Brecha implementacion evidencia

IMPLEMENTACIÓN DE LA EVIDENCIA EN LA PRÄCTICA CLÍNICA

Concepción Campos-Asensio

START

Concepción Campos-Asensio

Bibliotecaria Hospital Universitario de Getafehttps://bibliogetafe.com/ https://orcid.org/0000-0003-2724-2563 https://twitter.com/biblioGetafe

"Existe una brecha significativa entre la investigación primaria y la adopción plena en la práctica de las innovaciones en el cuidado de la salud"

JENNIFER GreenwooD,Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA RFUMS Center for Interprofessional Evidence Based Practice, a JBI Centre of Excellence, North Chicago, IL, USA

Greenwood, Jennifer. Overcoming challenges with getting current evidence into practice. JBI Evidence Synthesis 21(11):p 2152-2153, November 2023. | DOI: 10.11124/JBIES-23-00473

Datos

que demuestran la existencia de disparidad entre la mejor evidencia y la práctica real

Solo el 60% de la atención se ajustaba a las directrices de consenso publicadas y que hasta el 10% de la atención podría ser perjudicial para los pacientes

Recomendaciones de tratamiento de nuevas terapias que aparecen en los libros de texto médicos más de 10 años después

Pasan una media de 17 años desde la realización de ensayos controlados aleatorios hasta su incorporación a la práctica

Weed LL. New connections between medical knowledge and patient care. Br Med J 1997;315:231-5.

Braithwaite J, Glasziou P, Westbrook J. The three numbers you need to know about healthcare: the 60-30-10 challenge. BMC Med 2020;18:102.

Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000: Patient-Centered Systems. Schattauer Verlag; 2000.

Studies suggest that it takes an average of 17 years for research evidence to reach clinical practice

Original Research

Negative results

18%

Variable

Negative results

Submission

Balas EA, Boren SA. Managing clinical knowledge for health care improvement In: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000: Patient-Centered Systems. Schattauer Verlag; 2000.

46%

0.5 years

Acceptance

0.6 years

Publication

Lack of publication

35%

Expert Opinion

0.3 years

Inconsistent indexing

Bibliographic databases

35%

0.6-13.0 years

Review, paper, textbook

9.3 years

Implementation

27%

1,5 M

Bibliografía

• Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000: Patient-Centered Systems. Schattauer Verlag; 2000.
• Weed LL. New connections between medical knowledge and patient care. Br Med J 1997;315:231-5.
• Braithwaite J, Glasziou P, Westbrook J. The three numbers you need to know about healthcare: the 60-30-10 challenge. BMC Med 2020;18:102.
• Song F, Parekh S, Hooper L, Loke YK, Ryder J, Sutton AJ, Hing C, Kwok CS, Pang C, Harvey I. Dissemination and publication of research findings: an updated review of related biases. Health Technol Assess. 2010 Feb;14(8):iii, ix-xi, 1-193. doi: 10.3310/hta14080. PMID: 20181324.
• Balas EA, Austin SM, Ewigman BG, Brown GD, Mitchell JA. Methods of randomized controlled clinical trials in health services research. Med Care. 1995 Jul;33(7):687-99. doi: 10.1097/00005650-199507000-00005. PMID: 7596208.
• Pulido M, González JC, Sanz F. Artículos originales publicados en Medicina Clínica durante 30 años (1962-1992): número de autores, intervalo entre la aceptación y publicación y referencias bibliográficas. Med Clin (Barc). 1994 Dec 10;103(20):770-5. Spanish. PMID: 7861835.
• Kumar PD. Publication lag intervals--a reason for authors'apathy? J Assoc Physicians India. 1992 Sep;40(9):623-4. PMID: 1308024.
• Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA. 1992 Jul 8;268(2):240-8. PMID: 1535110.
• Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR. Publication bias in clinical research. Lancet. 1991 Apr 13;337(8746):867-72. doi: 10.1016/0140-6736(91)90201-y. PMID: 1672966.
• Koren G, Graham K, Shear H, Einarson T. Bias against the null hypothesis: the reproductive hazards of cocaine. Lancet. 1989 Dec 16;2(8677):1440-2. doi: 10.1016/s0140-6736(89)92044-8. PMID: 2574369.
• Dickersin K, Chan S, Chalmers TC, Sacks HS, Smith H Jr. Publication bias and clinical trials. Control Clin Trials. 1987 Dec;8(4):343-53. doi: 10.1016/0197-2456(87)90155-3. PMID: 3442991.
• Poynard T, Conn HO. The retrieval of randomized clinical trials in liver disease from the medical literature. A comparison of MEDLARS and manual methods. Control Clin Trials. 1985 Dec;6(4):271-9. doi: 10.1016/0197-2456(85)90103-5. PMID: 3907971.