HOW DO WE TRANSLATE EVIDENCE
A LOCAL EXAMPLE OF WHERE CLINICIANS AND
RESEARCHERS SOLVE THE PROBLEM TOGETHER
Significant challenges exist when trying to integrate the
best-quality evidence into daily clinical practice. However,
lack of time, lack of skills to understand the literature and
lack of resources are all cited as key barriers. Reducing
these barriers would benefit patients and reduce the risk of
harm (Grol and Grimshaw 2003, Dawes 2005).
In 2003, a group of local clinicians and researchers picked up
the challenge of how to get evidence into musculoskeletal
practice. The Musculoskeletal Research Facilitation Group
was established. It is a multidisciplinary group which looks
for the best evidence to inform and underpin clinical
practice. Members include physiotherapists, occupational
therapists, rheumatologists, nurses, podiatrists, clinical
researchers, librarians and systematic reviewers.
Clinicians are encouraged to send in queries to the group
that concern their clinical practice. This may relate to
treatment, diagnosis, prognosis or could be about system
or professional change e.g. the benefits of telephone triage.
The literature is searched and the evidence appraised.
The process culminates in developing recommendations
for practice based on the best available evidence, which are
disseminated through local networks and are housed on
our website www.keele.ac.uk/ebp/mrfgroup
Here we describe two case studies. We hope we can inspire
you to use the information we have produced to inform
your practice, generate clinical questions, or even form
your own group.
Case study 1: Shoulder exercises
A busy physiotherapist used shoulder stability exercises to treat patients
with supraspinatus impingement syndrome. She found this to be a valuable
approach but asked the group if there was any evidence to justify the treatment.
1. She raised the question and helped to refine it, given her working context.
2. The librarian found nine relevant published studies.
3. A sub-group appraised and generated a clinical recommendation.
• There was no evidence specific to this type of exercise (scapula stabilisation),
but the literature did indicate positive outcomes for general shoulder exercises.
• The group decided that this was an important area of practice, so they
worked with their academic colleagues at the Arthritis Research UK
Primary Care Centre, Keele University, to develop a randomised controlled
trial to explore this intervention.
• This was funded by the NIHR and the results are expected in 2014.
For more details on this topic go to: www.keele.ac.uk/media/keeleuniversity/ri/primarycare/ebpmicro/catbank/shoulder.pdf
“On occasion we have asked questions that have changed our practice within the acute hospital.
This process has been reassuring and rewarding.”
These bulletins are designed to provide information for general practitioners, the primary care team, teachers, trainers and policy makers about musculoskeletal problems in practice.