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VIEWPOINT

From knowledge to practice in chronic cardiovascular disease: a long and winding road

Sumit R. Majumdar, MD, MPH^*, Finlay A. McAlister, MD, MSc^*,* and Curt D. Furberg, MD, PhD

^* Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Manuscript received November 3, 2003; revised manuscript received December 18, 2003, accepted December 23, 2003.

^* Reprint requests and correspondence: Dr. Finlay A. McAlister, Division of General Internal Medicine, Department of Medicine, University of Alberta, 2E3.24 Walter Mackenzie Health Sciences Centre, 8440-112th Street, Edmonton, Alberta, Canada, T6G 2B7.
finlay.mcalister{at}ualberta.ca

Although clinical practices evolve over time, the translation of specific research evidence into clinical practice is unpredictable, inconsistent, and complex. In this paper, we use examples from chronic cardiovascular conditions to: 1) highlight two types of care gaps; 2) describe the most common potential barriers to the application of evidence into clinical care; and 3) outline which of the strategies for translating evidence into clinical care have been shown to be ineffective, which strategies have been shown to be effective and to describe some untested approaches that hold promise.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   HF = heart failure   HOPE = Heart Outcomes Prevention and Evaluation study   MI = myocardial infarction   RCT = randomized clinical trial

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