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  1. T Smith,
  2. G Harvey,
  3. M Maresh,
  4. H McKenna,
  5. R Baker

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    This journal scan is based on a hand search of a number of clinical journals as well as others focusing on improvement and management for the period from December 2000 to February 2001

    Getting evidence based health care into practice

    Much of the evidence from clinical trials is based on the study of the use of interventions in specially selected groups of patients who often seem unlike many of those who seek health care. Moreover, clinical trials do not take into account the organisational circumstances in which care is given. But how much should these sort of observations influence thinking about and practice of evidence based health care? Understanding better the process by which outcomes and effectiveness research affect policy and practice may help to answer these important questions.

    Stryer D, Tunis S, Hubbard H, et al. The outcomes of outcomes and effectiveness research: impacts and lessons from the first decade. Health Serv Res 2000;35:977–95.

    Abstract reproduced from original.

    This study assesses the outcomes of the Agency for Healthcare Research and Quality's first decade of focus on outcomes and effectiveness research and identifies needs and opportunities for the study of OER in the coming years. Study findings were collected in response to an inquiry by the Center for Outcomes and Effectiveness Research at AHRQ in July 1997 to all principal investigators funded between 1989 and 1997. The request was for investigators to identify their most salient findings and supply material for up to three slides. OER has had moderate but significant success meeting initial expectations from the field. Challenges for the next generation of OER include advancing from hypothesis generation to definitive studies of effectiveness, and acceleration of the process by which findings affect policy, practice, and outcomes.

    Starfield B. New paradigms for quality in primary care. Br J Gen Pract 2001;51:303.

    Barbara Starfield's investigations of the impact of primary health care services in different health care systems are familiar. She has shown that, where primary care is strong, countries have lower health care costs. She has also been able to demonstrate a relationship between population mortality …

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