Applying the results of clinical trials to patients to general practice: perceived problems, strengths, assumptions, and challenges for the future.

Randomized controlled trials (RCTs) and systematic reviews of RCTs now provide the most robust external evidence about the effectiveness of patient care. There are, however, several assumptions made when applying the results of RCTs to individual patients. This paper aims to outline the perceived barriers against the use of RCTs in practice, while emphasizing the rationale and advantages underlying the approach. A critical discussion concerning the assumptions made when applying evidence from RCTs to individual patients will be presented, with a worked example derived from a patient with acute sinusitis. Finally, proposals concerning the effective implementation of evidence derived from RCTs in the context of individual patient care will be discussed.