Does It Really Take 17 Years for Clinical Trial Results to Reach Clinical Practice? A Meta-Research Protocol of the Evaluation of Trials Informing Recommendations

Abstract

Introduction

It has been estimated to take 17 years for research to change clinical practice. Scientific Knowledge Accelerator Foundation aims to narrow this research-practice gap, hypothesising that making scientific evidence computable will accelerate the pace of knowledge transfer. We designed this study to develop a reusable process for measuring the rate of knowledge transfer from clinical trials to practice guidelines to evaluate the effectiveness of our efforts in the years to come.

Methods

Our study uses citation in clinical guidelines as a proxy for use of research in practice. We will evaluate a convenience sample of randomised controlled trials (RCTs), trace their citations in the clinical literature, and measure the length of time it takes for RCT results to be incorporated into recommendations for clinical practice. For each ‘index article’ in our convenience sample, we will record the date its results were publicly available (including preprint date and date of posting results in a registry, if applicable). Then, we will identify articles that cite the index article, sorting by date to find the earliest use of the RCT findings to inform an evidence-based recommendation for clinical practice. To qualify, these articles will meet three criteria: (1) systematically derived, (2) incorporating the RCT in the results section of the article and (3) making a recommendation intended to inform clinical practice. Review articles meeting the first two criteria will be checked for their use in subsequent generation of recommendations.

Discussion

This study will develop a process to approach the question, ‘How long does it take for results of clinical trials to be incorporated into published systematically derived recommendations intended to guide clinical practice?’