The paths from research to improved health outcomes

Evidence-based medicine aims to provide clinicians and patients with choices about the most effective care based on the best available research evidence. To patients, this is a natural expectation. To clinicians, it's a nearly impossible dream. The U.S. Institute of Medicine report “Crossing the Quality Chasm” has documented and drawn attention to the gap between what we know and what we do (1). The report identified 3 types of quality problems—overuse, underuse, and misuse. It suggested that “The burden of harm conveyed by the collective impact of all of our health care quality problems is staggering.” While attention has focused ...