Study: More research-based evidence needed in clinical decision-making

Healthcare systems around the world are failing to use evidence obtained through research when making decisions, causing inefficiencies and reduced quantity and quality of life, according to Sharon Straus, MD, a geriatrician and director of knowledge translation at St. Michael's Hospital in Toronto and guest editor of the January edition of Journal of Clinical Epidemiology.

"Failures to use research evidence to inform decision-making are apparent across all key decision-maker groups," the doctor stated.

Extrapolating data from the U.S., Straus estimated that about 55 percent of adult patients do not receive recommended care. “Studies have shown that only 40 percent of people with osteoporosis get appropriate therapy, as do only two-thirds of stroke patients,” noted Straus.

St. Michael's is conducting the Delirium Prevention Project, and using knowledge translation--closing the gap between evidence and information obtained through research and what is done or is standard practice or policy--to improve care. 

“Studies show that one-third to two-thirds of older people with hip fracture become delirious, or confused, leading to more long-term care and higher death rates, yet prevention strategies are not consistently used,” Straus stated.

The project involves nursing, physiotherapy, occupational therapy, medicine and pharmacy staff using evidence-based approaches in everyday care to help lower delirium and ensure patients are receiving best possible treatment, according to Straus.

Not all knowledge should be translated into action right away: It's important there first be a "mature and valid evidence base," she wrote.

"The realities of healthcare systems are that we have insufficient resources to do everything and thus we must work with stakeholders, including patients, public, clinicians and policy makers to establish an explicit prioritization process for knowledge translation activities," Straus concluded.

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