We should overcome the barriers to evidence-based clinical diagnosis!
BACKGROUND
The wise integration of evidence from health care research into diagnostic decisions could influence patient outcomes by improving clinical diagnosis, reducing unnecessary testing, and minimizing diagnostic error. Yet for many, this promise does not match reality. Here, we collect and categorize barriers to the use of health care research evidence in diagnostic decisions, examine their potential consequences, and propose potential ways to overcome these impediments.


METHODS
Barriers were derived from observations over years of trying to inform clinical diagnoses with research evidence, and from interpretations of the literature.


RESULTS
Barriers are categorized into those related to the evidence itself, those related to diagnosticians, and those related to health care systems. Tentative solutions are proffered. Data are lacking on the frequency and impact of the identified barriers, as well as on the effectiveness of the proposed solutions.


CONCLUSIONS
Barriers to the sensible use of evidence from health care research in clinical diagnosis can be identified and categorized, and possible solutions can be imagined. We could, and should, muster the will to overcome these barriers.
Richardson
W Scott
WS
Department of Medicine, Boonshoft School of Medicine, Wright State University, PO Box 927, Dayton, OH 45401, USA. scott.richardson@wright.edu
D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000379:methods; D003933:Diagnosis; D003951:Diagnostic Errors; D004502:Education, Medical, Continuing; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D051188:Knowledge Bases; D011336:Probability; D011361:Professional Competence; D012107:Research Design