Evidence-based practice, research, peer review, and publication.

For about a quarter of a century, concerns have been expressed about published biomedical research. It became more acute after some published research and broad dissemination was found fraudulent. With the emphasis now being placed on scientifically validated or evidence-based practice, it has become more imperative that clinical guidelines be based on credible information in our textbooks and research literature. Since the early 1990s, it has been found that much of the research in our electronic databases does not meet quality standards and often is irrelevant, calling into questions problems with peer review, including the selection and publication process of our journals. This column is devoted to calling attention to these problems not only to CRNAs and other researchers, but also to the consumers of research who often use it to make changes in their practice. It also calls attention to the CRNA community about the movement toward calls for greater accountability in practice, both as to quality and cost, from which the movement toward evidence-based practice, the identification and benchmarking of best practices, and the development and implementation of clinical practice guideline has evolved. To feel ownership in anesthesia-related clinical practice guidelines, CRNAs must become involved in their development and implementation.