Translating Research into Practice: The Physicians' Perspective

Background: Previous research has identified, on average, a 17-year evidence-to-practice gap within health care. While some studies yield statistically significant results, they may have little clinical relevance, or, the quality of the medical evidence is weak or misleading. A researcher-practitioner gap precludes resolution of important clinical problems physicians routinely confront. These represent lost opportunities for improving the quality of care, result in the misuse of ineffective treatments, the under use of evidence-based recommendations, and, contribute to the translational research gap.

Objectives: This multi-method study incorporated personal physician interviews and survey design to examine how internists, cardiologists and oncologists translate new research findings into practice. These specialties were chosen as they represent diverse practice areas with unique features of knowledge transfer, dissemination and utilization.

Methods: Through a series of interviews, barriers to translational research and how physicians respond to new findings that conflict with current practice standards were assessed. Subsequently, a written survey further evaluated these areas, along with the current state of adoption of electronic medical record systems– a vehicle for reducing the translational research gap.

Results: Evidence suggests the 17-year translational research gap has been reduced and varies by medical specialty. Additionally, many research studies fail to address important unresolved clinical questions physicians confront each day, especially within oncology.

While the strength of the medical evidence most strongly influences the uptake of new findings into clinical practice, accessibility, timeliness and cost are also important factors. Furthermore, while many physicians consider their understanding of research design as strong, they perceive their statistical prowess as average or weak. Specialty organizations can play an important role in deciphering the quality of new scientific evidence, especially when it conflicts with current standards of practice.

Interestingly, a gap was also identified between physician adherence to evidence-based and preventive guidelines and insurance reimbursement that warrants further evaluation. Finally, changes to the individual, organizational and cultural levels of medical decision making remain major barriers to greater adoption of electronic medical record systems.

Conclusion: Multiple factors influence knowledge transfer, the uptake of new research results and medical decision making. Delay in greater adoption of electronic medical record systems impedes the translational research process and represents countless missed opportunities for improving the quality of health care. More effective knowledge transfer must occur at the point of service to drive medical decision making toward greater evidence-based decisions that ultimately, enhances the quality of care.