Performance Improvement 2013-2014. What Factors Help or Impede the Translation and Dissemination of Comparative Effectiveness Research into Medical Practice?


This project developed a framework for considering enablers and barriers to the translation of comparative effectiveness research (CER) findings into practice and then, through a review of the literature and key informant interviews, examined five cases of CER dissemination.

Observations from these five studies led to five key findings: 1) Financial incentives are primary drivers of the adoption of new clinical practices, whether or not these practices are supported by the CER evidence. CER results that threaten the financial interests of a stakeholder will be challenged at all phases of the translation process; 2) Even the best CER studies may fail to produce an unambiguous winner so it may be difficult to achieve a consensus interpretation of the results; 3) Cognitive biases play an important role in stakeholder interpretation of CER evidence and may be a formidable barrier in all phases of CER translation; 4) The questions posed by a CER study and its design may not adequately address the needs of end users or focus adequately on the decision making opportunities with the greatest potential to influence clinical practice and 5) Clinical decision support and patient decision aids can help to align clinical practice with CER evidence, but they are not widely used.

Report Title: Dissemination and Adoption of Comparative Effectiveness Research when Findings Challenge Current Practice
Agency Sponsor: OASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Caroline Taplin, 202-690-7906
Performer: Rand Corporation
Record ID: 9636 (December 30, 2012)

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"PerformanceImprovement2014.pdf" (pdf, 671.65Kb)

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