When is evidence sufficient for decision-making? A framework for understanding the pace of evidence adoption

J Comp Eff Res. 2013 Jul;2(4):383-91. doi: 10.2217/cer.13.39.


Translation of medical evidence into practice has not kept pace with the growth of medical technology and knowledge. We present three case studies--statins, drug eluting stents and bone marrow transplantation for breast cancer--to propose a framework for describing five factors that may influence the rate of adoption. The factors are: validity, reliability and maturity of the science available before widespread adoption; communication of the science; economic drivers; patients' and physicians' ability to apply published scientific findings to their specific clinical needs; and incorporation into practice guidelines.

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Bone Marrow Transplantation / trends
  • Breast Neoplasms / therapy
  • Coronary Stenosis / therapy
  • Decision Making*
  • Diffusion of Innovation*
  • Drug-Eluting Stents / trends
  • Evidence-Based Medicine*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypercholesterolemia / drug therapy
  • Randomized Controlled Trials as Topic
  • Translational Medical Research


  • Anticholesteremic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors