Lost in translation: transferring knowledge from research to clinical practice†

The importance of research evidence in clinical decision-making is accepted on an intellectual level and is largely unquestioned. It is assumed that by funding research an eventual improvement in healthcare will occur. In practice, however, behaviour often diverges from evidence-based recommendations (Oxman 1995) and good clinical evidence is not necessarily used. It can sometimes take 17 years to translate findings into clinical practice (Balas 2000). Antipsychotic medications may be prescribed outside the evidence-informed effective range and evidence-based psychosocial interventions such as family therapy may be available only to the few (Drake 2001). Research evidence is frequently not reflected in guidelines, expert advice and clinical practice, thereby robbing the patient of the benefits of advances in medical research. Failure to translate successful research into practice is a major cost to the public. Adoption of an innovation, such as a newer medication or a novel psychological therapy, is not an instantaneous act; it is a process that occurs over time (Dobbins 2001). Knowledge translation is an increasingly important topic and describes efforts to facilitate the transfer of high-quality evidence from research into clinical practice throughout the careers of medical doctors. It represents a process whereby research information is not only received but also acted on. Transforming research evidence into practice is a demanding task requiring creativity and endurance. Several factors have increased the need for better knowledge dissemination in medicine and psychiatry. The growth of science and technology, increased media attention on scientific discoveries and the demand for political accountability have all intensified the demand for better dissemination and utilisation of research evidence in healthcare settings (Dobbins 2001). In mental healthcare, a major challenge is to translate scientific advances rapidly into clinical practice, with a route from evidence to action that is efficient and explicit (Geddes 1998).