Knowledge does not equal action—bridging the chasm between research evidence and its application

In the medical world, progress cannot happen without new knowledge. Researchers conducting innovative research often presume that sharing their breakthroughs in scientific journals or presenting at conferences will directly contribute to improving patients care. While dissemination through these channels is crucial, it is equally imperative to recognize that the journey from groundbreaking research to tangible improvements in patient outcomes involves more than just raising awareness. It's not only about what we discover but also about how effectively we can translate those findings into real-world applications for the benefit of patients.

Researchers have found that, on average, it takes a baffling 17 years for scientific evidence to be adopted at a clinical level—notwithstanding the fact that it is disseminated by the traditional means of scientific publications or conferences. To reduce the gap between research evidence and application, the concept of knowledge translation was introduced focusing on accelerating the update of findings into healthcare decision making and practice. After all, swift scientific progress is as dependent on knowledge translation as it is on the research itself.  Due to its international outlook and its strong footing in research, education, and community, the AO Foundation is uniquely placed to turn itself into a prime destination for knowledge translation. 

In February 2024, the new AO Spine Knowledge Translation task force started designing a sustainable, integrated framework for generating and translating knowledge. In photo, from left to right: Richard Bransford, Olesja Hazenbiller, Charles Fisher, Emre Acaroğlu, Muzahem Taha, Klaus Schnake, Asdrubal Falavigna, Mike Kelly, Ben Davies, Janneke Loomans, Lisa Petermann, Jayr Bass, and Daisy Kudre-Schnyder.

Emphasizing action, not just the question

At its core, knowledge translation is about involving the right people at the right time. One of the challenges therefore is to establish a solid understanding of exactly who needs to know what, and what each person needs to do differently in order to successfully put new knowledge into action. Simply making new results available to practitioners in the operating theater will not be sufficient.

As there’s significantly more research published, it’s becoming more challenging for surgeons to stay up to date on the latest insights in their fields.  Even surgeons who constantly keep themselves up to date on all the latest research in their specialty may not be able to implement insights directly in their work. Implementation may depend on local and environmental factors like available equipment or working processes that are not within the direct circle of influence of a surgeon. The decision to adopt new knowledge is not only up to the surgeons themselves. It must be endorsed at the administrative, regulatory, or even at the political level—which in turn requires that the responsible persons at these levels have to be aware about the existence of new knowledge.

In fact, in some regions of the world, among them North America and Britain, it is increasingly difficult to receive funding without having submitted a knowledge translation plan with the initial application. This means that a detailed plan of how exactly a study's outcomes will be disseminated must be in place before the study even begins. In many cases, continuous evaluation will be required to be undertaken throughout the entire course of the study to ensure at any given point that the plan achieves its objectives.