Research methodology in rheumatology.

The evidence-based medicine research community is increasingly recognizing that the translation of evidence into clinical practice is an important research agenda. This paper describes research methods related to transferring knowledge to different audiences: clinicians, consumers and policymakers. The iterative measurement loop (IML) described in 1987 (Tugwell 1987) highlights the 6 steps of evidence-based research that leads to the translation of evidence into practice and re-evaluation of the impact of evidence-based medicine (Figure 1). This paper describes research methods for assessing steps of the IML with the goal of improving knowledge translation and uptake of evidence-based medicine. Evidence-based medicine has been deŽ ned as the process of systematically Ž nding, appraising, and using contemporaneous research Ž ndings as the basis for clinical decisions. Evidence-based medicine asks questions, Ž nds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient’s problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful Ž ndings in clinical practice (Rosenberg 1995) The challenge of evidence-based medicine is to allow clinicians and consumers to quantify the impact of an intervention on individual patients. Research methodology in rheumatology