Managing evidence-based knowledge: the need for reliable, relevant and readable resources

Straus S, Haynes RB
CMAJ. 2009 Apr 28;180(9):942-5

Nowadays few would argue against the need to base clinical decisions on the best available evidence. In practice, however, clinicians face serious challenges when they seek such evidence.

Research-based evidence is generated at an exponential rate, yet it is not readily available to clinicians. When it is available, it is applied infrequently. A systematic review of studies examining the information-seeking behaviour of physicians found that the information resource most often consulted by physicians is textbooks, followed by advice from colleagues. The textbooks we consult are frequently out of date, and the advice we receive from colleagues is often inaccurate. Also, nurses and other health care professionals refer only infrequently to evidence from systematic reviews in clinical decision-making.

The sheer volume of research-based evidence is one of the main barriers to better use of knowledge. About 10 years ago, if general internists wanted to keep abreast of the primary clinical literature, they would have needed to read 17 articles daily. Today, with more than 1000 articles indexed daily by MEDLINE, that figure is likely double. The problem is compounded by the inability of clinicians to afford more than a few seconds at a time in their practices for finding and assimilating evidence. These challenges highlight the need for better infrastructure in the management of evidence-based knowledge.


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