The Chasm between Evidence and Practice
The Chasm between Evidence and Practice
Extent, Causes, and Remedies
Studies consistently show that health care practitioners are poor at processing statistical information on risk. Indeed, almost everybody in health care, apart from a few people with advanced training, is poor at processing statistical information. The inability to process statistical information among health care practitioners is one cause of patients failing to receive optimal care. But there are many others, including a flawed and biased information base, unawareness of evidence, unwillingness to accept the evidence, lack of applicability of the evidence, inability to implement treatments, failures to act, unwillingness of patients to accept evidence, and failure to adhere to treatments. Commissioners of health care and those who set policy may be in a much stronger position than practitioners to follow evidence, as they have access to expert advice and are not under the same time pressures as practitioners. The reductionist ideas of evidence-based medicine, however, are not simply applied in commissioning and the making of policy. Improvement is most likely to come with a systems approach, making it easy for practitioners to use interventions based on evidence and more difficult to use those not based on evidence.
Keywords: Strüngmann Forum Reports, evidence-based medicine, medical reporting, research bias, risk literacy, statistical literacy, unawareness of evidence
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