BMJ 1998;317:405-409 ( 8 August )

Education and debate

Getting research findings into practice

Decision analysis and the implementation of research findings

This is the sixth in a series of eight articles analysing the gap between research and practice

R J Lilford, professor of health services research, ^a S G Pauker, professor, ^b D A Braunholtz, senior research fellow, ^a Jiri Chard, research associate. ^c

^a Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT, ^b Department of Medicine, New England Medical Centre, Tufts University, 750 Washington Street, Boston, MA 02111, USA, ^c MRC Health Services Research Collaboration, University of Bristol, Bristol BS8 2PR

Correspondence to: Professor Lilford rlilford@doh.gov.uk

Series editors: Andrew Haines and Anna Donald

The first 150 words of the full text of this article appear below.

Evidence based medicine is more than just reading the results of research and applying those results to patients because patients have particular features that may make them different from the "average" patient studied in a clinical trial.¹ There are two types of differences. The first type of differences comprise those that affect probability (for example, the probability that treatments will have the same absolute or relative effects as those measured in the trial). The second type of differences comprise those values (or utilities) that affect how much of a side effect a person is prepared to trade off against the positive advantages of treatment.

Thus it is necessary for doctors to relate the results from a trial to their particular patient. Health professionals usually do this intuitively, but formal decision analysis provides an intellectual framework for developing an explicit decision making algorithm which can be criticised and improved. Although, currently, . . . [Full text of this article]

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Decision analysis loses the meaning of human values by quantifying them

Nick Steel
bmj.com, 18 Aug 1998 [Full text]

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Peter Bourdillon
bmj.com, 27 Aug 1998 [Full text]

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