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The paths from research to improved health outcomes

¹ University of Oxford
Oxford, UK
² McMaster University
Hamilton, Ontario, Canada

Key Words: evidence-based medicine

The first 150 words of the full text of this article appear below.

Evidence-based medicine aims to provide clinicians and patients with choices about the most effective care based on the best available research evidence. To patients this is a natural expectation. To clinicians this is a near impossible dream. The US report Bridging the quality chasm has documented and drawn attention to the gap between what we know and what we do.¹ The report identified 3 types of quality problems—overuse, underuse, and misuse. It suggested: "The burden of harm conveyed by the collective impact of all of our health care quality problems is staggering." While attention has focused on misuse (or error), a larger portion of the preventable burden is likely to be the evidence-practice gaps of underuse and overuse.

Research that should change practice is often ignored for years—for example, crystalloid (rather than colloid) for shock,² supine position after lumbar puncture,³ bed rest for any medical condition,³ and appropriate use of . . . [Full text of this article]