When Is Evidence Sufficient for Decision-Making?

A Framework for Understanding the Pace of Evidence Adoption


A study led by the National Pharmaceutical Council and two leading researchers that was published in the Journal of Comparative Effectiveness Research outlines influential factors that impact how quickly new medical evidence is adopted and put into practice by health care decision-makers.

According to the Institute of Medicine, it takes an average of 17 years for new data, or evidence, to become part of routine care. Using three well-documented cases in which new information was disseminated to the public—statins, drug-eluting stents and bone marrow transplantation for breast cancer—the authors developed a framework to determine which factors were most influential in changing clinical practice. Their framework includes the following considerations:  

  • Validity, reliability, and maturity of the science: Is the current understanding of the particular condition and its treatment understood well enough so that new information can be taken into account?
  • Economic drivers that might influence adoption: Who is paying for the treatment? Is it being reimbursed? What marketing or detailing efforts were influential?
  • Rapid (or slow) incorporation into practice guidelines: How quickly—or slowly—were the results accepted by groups that develop guidelines?
  • Communication: Are the results being amplified by major media outlets, celebrities or social media?
  • Patients’ and providers’ ability to apply results to their needs: Can patients or providers apply published evidence to their decisions?

The overall goal of the framework is to encourage consideration of the critical factors that affect adoption and help to optimize the pace with which new treatments and new findings about treatments are brought into routine clinical practice.