Dissemination and Adoption of Comparative Effectiveness Research Findings When Findings Challenge Current Practices. Chapter Seven: Factors Influencing the Translation of CER Research into New Clinical Practices: A Synthesis of Themes from the Case Studies


As the preceding chapters illustrate, a myriad of factors influence whether CER translation into clinical practice is ultimately successful. However, our synthesis suggests that some of these factors are “root causes,” i.e., they are fundamental and may represent high-leverage points for action to improve adoption of a new practice. We have identified at least five root causes of the failure of CER to change clinical practice. They manifest themselves in somewhat different ways across the case studies, appear to explain the strategies of many stakeholders who have an interest in CER, and typically exert their effects over multiple phases of the CER translation process. In the following, we describe the root causes in order of importance and describe the various mechanisms through which they impede the adoption of new clinical practices. We also describe the limitations of our study. In Chapter Eight we discuss the policy implications of our findings and suggest opportunities for future research that would either address gaps in our analysis or that would build directly on the lessons learned from this study.


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