Translating research evidence into clinical practice: new challenges for critical care

High quality research evidence is now available to guide and shape the practice of critical care. As the generation of such evidence increases, the challenge facing critical care medicine will be translation of this evidence into measurable improvement in patient outcome. Significant barriers to this process of translation exist that will require substantial effort and resources to overcome. We briefly review the nature of translational barriers to incorporation of research evidence into clinical practice and the conventional approach to surmounting these barriers, and provide examples of barriers and potential solutions to emerging therapies in critical care.

[1]  D. Ketley,et al.  Impact of clinical trials on clinical practice: example of thrombolysis for acute myocardial infarction , 1993, The Lancet.

[2]  D. Schoenfeld,et al.  Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. , 2000, The New England journal of medicine.

[3]  J Ean,et al.  Efficacy and safety of recombinant human activated protein C for severe sepsis. , 2001, The New England journal of medicine.

[4]  A J Rotondi,et al.  Community-wide assessment of intensive care outcomes using a physiologically based prognostic measure: implications for critical care delivery from Cleveland Health Quality Choice. , 1999, Chest.

[5]  A. Morris Protocol management of adult respiratory distress syndrome. , 1993, New horizons.

[6]  R Jones,et al.  Twenty years of implementation research. , 2000, Family practice.

[7]  B J McNeil,et al.  Does more intensive treatment of acute myocardial infarction in the elderly reduce mortality? Analysis using instrumental variables. , 1994, JAMA.

[8]  J. Helterbrand,et al.  Efficacy and safety of recombinant human activated protein C for severe sepsis , 2003 .

[9]  Erry,et al.  Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction. , 1995, The New England journal of medicine.

[10]  E. Hannan,et al.  The decline in coronary artery bypass graft surgery mortality in New York State. The role of surgeon volume. , 1995, JAMA.

[11]  J. Kress,et al.  Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. , 2000, The New England journal of medicine.