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A qualitative assessment of the research used in the development of a widely used Clinical Practice Guideline (CPG) to gain insight into the kinds of evidence that informs the development of CPGs.
All articles cited within the 2003 Canadian Pediatric Asthma Consensus Guideline (“the Guideline”) were secured, as was the literature cited by these articles. Two independent reviewers coded all 98 articles referenced by the Guideline (“primary citations”), and the 3,167 articles referenced by the primary citations (“secondary citations”), along three schemes: article type, research design and article orientation.
Among the primary and secondary citations Clinical research was the most represented type (53%), followed by Health Services (25%), Population Health (18%), and Biomedical (4%). There was a strong interdependence between Clinical and Health Services Research articles with each type frequently citing the other. Observational study designs were most common (48%), followed by experimental studies (31%) and secondary research (21%).
While CPGs rely on significant support from clinical or biomedical randomized controlled trials, the translation of research into practice is non-linear with an important role for Health Services Research and Population Health. This may have implications for funding agencies and other supporters of health research who are working to bridge the gap between research and clinical practice.
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