The main aim of evidence-based treatment recommendations and guidelines are to translate findings from health research into clinical practice. When implemented successfully these should improve quality of care and lead to improved health outcomes. However many and varied obstacles stand in the way of achieving these endpoints. These range from a paucity of high quality trials to inform the recommendations; lack of a transparent and systematic approach to evidence synthesis and assessing the quality of that evidence (which sometimes leads to conflicting recommendations); and lack of a suitably targeted dissemination strategy. In addition while physicians may be aware of published recommendations, this does not necessarily translate into altered physician behaviour.
This presentation will consider the generalisability of clinical trials to treatment recommendations. To be clinically useful, both clinical trials and treatment recommendations must be applicable to patients typically seen in routine care, i.e. they require external validity. They also need to address relevant clinical problems. Different methods for generating treatment recommendations will also be discussed - from the all-purpose method of generating treatment recommendations by an assembled panel of experts in the field, to the alternate approach taken by the 3e (Evidence, Expertise, Exchange) Initiative which involved a large number of rheumatologists from different countries generating practical recommendations on a range of topics relevant to clinical practice by integrating evidence synthesis with expert exchange.
Disclosure of Interest None declared
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