of its objectives, and the magazine Pulse brands itself as “Informing, supporting, championing” GPs, while Nursing Standard states that it brings its readers “exclusive, up-to-the-minute coverage on issues affecting nursing practice”.…”