So much research evidence, so little dissemination and uptake: mixing the useful with the pleasing

EBMH notebookSo much research evidence, so little dissemination and uptake: mixing the useful with the pleasingTo the continuing consternation of many health scientists, their best research results, the fruits of much caring toil and labour, often appear to remain unused by health clinicians and policy decision makers.Despite the volumes of research evidence available, relatively little is disseminated and taken up or applied in practice.[1][2][3] These dissemination and uptake problems are neither new nor unique.The literature from many disciplines is replete with examples of new research findings not being widely used in decision making, sometimes for decades or more.4 5 The problem, however, has been noticed more acutely in the health disciplines in the previous decade with the widespread adoption of "evidence-based" approaches, and with the ensuing concern that health practices and policies should be based on the best research evidence available.1 2 Research dissemination and uptake problems have been particularly well described for physicians.Numerous studies have documented that physicians have difficulty applying new research findings in clinical practice, even when these findings are packaged in ready to use formats such as clinical practice guidelines. 1 2 The same problem likely exists for nurses, social workers, and other health practitioners also.The problem of research dissemination and uptake becomes considerably more complex when other kinds of health research audiences, such as administrative and legislative policy decision makers, are considered.These groups are even more diverse than clinical practitioners regarding their research information needs, and regarding barriers to and incentives for research dissemination and uptake. 1 6 These groups have certainly been less well studied. 1 6 What factors contribute to the problem with research dissemination and uptake-with clinical as well as administrative and legislative decision makers?Why does the problem persist in the health fields (including mental health)?Are any new directions or strategies emerging to help to alleviate the problem?These questions will be considered from a broad health policy perspective.With over 2 million articles published annually in over 20 000 health related journals, 7 the problem cannot be due to insufficient quantities of research evidence.In fact, the burgeoning quantities of research evidence are part of the problem, overwhelming clinical practitioners and other decision makers with too much evidence.These large quantities of research evidence are also scattered across multiple sources and in different media, making convenience of access an issue.Although the quantity of research evidence may be overwhelming, the quality may not be, however.It is unclear how much of the research evidence published annually is of sufficiently high quality (with respect to scientific rigour and practical relevance) to merit decision makers changing their practices or policies in response.To complicate matters, particularly in mental health, scientific evidence is still lacking, or is still controversial, for application to many important problems.