Knowledge Translation Series - Guest Editor, Sharon Straus
Successful high-quality knowledge translation research: three case studies

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Case example #1—Using physician-specific performance feedback and achievable benchmarks to improve the quality of primary care [1]

Background: Patients receive about half of the recommended evidence-based primary care for which they are eligible. Physicians currently receive a great deal of audit and feedback about how they are doing, but whether such efforts are warranted is poorly understood.

Question: Over and above traditional quality improvement interventions that included physician-specific feedback, would provision of “achievable benchmark” data lead to better patient outcomes?

Intervention: Most benchmark data are

Case example #2—Using clinical decision support with electronic prompts to increase thromboprophylaxis and decrease venous thromboembolism in hospitalized patients [2]

Background: Despite the fact that deep venous thrombosis and pulmonary embolism (DVT/PE) are a common but largely preventable complications of hospitalization, inexpensive and evidence-based thromboprophylactic measures are universally underused. Many attempts have been made to increase rates of DVT/PE prophylaxis.

Question: Will an automated clinical decision support system with physician prompts improve quality of care and reduce rates of DVT/PE?

Intervention: A computerized decision support

Case example #3—Using a multifaceted intervention directed at patients and physicians to decrease antibiotic use for acute bronchitis [3]

Background: Almost all the cases of acute bronchitis treated on an outpatient basis are caused by viruses. Despite the widespread dissemination of evidence-based guidelines, most of the patients still receive antibiotics leading to adverse events, increased antibiotic resistance in the community, and excess costs. Antibiotic use in this setting needs to be safely curtailed but most attempts have not been able to change practice.

Question: Will interventions directed at patients and/or their

Future research

These case examples illuminate at least four common problems in knowledge translation research that need to be better addressed. First, investigators often test multifaceted (or multiple component) interventions. If such an intervention is found to work, those wanting to apply the work in their own settings must apply all components of the intervention as described. KT researchers need to start conducting more three to four armed trials or formal factorial trials to better determine what works

Summary

These three case examples in successful high-quality knowledge translation research are each important contributions to the literature. They each demonstrate how disparate various clinical problems may be, how complex interventions may need to be, and how difficult implementation and evaluation will be. Nevertheless, collectively, these investigators overcame many of the problems endemic to the field. These cases are state-of-the-art examples of rigorous knowledge translation research directed

Acknowledgments

This study was supported by Salary award from the Alberta Heritage Foundation for Medical Research (Health Scholar).

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References (9)

  • C.I. Kiefe et al.

    Improving quality improvement using achievable benchmarks for physician feedback: a randomized controlled trial

    JAMA

    (2001)
  • N. Kucher et al.

    Electronic alerts to prevent venous thromboembolism among hospitalized patients

    N Engl J Med

    (2005)
  • R. Gonzales et al.

    Decreasing antibiotic use in ambulatory practice: impact of a multidimensional intervention on the treatment of uncomplicated acute bronchitis in adults

    JAMA

    (1999)
  • E.D. Peterson et al.

    Association between hospital process performance and outcomes among patients with acute coronary syndromes

    JAMA

    (2006)
There are more references available in the full text version of this article.

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