Examining and addressing evidence-practice gaps in cancer care: a systematic review

Abstract

BackgroundThere is increasing recognition of gaps between best scientific evidence and clinical practice. This systematic review aimed to assess the volume and scope of peer-reviewed cancer research output in the years 2000, 2005, and 2010.MethodsEligible papers were published in English and reported on evidence-practice gaps in cancer care. The electronic database Medline was searched for three time periods using MeSH headings and keywords. Abstracts were assessed against eligibility criteria by one reviewer and checked by a second. Papers meeting eligibility criteria were coded as data-based or non-data-based, and by cancer type of focus. All data-based papers were then further classified as descriptive studies documenting the extent of, or barriers to addressing, the evidence-practice gap; or intervention studies examining the effectiveness of strategies to reduce the evidence-practice gap.ResultsA total of 176 eligible papers were identified. The number of publications significantly increased over time, from 25 in 2000 to 100 in 2010 (p < 0.001). Of the 176 identified papers, 160 were data-based. The majority of these (n = 150) reported descriptive studies. Only 10 studies examined the effectiveness of interventions designed to reduce discrepancies between evidence and clinical practice. Of these, only one was a randomized controlled trial. Of all data-based studies, almost one-third (n = 48) examined breast cancer care.ConclusionsWhile the number of publications investigating evidence-practice gaps in cancer care increased over a ten-year period, most studies continued to describe gaps between best evidence and clinical practice, rather than rigorously testing interventions to reduce the gap.

Adherence to granulocyte-colony stimulating factor (G-CSF) guidelines to reduce the incidence of febrile neutropenia after chemotherapy—a representative sample survey in Germany

“…Several studies have reported a gap between evidence-based results [9] and a lack of implementation in routine practice. There are no available studies to describe how this gap can be closed, however [8]. One problem in implementing G-CSF guidelines might be the ignorance of the FN risk classifications of chemotherapy protocols.…”

Implementation research in emergency medicine: a systematic scoping review

“…Of those papers focusing on implementing an intervention, only a small number used rigorous evaluations, and this may be due to the difficulty of carrying out well-controlled trials in this field 14. Improving care in the ED often involves organisational change, where the unit of analysis is the ED as a whole.…”

“…Although volume of research output can provide an indication of the amount of research that is being carried out in a particular field and is a proxy indicator of scientific productivity,14 15 it is acknowledged that this is not a measure of the quality or health impact of this research.To present the number and proportion of implementation research papers by scope including type of implementation research, research study design, target population/clinical condition and country of origin in order to describe the state of the science in EM for the years specified.To provide recommendations to inform future implementation research in EM.…”

“…Although volume of research output can provide an indication of the amount of research that is being carried out in a particular field and is a proxy indicator of scientific productivity,14 15 it is acknowledged that this is not a measure of the quality or health impact of this research.…”

Evidence-practice gaps in lung cancer: A scoping review

“…A recent systematic review of evidence-practice gaps in cancer care notes that descriptive studies make up about 90% of published literature and fewer than 10% of studies utilise interventions designed to address these gaps (Bryant et al, 2014). A recent systematic review of evidence-practice gaps in cancer care notes that descriptive studies make up about 90% of published literature and fewer than 10% of studies utilise interventions designed to address these gaps (Bryant et al, 2014).…”