January 2009 - Health Resources Digest

Health Resources Digest

January 2009

EurasiaHealth Knowledge Network

The Health Resources Digest is distributed free of charge as a service of the EurasiaHealth Knowledge Network/American International Health Alliance (AIHA). If this document is to be re-distributed or posted on another Web site, we request that it be posted in full/without alteration, that credit is given to the EurasiaHealth Knowledge Network as the source of the document, and a link to www.eurasiahealth.org is included in the credit notice.

Translating Medical Knowledge into Practice

International and National Organizations and Projects

Knowledge Translation+

Knowledge Translation+ (KT+) is provided by McMaster University’s Health Information Research Unit. KT+ provides access to the current evidence on "T2" knowledge translation (ie, research addressing the knowledge to practice gap), including published original articles and systematic reviews on health care quality improvement, continuing professional education, computerized clinical decision support, health services research and patient adherence. Its purpose is to inform those working in the knowledge translation area of current research as it is published.

 T1 KT involves translational research from the lab to humans, while T2 KT has to do with understanding and enhancing the dissemination and application of research-derived knowledge in health care (Hulley et al, 2007). You will find two types of articles on this site: Quality-filtered KT Articles - The best evidence relevant to knowledge translation in the areas of quality improvement, continuing medical education, computerized clinical decision support, health services research and patient adherence, identified from over 130 premier clinical journals. All citations are pre-rated for quality by research staff at McMaster University. All articles are then rated for clinical relevance and interest by at least 3 members of a worldwide panel of practicing health professionals. Non-filtered KT Articles - Knowledge translation research articles identified from other sources (e.g., MEDLINE) that are not quality filtered but have relevant KT content. These papers are not rated by the panel of health professionals. The service includes: A cumulative searchable bibliographic database of evidence from the health care literature , and An email alerting system. Free registration required.

URL: http://plus.mcmaster.ca/kt/Default.aspx

Cochrane Effective Practice and Organisation of Care Group (EPOC)

The Cochrane Effective Practice and Organisation of Care Group (EPOC) is a Collaborative Review Group of the Cochrane Collaboration: an international organisation that aims to help people make well informed decisions about health care by preparing, maintaining and ensuring the accessibility of systematic reviews of the effects of health care interventions. The focus of EPOC is on reviews of interventions designed to improve professional practice and the delivery of effective health services. This includes various forms of continuing education, quality assurance, informatics, financial, organisational and regulatory interventions that can affect the ability of health care professionals to deliver services more effectively and efficiently. Interventions that aim to influence professional practice through patients are within the scope of EPOC. An organisational intervention is a change in who delivers health care, how care is organised, or where care is delivered.

URL: http://www.epoc.cochrane.org/en/index.html


WHO Collaborating Center for Knowledge Translation and Health Technology Assessment in Health Equity

The Institute of Population Health at the University of Ottawa was designated in April 1996 as the WHO Collaborating Center for Health Technology Assessment. In 2007, the Centre for GlobalHealth at the University of Ottawa was designated as the WHO Collaborating Center for Knowledge Translation and Health Technology Assessment in Health Equity. The Centre promotes the concept of technology assessment, the establishment of technology assessment systems, methodological support, training seminars in member countries, and collaborating among institutions with similar intent. To date, the Centre has focused on the development of a "tool kit" for needs-based and equity-oriented policy decisions and decision-aids for patient information. The Toolkit is a text and web-based summary of approaches to Needs-Based Health Technology Assessment (NBHTA). URL: http://www.cgh.uottawa.ca/whocc/index.htm


Knowledge Translation – Canadian Institutes of Health Research

 The Canadian Institutes of Health Research (CIHR) has referred to knowledge translation as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.” This process takes place within a complex system of interactions between researchers and knowledge users which may vary in intensity, complexity and level of engagement depending on the nature of the research and the findings as well as the needs of the particular knowledge user.

URL: http://www.cihr-irsc.gc.ca/e/29418.html


Effective Dissemination of Findings from Research – a compilation of essays

This compilation contains essays resulting from a workshop on effective dissemination of findings from research organized by the Institute of Health Economics. The publication is intended as one of the many available resources on dissemination of research findings for those interested in the subject. Considerable sums are spent on research, but concern continues that relevant findings are too often not appreciated or taken up by those who might benefit. The Institute of Health Economics (IHE), Alberta, Canada, 2008

URL: http://www.ihe.ca/documents/Dissemination.pdf


Journals and articles


Implementation Science

Implementation Science is an open access, peer-reviewed online journal that aims to publish research relevant to the scientific study of methods to promote the uptake of research findings into routine healthcare in both clinical and policy contexts. Biomedical research constantly produces new findings - but often these are not routinely translated into health care practice. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice, and hence to improve the quality and effectiveness of health care. It includes the study of influences on healthcare professional and organisational behaviour. Implementation science is an inherently interdisciplinary research area and the journal is not constrained by any particular research method. Implementation Science wishes to publish articles of high scientific rigour using the most appropriate methods to produce generalisable answers to study questions. As well as hosting papers describing the effectiveness of interventions Implementation Science provides a unique home for articles describing intervention development, evaluations of the process by which effects are achieved and the role of theory in the area of implementation research. The journal is also interested in publishing Debate/Discussion articles that present novel methods (particularly those that have a theoretical basis) of addressing current problems.

URL:  http://www.implementationscience.com/


The Journal of Continuing Education in the Health Professions   - Special Issue on Knowledge Translation, Volume 26, Issue 1, Winter 2006

Free access to abstracts and some full-text articles

URL: http://www.jcehp.com/vol26/2601.asp


Academic Emergency Medicine - Special Issue on Knowledge Translation in Emergency Medicine

November 2007 issue of Academic Emergency Medicine was dedicated to the consensus conference on Knowledge translation. “Emergency medicine in the United States is facing tremendous challenges due to recent public health emergencies, continuing threats of bioterrorism, and an increasing and unprecedented demand for emergency department services. These challenges include overcrowding; long waiting times; "boarding" of patients; ambulance diversion; a need for better, more reliable tools for triaging patients; and medical errors and other patient safety concerns. These challenges and concerns were brought to the forefront several years ago by the Institute of Medicine in several landmark reports that call for closing the research-to-practice gap in emergency medicine. The Agency for Healthcare Research and Quality is funding a number of projects that address many of the concerns raised in the reports, including the use of an advanced access appointment scheduling system to improve access to care; the use of an electronic medical record system to reduce waiting times and errors and improve patient and provider satisfaction; and the refinement of the Emergency Severity Index, a five-level triage scale to get patients to the right resources at the right time. The agency's Healthcare Cost and Utilization Project is gathering data that will allow researchers to examine a broad range of issues affecting the use, quality, and cost of emergency services..“  Free full-text access to all articles from this issue.

URL: http://www3.interscience.wiley.com/journal/120825360/issue


Kahn JM. Disseminating clinical trial results in critical care. Crit Care Med. 2009 Jan;37(1 Suppl):S147-53.

„Efficient translation of clinical evidence into clinical practice is among the greatest challenges to evidence-based medicine. The field of knowledge transfer seeks to understand the barriers to evidence uptake and develop new methods to effectively disseminate clinical trial results. Traditionally, barriers to evidence-based practice are categorized into those of knowledge, attitudes, and behavior. Efforts to improve translation of evidence into practice should uncover and address each of these barriers and be customized to the specific intervention. To help aid knowledge transfer, interventions in clinical trials should be as simple as possible and answer questions important to actual caregivers. Potentially innovative methods for improving knowledge transfer include expanding community research networks, clinical registries to monitor evidence uptake, and community-based participatory research. It is essential that investigators conducting clinical trials prioritize knowledge transfer to ensure that new therapies in critical care are actually reaching the critically ill.“ (Free full-text access through HINARI)

URL: http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200901001-00021.htm


Pronovost PJ, Berenholtz SM, Needham DM. Translating evidence into practice: a model for large scale knowledge translation. BMJ. 2008 Oct 6

„Evidence based therapies that prevent morbidity or death are often not translated into clinical practice. One reason is that research often neglects how to deliver therapies to patients. Consequently, errors of omission are prevalent and cause substantial preventable harm. Attempts to increase the reliable use of evidence based therapies have generally focused on changing doctors’ behaviour.3 However, doctors work in a healthcare team within a larger hospital system, which must be considered when attempting to improve the reliability of patient care. Models to increase the reliable use of evidence based therapies typically focus on translating evidence into practice or on the best methods to run a collaborative; few if any have done both.4 Our model embeds an explicit method for knowledge translation in a collaborative model for broader dissemination of knowledge into practice“. (Free full-text access through HINARI)

URL: http://www.bmj.com/cgi/content/extract/337/oct06_1/a1714


Related Eurasia Health Knowledge Network links;

Health Resources Digest, December 2008 – Evidence-Based Social Work

Health Resources Digest, September 2007 - Clinical Practice Guidelines: Development and Implementation

Compiled by Irina Ibraghimova,
Coordinator, Medical and Information Resources
American International Health Alliance

Back issues of the Health Resources Digest are archived at