Faculty of Medicine, Otto-von-Guericke-University Magdeburg, Institute of Social Medicine and Health Systems Research, Leipziger Straße 44, 39120, Magdeburg, Germany.
Faculty of Medicine, Otto-von-Guericke-University Magdeburg, Institute of General Practice, Leipziger Straße 44, 39120, Magdeburg, Germany.
BMC Fam Pract. 2021 Oct 20;22(1):211. doi: 10.1186/s12875-021-01560-3.
It may take 15 years or longer before research evidence is integrated into clinical practice. This evidence-to-practice gap has deleterious effects on patients as well as research and clinical processes. Bringing clinical knowledge into the research process, however, has the potential to close the evidence-to-practice gap. The NEUROTRANS-Project attempts to bring research and practice together by focusing on two groups that usually operate separately in their communities: general practitioners and neuroscientists. Although both groups focus on dementia as an area of work, they do so in different contexts and without opportunities to share their expertise. Finding new treatment pathways for patients with dementia will require an equal knowledge exchange among researchers and clinicians along with the integration of that knowledge into research processes, so that both groups will benefit from the expertise of the other.
The NEUROTRANS-Project uses a qualitative, multi-stage research design to explore how neuroscientists and general practitioners (GPs) approach dementia. Using a grounded theory methodology, it analyzes semi-structured interviews, case vignettes, focus groups with GPs in Saxony-Anhalt, Germany, and informal conversations with, and observations of, neuroscientists from the German Center for Neurodegenerative Diseases in Magdeburg.
The NEUROTRANS-Project identified a clear division of labor between two highly specialized professional groups. Neuroscientists focus abstractly on nosology whereas general practitioners tend to patient care following a hermeneutic approach integrating the patients' perspective of illness. These different approaches to dementia create a barrier to constructive dialogue and the capacity of these groups to do research together with a common aim. Additionally, the broader system of research funding and health care within which the two groups operate reinforces their divide thereby limiting joint research capacity.
Overcoming barriers to research collaboration between general practitioners and neuroscientists requires a shift in perspective in which both groups actively engage with the other's viewpoints to facilitate knowledge circulation (KC). Bringing 'art into science and science into art', i.e. amalgamating the hermeneutic approach with the perspective of nosology, is the first step in developing joint research agendas that have the potential to close the evidence-to-practice gap.
研究证据要经过 15 年或更长时间才能被整合到临床实践中。这种证据到实践的差距对患者以及研究和临床过程都有不利影响。将临床知识引入研究过程具有缩小证据到实践差距的潜力。NEUROTRANS 项目通过专注于通常在社区中单独运作的两个群体来尝试将研究和实践结合起来：全科医生和神经科学家。尽管这两个群体都专注于痴呆症作为一个工作领域，但他们的工作背景和方式不同，没有机会分享专业知识。为痴呆症患者找到新的治疗途径需要研究人员和临床医生之间进行平等的知识交流，并将这些知识纳入研究过程，使两个群体都能从对方的专业知识中受益。
NEUROTRANS 项目采用定性、多阶段的研究设计，探索神经科学家和全科医生（GP）如何处理痴呆症。使用扎根理论方法，它分析了来自德国马格德堡神经退行性疾病中心的神经科学家的半结构化访谈、案例描述、格但斯克-桑多梅日地区全科医生焦点小组的非正式对话和观察。
NEUROTRANS 项目发现了两个高度专业化的专业群体之间明确的分工。神经科学家抽象地专注于疾病分类学，而全科医生则倾向于采用一种解释学方法，综合患者对疾病的看法来进行患者护理。这种对痴呆症的不同处理方式形成了建设性对话的障碍，也限制了这些群体以共同目标一起进行研究的能力。此外，这两个群体所运作的更广泛的研究资助和医疗保健系统也强化了他们之间的分歧，从而限制了联合研究能力。
克服全科医生和神经科学家之间的研究合作障碍需要转变观念，使两个群体都积极参与对方的观点，以促进知识流通（KC）。将“艺术融入科学，科学融入艺术”，即把解释学方法与疾病分类学的观点融合起来，是制定有潜力缩小证据到实践差距的联合研究议程的第一步。
