Department of Medicine, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, 501 Smyth Road, Box 711, Ottawa, ON, K1H 8L6, Canada.
Implement Sci. 2012 May 31;7:50. doi: 10.1186/1748-5908-7-50.
One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred?
We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the likely barriers and facilitators. Although our evidence on the likely effectiveness of different strategies to overcome specific barriers remains incomplete, there is a range of informative systematic reviews of interventions aimed at healthcare professionals and consumers (i.e., patients, family members, and informal carers) and of factors important to research use by policy makers.
There is a substantial (if incomplete) evidence base to guide choice of knowledge translation activities targeting healthcare professionals and consumers. The evidence base on the effects of different knowledge translation approaches targeting healthcare policy makers and senior managers is much weaker but there are a profusion of innovative approaches that warrant further evaluation.
临床和卫生服务研究中最一致的发现之一是未能将研究转化为实践和政策。由于这些证据-实践和政策差距，患者无法从医疗保健的进步中获得最佳效益，并且面临不必要的医源性伤害风险，医疗保健系统也面临不必要的支出，导致重大的机会成本。在过去的十年中，国际政策和研究越来越关注如何缩小证据-实践和政策差距。在本文中，我们总结了当前的概念和证据，以指导知识转化活动，将其定义为 T2 研究（将新的临床知识转化为改善健康）。我们围绕五个关键问题组织文章：应该转移什么；应该向谁转移研究知识；应该由谁转移研究知识；应该如何转移研究知识；以及，应该以什么效果转移研究知识？
我们建议，知识转化的基本单位通常应该是最新的系统评价或其他研究结果的综合。知识转化者需要确定不同目标受众的关键信息，并以语言和知识转化产品的形式呈现这些信息，以便不同受众易于吸收。知识转化对不同目标受众的相对重要性将因研究类型和不同利益相关者群体的知识转化终点而异。有许多计划中的知识转化模型，源自不同的学科、背景（即设置）和目标受众观点。其中大多数表明，如果选择知识转化策略是根据对可能的障碍和促进因素的评估，那么为医疗保健专业人员和消费者制定的有计划的知识转化更有可能成功。尽管我们关于克服特定障碍的不同策略的有效性的证据仍然不完整，但有一系列针对医疗保健专业人员和消费者（即患者、家庭成员和非正式照顾者）以及对政策制定者研究使用重要的因素的干预措施的信息丰富的系统评价。
针对医疗保健专业人员和消费者的知识转化活动有大量（如果不完整）的证据基础可供选择。针对医疗保健政策制定者和高级管理人员的不同知识转化方法效果的证据基础要薄弱得多，但有许多创新方法值得进一步评估。
