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October 24, 2005

In Search of Evidence: Is There the Will and a Way?

Arch Intern Med. 2005;165(19):2194-2195. doi:10.1001/archinte.165.19.2194

Scientifically, politically, economically, and perceptually, there are growing demands by both society as a whole and the medical profession that evidence must drive clinical decision pathways. The best level of evidence as incorporated into clinical practice guidelines originates from randomized clinical trial data. For many years, the process of obtaining objective clinical data has been a path across a minefield. Even under the most optimal circumstances, obstacles confront most clinical research projects that can delay the reporting of important clinical information. In this issue of the ARCHIVES, Embi et al1 present the use of the electronic health record (EHR)–based clinical trial alert (CTA) system to address the problem of rapid subject recruitment by physicians, one of the recognized obstacles that can delay successful completion of a clinical trial. Although the authors recognize the limitations of this particular CTA intervention, including a small number of physicians at a single institution, along with the use of a single EHR to test a single clinical trial, this article serves as an invitation to incorporate the evolving use of technology in the clinical practice setting to enhance all phases of the clinical research process.

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