17 year gap (was change with 1 day training)

Elias Peter pheski69 at GMAIL.COM
Sun Jun 3 12:10:56 UTC 2018


(Note: I’m branching a thread here, and have changed the subject line accordingly.)

The commonly cited figure of a 17-year gap to translate original research into clinical practice should be treated with some skepticism. 

First, it is based on a single 18-year old paper that became a ‘meme’ after it was cited in the Institute of Medicine 2001 paper Crossing the Quality Chasm. Much has changed since 2000. 

Second, there is no consensus in the published literature. Morris, Wooding and Grant list 23 widely divergent estimates in their 2011 review of this issue.

Third, speed is only one factor. Validity is another. Think, for example, of the rapid proliferation of stem cell therapy clinics at a time when the role of steam cell therapy remains very much uncertain.

I think the processes of knowledge adoption and behavior change are too complex to be easily or productively lumped into a single statistic. Think about the zombie preference for hydrochlorthiazide over chlorthalidone for hypertension, the lack of hand washing in medical settings, the use of eye patching for corneal abrasions or antibiotic ointment on wounds, the use of stenting in the setting of chronic and stable angina, the infatuation with nutraceuticals in the same culture that is skeptical about immunizations but loves things like stem cell therapy and proton beam therapy.

Peter Elias

(Morris, Zoë Slote, Steven Wooding, and Jonathan Grant. “The Answer Is 17 Years, What Is the Question: Understanding Time Lags in Translational Research.” Journal of the Royal Society of Medicine 104.12 (2011): 510–520. PMC. Web. 3 June 2018.)

(Lawrence W Green; Making research relevant: if it is an evidence-based practice, where's the practice-based evidence?, Family Practice, Volume 25, Issue suppl_1, 1 December 2008, Pages i20–i24, https://doi.org/10.1093/fampra/cmn055 <https://doi.org/10.1093/fampra/cmn055>)

(Balas EA,  Boren SA. , Managing Clinical Knowledge for Health Care Improvement. Yearbook of Medical Informatics 2000: Patient-centered Systems , 2000Stuttgart, GermanySchattauer(pg. 65-70))

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On 2018.06.02, at 8:33 PM, Lyn Behnke <lynbehnke at GMAIL.COM> wrote:

Hmm. There is something banging in the back of my mind, but I believe it is related to the type of change you want to make.  Most changes in Medicine/nursing has some system change associated with it now days and it takes a long time to make a “simple” change.  In terms of new research, it takes about 17 years to get the new research into practice.  In terms of documentation changes, the EHR has to change, users have to be taught, programmers have to reprogram and it is quite a complicated procedure.  So, the 1 day of training is lost in all the lag time it takes to make a change.
 
From: Nick Rainey <nickraineydpt at GMAIL.COM <mailto:nickraineydpt at GMAIL.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Nick Rainey <nickraineydpt at GMAIL.COM <mailto:nickraineydpt at GMAIL.COM>>
Date: Saturday, June 2, 2018 at 6:21 PM
To: <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Change with 1 day training
 
I thought I read something recently either in this group or elsewhere about the difficulty of making actual practice change with a 1 day training. Anyone have any good quotes or written material on this? 
 <>
 
Thanks in advance.
--
Nick Rainey
520-955-1820
 

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