Faculty of Information and Media Studies, The University of Western Ontario, 1151 Richmond St, London, ON N6A 5B7, Canada.
Health Res Policy Syst. 2013 Apr 12;11:13. doi: 10.1186/1478-4505-11-13.
Significant emphasis is currently placed on the need to enhance health care decision-making with research-derived evidence. While much has been written on specific strategies to enable these "knowledge-to-action" processes, there is less empirical evidence regarding what happens when knowledge translation (KT) processes do not proceed as planned. The present paper provides a KT case study using the area of health care screening for intimate partner violence (IPV).
A modified citation analysis method was used, beginning with a comprehensive search (August 2009 to October 2012) to capture scholarly and grey literature, and news reports citing a specific randomized controlled trial published in a major medical journal on the effectiveness of screening women, in health care settings, for exposure to IPV. Results of the searches were extracted, coded and analysed using a multi-step mixed qualitative and quantitative content analysis process.
The trial was cited in 147 citations from 112 different sources in journal articles, commentaries, books, and government and news reports. The trial also formed part of the evidence base for several national-level practice guidelines and policy statements. The most common interpretations of the trial were "no benefit of screening", "no harms of screening", or both. Variation existed in how these findings were represented, ranging from summaries of the findings, to privileging one outcome over others, and to critical qualifications, especially with regard to methodological rigour of the trial. Of note, interpretations were not always internally consistent, with the same evidence used in sometimes contradictory ways within the same source.
Our findings provide empirical data on the malleability of "evidence" in knowledge translation processes, and its potential for multiple, often unanticipated, uses. They have implications for understanding how research evidence is used and interpreted in policy and practice, particularly in contested knowledge areas.
目前非常强调需要利用研究产生的证据来增强医疗保健决策。虽然已经有很多关于使这些“知识转化为行动”过程的具体策略的论述，但关于知识转化（KT）过程不按计划进行时会发生什么的实证证据较少。本文提供了一个 KT 案例研究，该案例使用医疗保健领域的亲密伴侣暴力（IPV）筛查。
使用修改后的引文分析方法，从一项全面的搜索（2009 年 8 月至 2012 年 10 月）开始，以捕获学术和灰色文献以及引用发表在主要医学期刊上的一项特定随机对照试验的新闻报道，该试验研究了在医疗保健环境中对女性进行 IPV 暴露筛查的有效性。使用多步混合定性和定量内容分析过程提取、编码和分析搜索结果。
该试验在 112 个不同来源的期刊文章、评论、书籍、政府和新闻报道中的 147 篇引文中被引用。该试验还构成了几个国家级实践指南和政策声明的证据基础。对该试验的最常见解释是“筛查没有益处”、“筛查没有危害”或两者兼而有之。这些发现的代表性方式存在差异，从对发现的总结，到对一个结果的优先考虑，再到对试验方法严谨性的批判性限定等。值得注意的是，解释并不总是内部一致的，同一来源中有时会以相互矛盾的方式使用相同的证据。
我们的研究结果提供了关于知识转化过程中“证据”的可变性及其在多个、经常是意想不到的用途中的潜力的经验数据。它们对于理解研究证据在政策和实践中的使用和解释具有意义，特别是在有争议的知识领域。
