Bridges from evidence to practice are fragile

EDITOR,—C M Sudlow and colleagues are right to raise doubts about the applicability of the evidence regarding anticoagulation for atrial fibrillation to current situations in both primary and secondary care.1 This debate takes place, however, in a wider context: there are further barriers to the implementation of research findings that need to be addressed. Clinical situations are complex, and even if all the relevant resources were in place for widespread anticoagulant treatment how likely is it that such treatment would become routine rather than the domain simply of enthusiasts? Three such …