| Background. Previous research has identified, on average, a 17-year evidence-to-practice gap within health care. While some studies yield statistically significant results, they may have little clinical relevance, or, the quality of the medical evidence is weak or misleading. A researcher-practitioner gap precludes resolution of important clinical problems confronting physicians and represents lost opportunities for improving the quality of care, misuse of ineffective treatments and under use of evidence-based recommendations.;Objectives. This multi-method study incorporated physician interviews and survey design to examine how internists, cardiologists and oncologists translate new research findings into practice. These specialties represent diverse practice areas with unique features of knowledge transfer and utilization.;Methods. Through a series of interviews, barriers to translational research and how physicians respond to new findings that conflict with current practice standards were assessed. A written survey further evaluated these areas, the status of adoption of electronic medical record systems---a vehicle for reducing the translational research gap, and perceptions of pay-for-performance incentives.;Results. Evidence suggests the translational research gap has been reduced and varies by medical specialty. Additionally, many research studies fail to address important unresolved clinical questions physicians confront each day, especially within oncology. While many physicians consider their understanding of research design as strong, their statistical prowess is average or weak. Specialty organizations can play an important role in deciphering the quality of new scientific evidence, especially when it conflicts with current standards of practice.;A gap was also identified between physician adherence to evidence-based and preventive guidelines and insurance reimbursement, warranting further evaluation. Finally, changes to the individual, organizational and cultural levels of medical decision making remain major barriers to greater adoption of electronic medical records and performance incentives.;Conclusion. Multiple factors influence knowledge transfer, the uptake of new research results and medical decision making. Delay in greater adoption of electronic medical record systems impedes the translational research process and represents countless missed opportunities for improving the quality of health care. More effective knowledge transfer must occur at the point of service to drive medical decision making toward greater evidence-based decisions that ultimately, enhance the quality of care. |
