Getting clinicians to use evidence from systematic reviews is difficult

On p 1041 Wyatt et al report a randomised trial of educational visits to motivate the heads of 25 district general obstetric units in England to use systematic review evidence. In 1994 and 1995 they had showed great variation in four common obstetric practices known to improve patient outcomes and that labour ward guidelines showed little agreement with Cochrane review evidence. The gap between Cochrane review evidence and clinical practice narrowed in 1995, but 46% of pregnant women studied were still not managed according to current evidence. Educational visits to senior staff led to a significant but clinically modest uptake of evidence from systematic reviews in only one of the four practices---use of ventouse.


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Relevant Article

Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units
Jeremy C Wyatt, Sarah Paterson-Brown, Richard Johanson, Douglas G Altman, Michael J Bradburn, and Nicholas M Fisk
BMJ 1998 317: 1041-1046. [Abstract] [Full Text] [PDF]

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