title: Barriers to implementing evidence-based clinical guidelines: a survey of early adopters.
abstract: OBJECTIVE
  The purpose of this study was to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines.
  
  
  METHODS
  This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges.
  
  
  RESULTS
  The most common barriers to implementation were difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems had to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature.
  
  
  CONCLUSIONS
  Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists' fears need to be addressed.
authors.affiliation: Center for Dental Informatics, Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA. hspallek@pitt.edu
authors.forename: Heiko
authors.initials: H
authors.lastname: Spallek
authors.forename: Mei
authors.initials: M
authors.lastname: Song
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Polk
authors.forename: Tanja
authors.initials: T
authors.lastname: Bekhuis
authors.forename: Julie
authors.initials: J
authors.lastname: Frantsve-Hawley
authors.forename: Krishna
authors.initials: K
authors.lastname: Aravamudhan
mesh_terms: D003430:Cross-Sectional Studies; D003813:Dentistry / Q000592:standards / Q000639:trends; D055094:Evidence-Based Dentistry; D006801:Humans; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D011795:Surveys and Questionnaires