Where does the ’17 years’ data point come from?
In 2010, after years of hearing that “[it takes on average]…17 years from research to practice…” I spent some time to dig into the facts…and I came away both impressed (by the underlying science) and concerned (by the barriers we face). The following is what I shared with my colleagues at Pfizer at the time….which generated MUCH conversation:
Here is the authors’ theoretical evidence:
And, here is the authors’ empirical evidence:
And finally here is the description of the simple mathematical construct for the 17 year reference:
Oh, by the way, this ’17 years’ measure is only getting us to 50% utilization of clinical recommendations!
Other (chilling) thoughts – remember this is 17 years ago, things are likely much worse:
- Passive diffusion does not work:
- If a doc were to read 2 articles a day, by the end of any year they would be centuries behind!
- A general physician would have to peruse 19 articles a day to keep up with relevant science
- Textbooks are often wrong, outdated, and misleading (w/ refs to support)
- 75% of docs admitted having problems understanding statistics commonly found in journals
- Medical education and the acquisition of professional credentials do not guarantee that medical knowledge will be coupled rigorously to the decision making processes needed in practice
- Innovative technologies are needed to deliver credible and evidence to the point of care
So, as we all make our way out to the west coast for the annual Alliance meeting, keep these challenges in mind. On one hand, very little has gotten better since 2010, on the other hand I believe we may be closer than ever to bending the innovation curve!
If our paths cross this week, I’d love to hear your thoughts on the topic!
For those interested in digging into these ideas for themselves, here is a link to the full reference:
Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000: Patient-Centered Systems. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH; 2000:65-70.