Annals of Emergency Medicine
Volume 49, Issue 3 , Pages 355-363 , March 2007

Knowledge Translation: Closing the Evidence-to-Practice Gap

  • Eddy S. Lang, MDCM, CCFP(EM), CSPQ

      Affiliations

    • Department of Emergency Medicine, McGill University and Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (Lang)
    • Corresponding Author InformationAddress for correspondence: Eddy S. Lang, MDCM, CCFP(EM), CSPQ, Emergency Department, SMBD Jewish General Hospital, 3755 Cote Ste Catherine, Montreal, Quebec, Canada H3T 1E2; 514-340-8222 ext 5568, fax 514-340-8138
  • ,
  • Peter C. Wyer, MD

      Affiliations

    • Columbia University College of Physicians and Surgeons, New York, NY (Wyer)
  • ,
  • R. Brian Haynes, MD, PhD, FRCPC

      Affiliations

    • the Department of Clinical Epidemiology and Biostatistics and Department of Medicine, McMaster University, Hamilton, Ontario, Canada (Haynes)

Received 11 July 2006 ,Revised 14 August 2006 ,Accepted 25 August 2006.

References 

  1. Canadian Institutes of Health Research. Canadian Institutes of Health Research knowledge translation strategy 2004-2009. http://www.cihr-irsc.gc.ca/e/26574.html#defining2006;
  2. Sung NS, Crowley WF, Genel M, et al. Central challenges facing the national clinical research enterprise. JAMA. 2003;289:1278–1287
  3. McGlynn EA, Asch SM, Adams J. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635–2645
  4. Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century [Institute of Medicine Web site]. http://www.iom.edu/report.asp?id=5432. Accessed September 5, 2006
  5. Cameron C, Naylor CD. No impact from active dissemination of the Ottawa Ankle Rules: further evidence of the need for local implementation of practice guidelines. CMAJ. 1999;160:1165–1168
  6. Holroyd BR, Wilson D, Rowe BH, et al. Uptake of validated clinical practice guidelines: experience with implementing the Ottawa Ankle Rules. Am J Emerg Med. 2004;22:149–155
  7. Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21:384–390
  8. Bachmann LM, Kolb E, Koller MT. Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326:417
  9. Auleley GR, Ravaud P, Giraudeau B, et al. Implementation of the Ottawa Ankle Rules in France: a multicenter randomized controlled trial. JAMA. 1997;277:1935–1939
  10. Stiell I, Wells G, Laupacis A, et al. Multicentre trial to introduce the Ottawa Ankle Rules for use of radiography in acute ankle injuries: Multicentre Ankle Rule Study Group. BMJ. 1995;311:594–597
  11. Graham ID, Stiell IG, Laupacis A, et al. Awareness and use of the Ottawa Ankle and Knee Rules in 5 countries: can publication alone be enough to change practice?. Ann Emerg Med. 2001;37:259–266
  12. Brehaut JC, Stiell IG, Visentin L, et al. Clinical decision rules “in the real world”: how a widely disseminated rule is used in everyday practice. Acad Emerg Med. 2005;12:948–956
  13. Woolley SL, Smith DR. Acute otitis media in children: there are guidelines but are they followed?. J Laryngol Otol. 2005;119:524–528
  14. Reuveni H, Asher E, Greenberg D, et al. Adherence to therapeutic guidelines for acute otitis media in children younger than 2 years. Int J Pediatr Otorhinolaryngol. 2006;70:267–273
  15. Ohman EM, Roe MT, Smith SC, et al. CRUSADE Investigators (Care of non-ST-segment elevation patients: insights from the CRUSADE national quality improvement initiative). Am Heart J. 2004;148:S34–S39
  16. Glasziou P, Haynes B. The paths from research to improved health outcomes. ACP J Club. 2005;142:A8–A10
  17. Haynes RB, Sackett DL, Gray JA, et al. Transferring evidence from research into practice, 2: getting the evidence straight. ACP J Club. 1997;126:A14–A16
  18. Buller-Close K, Schriger DL, Baraff LJ. Heterogeneous effect of an emergency department expert charting system. Ann Emerg Med. 2003;41:644–652
  19. McMaster Online Rating of Evidence. About MORE [McMaster Online Rating of Evidence Web site]. http://hiru.mcmaster.ca/more/AboutMORE.htm2006;
  20. Pluye P, Grad RM, Dunikowski LG, et al. Impact of clinical information-retrieval technology on physicians: a literature review of quantitative, qualitative and mixed methods studies. Int J Med Inform. 2005;74:745–768
  21. Kelly KD, Travers A, Dorgan M, et al. Evaluating the quality of systematic reviews in the emergency medicine literature. Ann Emerg Med. 2001;38:518–526
  22. Haynes RB, Cotoi C, Holland J, et al. the McMaster Premium Literature Service (PLUS) Project (Second-order peer review of the medical literature for clinical practitioners). JAMA. 2006;295:1801–1808
  23. Bullard MJ, Meurer DP, Colman I, et al. Supporting clinical practice at the bedside using wireless technology. Acad Emerg Med. 2004;11:1186–1192
  24. Anderson DR, Wells PS, Stiell I, et al. Thrombosis in the emergency department: use of a clinical diagnosis model to safely avoid the need for urgent radiological investigation. Arch Intern Med. 1999;159:477–482
  25. Brown MD, Vance SJ, Kline JA. An emergency department guideline for the diagnosis of pulmonary embolism: an outcome study. Acad Emerg Med. 2005;12:20–25
  26. Lindsay P, Schull M, Bronskill S, et al. The development of indicators to measure the quality of clinical care in emergency departments following a modified-Delphi approach. Acad Emerg Med. 2002;9:1131–1139
  27. Bizovi KE, Wears R, Lowe RA. Researching quality in emergency medicine. Acad Emerg Med. 2002;9:1116–1123
  28. Garg AX, Adhikari NK, McDonald H, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293:1261–1263
  29. Green RS, Howes D. the CAEP Critical Care Committee (Hypothermic modulation of anoxic brain injury in adult survivors of cardiac arrest: a review of the literature and an algorithm for emergency physicians). Can J Emerg Med. 2005;7:42–47
  30. Trzeciak S, Dellinger RP, Abate NL, et al. Translating research into clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest. 2006;129:225–232
  31. Agency for Healthcare Research and Quality. Fart sheet: translating research into practice (TRIP)-II [Agency for Healthcare Research and Quality Web site]. http://www.ahrq.gov/research/trip2fac.htm2006;
  32. Grol R, Wensing M. What drives change? (barriers to and incentives for achieving evidence-based practice). Med J Aust. 2004;180(6 suppl):S57–S60
  33. Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines? a framework for improvement. JAMA. 1999;282:1458–1465
  34. Bloom BS. Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. Int J Technol Assess Health Care. 2005;21:380–385
  35. O'Brien MA, Freemantle N, Oxman AD, et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2001;(2):CD003030.
  36. Jamtvedt G, Young JM, Kristoffersen DT, et al. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006;(2):CD000259.
  37. Grimshaw JM, Shirran L, Thomas R. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39(8 suppl 2):II2–II45
  38. Fesmire FM, Jagoda A. Are we putting the cart ahead of the horse: who determines the standard of care for the management of patients in the emergency department?. Ann Emerg Med. 2005;46:198–200
  39. Hayward RS. Clinical practice guidelines on trial. CMAJ. 1997;156:1725–1727
  40. Laupacis A. On bias and transparency in the development of influential recommendations. CMAJ. 2006;174:335–336
  41. Grimshaw J, Thomas RE, MacLennan G, et al. Health technology assessment 2004: vol 8: number 6. http://www.ncchta.org/execsumm/summ806.htm. Accessed
  42. Grad RM, Meng Y, Bartlett G, et al. Effect of a PDA-assisted evidence-based medicine course on knowledge of common clinical problems. Fam Med. 2005;37:734–740
  43. Sackett DL, Straus SE. Finding and applying evidence during clinical rounds: the “evidence cart.”. JAMA. 1998;280:1336–1338
  44. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997;336:243–250
  45. Yealy DM, Auble TE, Stone RA, et al. The emergency department community-acquired pneumonia trial: methodology of a quality improvement intervention. Ann Emerg Med. 2004;43:770–782
  46. Yealy DM, Auble TE, Stone RA, et al. Effect of increasing the intensity of implementing pneumonia guidelines: a randomized, controlled trial. Ann Intern Med. 2005;143:881–894
  47. Chouaid C, Bal JP, Fuhrman C, et al. Standardized protocol improves asthma management in emergency department. J Asthma. 2004;41:19–25
  48. Wears RL. Advanced statistics: statistical methods for analyzing cluster and cluster-randomized data. Acad Emerg Med. 2002;9:330–341
  49. Eldridge SM, Ashby D, Feder GS. Lessons for cluster randomized trials in the twenty-first century: a systematic review of trials in primary care. Clin Trials. 2004;1:80–90
  50. Campbell MK, Elbourne DR, Altman DG. for the CONSORT Group (CONSORT statement: extension to cluster randomised trials). BMJ. 2004;328:702–708
  51. Campbell JP, Maxey VA, Watson WA. Hawthorne effect: implications for prehospital research. Ann Emerg Med. 1995;26:590–594
  52. Dean NC, Suchyta MR, Bateman KA, et al. Implementation of admission decision support for community-acquired pneumonia. Chest. 2000;117:1368–1377
  53. Davis D, Evans M, Jadad A, et al. The case for knowledge translation: shortening the journey from evidence to effect. BMJ. 2003;327:33–35

 Supervising editor: E. John Gallagher, MD

 Funding and support: The authors report this study did not receive any outside funding or support.

 Reprints not available from the authors.

PII: S0196-0644(06)02142-1

doi: 10.1016/j.annemergmed.2006.08.022

Annals of Emergency Medicine
Volume 49, Issue 3 , Pages 355-363 , March 2007