Why health research is not put into practice

Professor Paul Glasziou, Director of the Centre for Evidence-based Medicine at Oxford University, is warning that much more needs to be done to translate good health research into medical practice to avoid wasting millions of dollars on health care.

He is a world authority on the 'gap' between health research and clinical practice, which is having a major financial impact on health systems around the world. Prof Glasziou is the visiting Margaret Black Fellow for 2007 at the University of Otago, Christchurch.

"We're spending billions of dollars on health practice which we know doesn't work as well as it should because health research has already provided that evidence. But there are still serious blockages moving this new research evidence into improved medical care, "he says.

"A central problem is the information flood. Every day there are 1500 health research papers published around the world. The problem for the average doctor is to pick up the results from those studies which should be changing and informing their practice. However, bad information often drives out or confounds the good at the present time."

Professor Glasziou has written four books about this serious and expensive health issue and has also spoken about the poor quality of some health research with inadequate descriptions of treatment.

"When you analyse what happens often patients are only getting 10% of the benefit from research findings because of what I call leakage along the information pipeline," he says. "This is wasting the millions of health dollars when findings are not applied, and outcomes not as good as they should be."

One of the solutions to this breakdown in applying research evidence to practice, either in hospitals or GPs' surgeries, is to use groups of people to filter the research results before it is passed on to doctors. It is also a question of providing national funding to purchase this process he says.

Professor Glasziou believes there also needs to be more accurate and research-based information for non-drug therapies. He says health systems are often biased in favour of using drugs, and more needs to be done to provide evidence-based information on alternative therapies and non-drug approaches.

He says for many conditions there are useful and proven non-drug therapies which are not easily accessible through a manual for doctors in the same way as drugs. At present he is working to develop an alternative reference guide for non-drug therapies, but one which is evidence-based.

Prof Glasziou is editor of the British Medical Journal's Evidence-Based Medicine and a member of the BMJ's editorial board.

Professor Glasziou is giving a public lecture on these important health issues at the University of Otago, Christchurch School of Medicine on Tuesday November 27, Rolleston Lecture Theatre at 5.30pm.

The lecture is titled: "Potholes along the road from research to practice".