Maximising the uptake of evidence into clinical practice: an information economics approach.

Evidence such as systematic reviews or clinical practice guidelines are information products, and clinicians are consumers of those products; their current proliferation but low uptake by consumers indicates an information oversupply. The costs and benefits of accessing and applying information are at least as important as are the costs and benefits of the treatments the information describes. In the same way that a citation index is a measure of the impact of a scientific paper, an evidence uptake index could measure effectiveness of evidence products in a clinical population. The uptake of evidence-based medicine may be hampered by the perceived high cost of changing to it. At present, most costs are borne by individual clinicians, but individual benefits for clinicians are downplayed in favour of population benefits. Specific strategies to increase evidence uptake into practice include decreasing the "cost of ownership"; increasing the direct or perceived value of evidence resources in routine practice; and customising evidence to suit different users, tasks and clinical contexts.