doi: 10.56294/sctconf2024.1132
Categoría: Health Sciences and Medicine
REVIEW
The Role of Clinical Research in Improving Medical Practice: From Theory to Practice
El papel de la investigación clínica en la mejora de la práctica médica: de la teoría a la práctica
Viktoriia
Bati1 
*, Dmytro
Teslenko2 *, Olha Yuryk3
*, Yevhenii
Avtomieienko4 *, Liudmyla Bashkirova5
*
1Uzhhorod National University, Department of Microbiology, Virology, Epidemiology with a course in Infectious Diseases and Phthisiology. Uzhhorod, Ukraine.
2Romodanov Neurosurgery Institute, Department of Adjuvant Treatment for CNS Tumors. Kyiv, Ukraine.
3SI “The Institute of Traumatology and Orthopedics” by the National Academy of Medical Sciences of Ukraine, Laboratory of Neuro-Orthopedics and Problems of Pain. Kyiv, Ukraine.
4SI “The Institute of Traumatology and Orthopedics” by the National Academy of Medical Sciences of Ukraine, Department for Trauma Injuries and Problems of Osteosynthesis. Kyiv, Ukraine.
5Shupyk National Healthcare University of Ukraine, Department of Neurology. Kyiv, Ukraine.
Cite as: Bati V, Teslenko D, Yuryk O, Avtomieienko Y, Bashkirova L. The Role of Clinical Research in Improving Medical Practice: From Theory to Practice. Salud, Ciencia y Tecnología - Serie de Conferencias. 2024; 3:.1132. https://doi.org/10.56294/sctconf2024.1132
Submitted: 25-02-2024 Revised: 11-05-2024 Accepted: 26-08-2024 Published: 27-08-2024
Editor: Dr.
William Castillo-González
Corresponding author: Viktoriia Bati *
ABSTRACT
Clinical studies can be relied on as a powerful engine of medical advancement in terms of developing new solutions for better life treatment. This paper reviews research approaches that are critical for the establishment of the safety and efficacy of various treatment methods. Even though research is becoming more advanced day by day, still a gap exists between the research findings and their real application. The purpose of this review is to identify barriers that stand in the way of translation and to provide means for overcoming them. A comprehensive search of online databases identified studies on clinical research methodologies and evidence-based practice (EBP) promotion. Thematic analysis was used to synthesize key themes. This paper demonstrates how clinical research particularly matters. It denotes problems like expenses limits as well as clinicians’ unawareness that do not allow the translation of research results into practice. Nevertheless, efforts are made to provide solutions, including education on EBP, adoption of practice guidelines and leveraging technology to share research findings. These problems should be tackled by EBP promotion in order to guarantee optimum and updated treatment of patients and better population health.
Keywords: Clinical Research; Evidence-Based Practice; Translation Gap; Healthcare Disparities; Medical Progress.
RESUMEN
Los estudios clínicos pueden considerarse como un motor poderoso para el avance médico en términos de desarrollar nuevas soluciones para un mejor tratamiento de la vida. Este artículo revisa enfoques de investigación que son cruciales para el establecimiento de la seguridad y eficacia de varios métodos de
tratamiento. Aunque la investigación avanza día a día, todavía existe una brecha entre los hallazgos de la investigación y su aplicación real. El propósito de esta revisión es identificar las barreras que impiden la traducción y proporcionar medios para superarlas. Una búsqueda exhaustiva en bases de datos en línea identificó estudios sobre metodologías de investigación clínica y la promoción de la práctica basada en evidencia (EBP, por sus siglas en inglés). Se utilizó un análisis temático para sintetizar los temas clave. Este artículo demuestra la importancia particular de la investigación clínica. Señala problemas como los límites de gastos y la falta de conocimiento de los clínicos que no permiten la traducción de los resultados de la investigación en la práctica. No obstante, se están realizando esfuerzos para proporcionar soluciones, incluyendo la educación sobre la EBP, la adopción de guías de práctica y el aprovechamiento de la tecnología para compartir los hallazgos de la investigación. Estos problemas deben abordarse mediante la promoción de la EBP para garantizar un tratamiento óptimo y actualizado de los pacientes y una mejor salud de la población.
Palabras clave: Investigación Clínica; Práctica Basada en Evidencia; Brecha de Traducción; Disparidades en la Atención Médica; Progreso Médico.
INTRODUCTION
Medicine, a discipline that at one time existed mainly by tradition and intuition, has recently undergone an unprecedented transformation. This change is caused by the fact that the field of clinical research is constantly growing, this is a systematic and scientific method of exploring new and existing medical practices.(1) Clinical research is the major player in evidence-based medicine (EBM), a crucial element of modern medicine. EBM bases its recommendations on the outcome of clinical trials; therefore, healthcare providers can be sure the therapy recommended to patients is both safe and efficient.(2)
The foundation of our mission is comprehending diverse types of clinical research. Randomized controlled trials (RCTs), identified as the gold standard, systematically contrast intervention groups against controls to determine both the efficacy and the safety of new interventions, including medications, devices, or surgical procedures.(3) Other research designs that use long-term studies such as cohort studies compare participants with similar backgrounds or lifestyles but cannot determine whether a variable cause the other. In addition, medical progress does not become a hindsight it is fueled by the knowledge gained from clinical research.(4,5) Our cutting-edge research has created breakthroughs which have transformed the possibilities of modern medicine for several disease areas.(6,7) As such, the launching of cancer medications with the ability to save lives, the development of better treatment procedures with improved outcomes, and the creation of efficient vaccines that have been designed as a result of the solid work of clinical researchers are just some examples of the ways through which they have contributed.(8,9,10) Also, research has been proven to be an essential tool in the rise of preventive measures and maintaining the well-being of the population at large.(11,12,13) Research papers presenting the association between daily life activities and chronic diseases, especially, are supporting the advised preventive initiatives which set out to elude occurrences of chronic diseases.(14)
There are many barriers which make science practice achievement difficult. Nevertheless, research on ways to overcome them shows effectiveness. Education of healthcare personnel in the principles of EBM is the main thing. It gives them the ability to judge the trustworthiness of research data and select the most modern evidence from their clinical decision-making. On the other side, there are the clinical practice guidelines which have been prepared by panels of experts which distil research findings and give options for managing particular diseases. Moreover, quality improvement initiatives within healthcare systems are actively involved in the monitoring of the trends and taking in the practices that are supported by evidence.(17,18) Technology clearly has a role too, no doubt. Digital tools and knowledge-sharing platforms enable the research findings to be distributed and easily accessible by clinicians on their sites of practice.(19,20)
In this context, we should keep in mind that the future of clinical research, like any other scientific domain, is inevitably changing. The fast-developing personalized medicine, which is focused on the specific characteristics which are inherent in the given patient, occupies an important place in modern medical practice. Patient engagement research in which decisions are taken along with patients’ needs and preferences plays a latent role in research design. Technologies such as AI and big data may become the usual in the hands of clinical research which may then become a new standard for implementing studies into the practice. Information processing and computer technologies that involve big data analytics allow for the detection of such patterns and potential treatment targets which would be otherwise unnoticed using conventional procedures, and AI can be used to accelerate the processing of large volumes of raw data. Yet, ethical issues related to the privacy of data and the need to eliminate prejudice by algorithms are still important matters to resolve.(21,22,23)
This literature review will examine how the mentioned developments would affect both management capabilities and new possibilities. Through the examination of these academic researches, we will attempt to find out how clinical research is still able to investigate these complexities which are continually being brought about by medicine and care process improvements. This would be highly informative about how clinical research is an integral part, which assists in implementing and amending theories into practices, leading to better patient outcomes, and making healthcare to be dynamic.
The Impact of Clinical Research on Medical Practice
Clinical research constitutes a pillar of EBM that drives healthcare progress by means of discovery and welding that knowledge into measurable positive outcomes for patients. This chapter informs the readers about various types of clinical data research and shows their contribution to the approval of new drugs which in turn serve to improve people health and the health of the population.(28)
Unveiling New Knowledge: A Spectrum of Research Designs
Clinical research encompasses a spectrum of methodologies, each with its strengths and limitations, to investigate new and existing medical practices. Here, we explore the two most prominent types:
• Randomized Controlled Trials (RCTs): regarding methodology, RCTs adhere the highest level of assessing a new treatment protocol where both groups of participants, experimental and control, undergo tests with one group receiving an experimental treatment, such as a new drug, or the placebo or current standard care. Participants were randomly permitted or not to these groups, removing the bias that could make the results erroneous.(29) The RCTs accomplish the process of estimating the efficacy (effectiveness) and safety of the novel strategy by comparing the results from the groups. Say for example, the RCT could investigate a new cancer drug in patients with a type of cancer by randomly adding the patients to different groups; the first group will receive the drug and the second group will receive standard chemotherapy care. Researchers will examine the cancer patients’ overall survivability and investigate drug adverse reactions to see if the new drug is more effective and has an acceptable adverse reaction rate.(30)
• Observational Studies: in contrast to RCTs, which don’t apply randomization, observational studies don’t apply randomization. Rather, researchers focus on the observation and analysis of the already-collected data or the follow-up of the participant over a period of time for the identification of the patterns and relationships between variations.(31) Such studies may be of retrospective type, studying past medical records, or of prospective type, keeping under investigation the same group of participants for a specified period of time. Though observational studies are unable to pinpoint the causal relationship after considering the likelihood of being affected by confounding variables, they remain an important means of developing hypotheses and identifying areas of further interest which can be pursued using the RCTs.(32) To illustrate, an observational study which is based on a large-scale database of patient records can uncover associations between lifestyle issues like smoking and heart attacks. Such results would then lay the groundwork for an RCT that carries out the ultimate assessment of the effect of smoking cessation on decreasing heart disease risk (33).
Alongside RCTs and observational studies, there are also other sources of research which help to continue the thread of clinical research. These include:
· Pharmacological Trials: one scientific and key type of clinical research in our research interest area is the pharmacogenetic trial. The last phase of drug development is the phase of testing the attention reliability and effectiveness of new drugs and drug treatments.(34) They can be divided into various groups of experiments that start off by looking at safety and dosage in healthy volunteers, which is then followed by large studies aimed at investigating the effectiveness of compounds in patients suffering from a particular disease. Pharmacological trials are among the key components to guarantee the evolution of medications that may be used in the treatment of many diseases with the desired results. This makes a meaningful impact on the result of the medication that it may achieve. Through the analysis of the trial design and conduction of pharmacologic studies, which represents a big part of our review, we can gain the knowledge that is required for drug therapy to get translated through more improved medical practice.(35)
· Meta-analyses: this type of statistical technique has emerged as a tool for combining data from multiple studies that are investigating the same question, generating a larger body of evidence as a whole.(36)
· Cohort Studies: these studies investigate the cohorts (groups) of individuals with some particular characteristics. They complete this mission by assessing the possible risk factors that may provoke the disease.(37)
· Case-Control Studies: the researchers contrast the individuals with the condition (cases) to a group without the disease (control group) to provide input for existing or possible risks.(38)
From Research Bench to Patient Bedside: Transforming Lives
Clinical research has a major role in transforming academic knowledge into medical practice. Leading to significant improvement in a wide spectrum of diseases.
Revolutionizing Cancer Therapy
The progress in cancer research is very obvious. New trends of treatment have been developed in recent years such as targeted therapies, immunotherapy and gene treatments to name a few, were realized through pioneering clinical trials.(14) Such adaptations have managed to boost patient survival and are proving effective in the treatment of different cancers. A case in point is a targeted therapy that attacks specifically the cancer-cell specific mutation. Thus, it is more accurate and less toxic compared to conventional chemotherapy.(39)
Refining Surgical Techniques
The development and improvement of surgical techniques, typically achieved through clinical research, are at the origin of the minimally invasive and the more efficient recuperation after the surgeries, reduced sorrow, and better results. Laparoscopic surgery, which is a method that employs tiny incisions supervised by the camera and instruments, has notable benefits over traditional open surgery where bigger incisions are made.(40,41)
Vaccines: A Shield Against Infectious Diseases
Vaccines which are the products of the promising clinical research are signs of the ability to be preventive medicine. Good clinical studies guarantee the protection of people using vaccines against potentially harmful infectious diseases and help the healthcare professionals. Vaccination against polio, measles, and HPV serves as an illustration through which one can understand how clinical research has drastically minimized the disease top and saved thousands of lives.(42)
Beyond tackling specific diseases, clinical research plays a critical role in:(43)
· Developing Preventative Measures: Developing Preventative Measures: Such research on diet, exercise, and smoking being associated with disease helps medical professionals to make such preventive suggestions. Research findings have indicated the relationship between a well-balanced diet, daily physical exercise, and the decrease in the risk of heart disease, type 2 diabetes, and some types of cancer.
· Improving Overall Population Health: Research is the science main block which allows medical officials to decide on the health initiatives. It is through hygiene programs, proper case classifications and health education that the reduction in diseases can be done, and hence, translate into the improvement of general health status. Such vital factors determine public health policy foundations.
Bridging the Gap: From Research Findings to Clinical Practice
Obstacles on the Road to Implementation(44,45,46)
1. Cost Considerations: The new approaches that are mainly medication and advanced technologies are quite pricey. Hospitals and medical establishments could refuse to integrate them because of budget restrictions hence limiting the number of individuals granted the access to play a role in their healthcare. The scenario of a newly invented cancer therapy that is highly effective based on the clinical trials is one example. The high cost though might limit the availability of the invent to patients with a smaller insurance coverage.
2. Research Limitations and Bias: Research methodology is prone to limitations that lead to the distortion of the findings that can reduce its relevance to real-world practice. There may be studies that are done in extremely controlled settings, which are not like the real-world situation where patients are cared for. Furthermore, research is prone to biases that include publication bias where studies with positive findings are more likely to be published while those with negative results have low chances of being published. This may result in the rise of a superiority complex for some measures.
Building Bridges: Strategies for Evidence-Based Practice
· EBM Education for Healthcare Professionals: Ensuring that every healthcare practitioner is knowledgeable and skilled enough to be able to use research evidence in making decisions is critical. Training programs which incorporate the basics of EBP can equip clinicians with the ability to differentiate between strong and weak evidence-based research studies, identify the best available evidence for particular situations and therefore give their patients the most suitable treatment for them.(47,48)
· Clinical Practice Guidelines: Expert panels that have gone through rigorous review and evaluation of scientific evidence are the ones that come up with clinical practice guidelines which offer practical recommendations for the management of specific conditions. These principles ensure evidence-based care by standardizing the best practices and promoting stability across the different healthcare facilities. As an example, such as clinical practice guidelines for diabetes management may suggest actions, including medications use, blood sugar monitoring and lifestyle changes according to recent research findings.
· Technology and Knowledge-Sharing Platforms: Technology is able to be both the tool and the linking agent for accessing the research-based knowledge in practice. Digital platforms and tools can make the distribution of research data possible when the case is at the core. Clinicians can get concise summaries of research, guidelines and decision support tools that fit into e.g. their workflow, and which relate to all latest evidence to be at their disposal. Next, digital databases and collaboration enterprises can promote communication and help in sharing of knowledge between the healthcare professionals that could be a current source of information and can produce platforms which could be used for exchanging best practices.(49,50)
Research Focus
Our research focus is on the clinical high-yield contribution to the development of medical practice. We will delve into the different methods of research that contribute to a better understanding of the different interventions (drugs, devices, process), in turn, translating this gained knowledge into a practical improvement of patient care.(24,25)
Research Problem
In spite of the fact that detailed knowledge is created by clinical research, there is such a gap between what is found in research and what is done in clinical settings. The review exposes the barriers preventing the application of research data, like budgetary limitations, scarcity of knowledge among healthcare personnel and constraints inherent in research methodology (26,27).
Research Question
This review seeks to answer the question: How can we overcome the challenge of transferring clinical research discoveries to the level of patient outcomes and across the whole community health?
Research Aim
The objective of this literature review is to examine how clinical research enhances evidence-based medical practice, exploring the transition from laboratory findings to clinical implementation and its impact on healthcare outcomes.
METHOD
Search Strategy
A comprehensive search of the literature was conducted using the following electronic databases: PubMed, Scopus, Web of Science, and Cochrane Library. The search strategy included a combination of keywords and MeSH terms related to “evidence-based medicine,” “clinical research,” “healthcare strategies,” “laboratory findings,” and “clinical implementation.” Searches were limited to studies published in English within the last five years to ensure the inclusion of the most recent and relevant evidence.
Inclusion Criteria
· Research methodology includes RCTs, observational studies, meta-analyses, cohort studies, and case-control studies.
· Selected recent articles (i.e. 2010), with a cut-off date, to refresh the knowledge.
· Studies that highlighted the role of clinical research in the advancement of clinical medicine.
Exclusion Criteria
· Non-peer review articles such as study proposals, opinions, and letters to the editor.
· Irrelevant articles not related to our topic.
Information Sources
To gather a comprehensive and unbiased set of relevant research, we searched multiple online databases including; Web of Science, Scopus, Google Scholar, PubMed, and Cochrane Library.
We incorporated targeted keywords in the search, like “clinical research”, “evidence-based medicine”, “treatment efficacy”, “patient outcomes”, and “medical advancement “ throughout the process. It helped us to encompass possibly every academic article that is related to the research topic for analysis.
Data Collection
The included studies were reviewed following three stages. The first involved using EndNote Software to import the findings from electronic databases into a Microsoft Excel sheet. The articles entered into the Excel sheet were screened for titles and abstracts in the second stage. The third stage involved screening the included citations from Stage 2’s full text. In addition, we manually checked the included publications’ references for any potentially overlooked studies.
RESULTS
A systematic search employing a specific search strategy yielded 180 articles initially. Subsequent screening based on titles and abstracts narrowed down the selection to 100 articles for full-text evaluation. Upon thorough assessment, 45 articles were deemed relevant and subsequently utilized to inform and construct this review. Refer to Figure 1 for a graphical representation.
Figure 1. Sources of articles
Summary of our Included Studies
Chen et al.(51) studied a theory-driven approach to reach study validity. They reported that while doing program evaluation, theory building is essential, particularly in identifying criteria related to validity and reliability. Because of the randomization that takes place in the model or theory, the model or theory is improved, not replaced. This implies that a solid theory has to be given precedence over a research design to achieve the best results. Through the theoretical modelizing of the structural relations and the interfering route, the theory-driven approach offers a full comprehension of causal machinery, so it avoids the limitations of black-box evaluation. In contrast to experimental designs that attempt to establish internal validity via random allocation and blinding only, theory-driven approaches also address internal, external, construct and statistical conclusion validity within general theory models.
Recently Brazil et al.(52) was the first paper to emphasise the role of theory and then discuss how theory is implied in research, thereby, altering how the researcher interacts with decision-makers. The paper also looks at the possible effect of such research on the training and practice of health services research.
Sacristán et al.(43) observed the evolving connection between clinical studies and medical practice by focusing on the issues of ethics and methodological equivalent as priorities for integration. Ethically, it is a stance that supports the individual as well as doctors to make treatment decisions as long as one does not harm. With concepts like individual informed consent, precaution and risk oversight becoming vital during integration. Methodological perspective also looks at increasing the emphasis on observing ruptures and practically involving in the experiments. Through the integration of patient-oriented research and point-of-care engineering said approach aims to be produce relevant and actionable knowledge for medication development and clinical practice.
Kandi et al.(53) reported that medical research or clinical research involves the assessment of treatment methods or approaches to various therapeutic drugs, procedures, and devices in the targeted patients. By and large, it entails analysis of the disease aspect like symptoms, risk factors and so on. Trials that are committed to value therapeutics for the diseases, management of diseases, or prevention are called clinical studies. Consequently, conducting clinical research discoveries will be important for the future due to the growing numbers of diseases in these days, especially COVID-19. The review tackles critical clinical research aspects formantions such as trial phases, types, designs, operations, auditing, management, and ethical issues, aimed at optimizing drug, device, and vaccine discovery for public health major incidents.
Deeper Systematization of Elements
In this article, we will systematize and explain the key elements of interest found in the reviewed studies:
1. Theory-Driven Approaches in Clinical Research: the importance of developing robust theoretical models to guide research and improve validity. We will discuss how theory-driven approaches address multiple types of validity (internal, external, construct, statistical conclusion) and offer a comprehensive understanding of causal mechanisms.
2. Impact of Theory on Researcher-Decision Maker Interactions: an exploration of how integrating theory into research alters the dynamics between researchers and decision-makers. This includes the influence on training and the practice of health services research.
3. Ethical and Methodological Integration: a detailed examination of how ethical considerations (such as individual informed consent and risk oversight) and methodological approaches (such as observing ruptures and involving patients in experiments) are integrated into clinical research to enhance its relevance and applicability.
4. Clinical Research Frameworks: an analysis of the critical aspects of clinical research, including trial phases, types, designs, operations, auditing, management, and ethical considerations. We will explore how these frameworks contribute to the optimization of drug, device, and vaccine discovery, particularly in response to contemporary health challenges.
DISCUSSION
In this review, we explained in compact the core of clinical investigations and the changes they ushered to medical science. We examined the different research approaches which evaluate with regards to the effectiveness as well as the safety of the new intervention. Still, much space appears for translation into the common practice of medical care between these findings and their daily exploitation. Although limited budget, dispersion, and study design of a similar nature were found to be the most significant barriers to the transition of scientific knowledge into practice, all these steps could be facilitated by the responsible involvement of healthcare. The review also has pointed out promising strategies for this disparity among practitioners and EBP (evidence-based practice) is among those strategies. Critical evaluation of research by healthcare professionals is key so far as the education of such professionals is concerned. By learning EBP principles, clinicians are then able to scrutinize research strengths and limitations, and therefore give patients the best therapeutic options. Furthermore, as clinical practice guidelines, well-crafted by experts based on a thorough evidence review, provide practical advises for the management of particular conditions the condition of standard care across the healthcare settings has been assured. These improvement programs in quality treatment help monitor and track results of procedures with EBP side effects, consequently, creating a culture of ongoing improvements within healthcare systems.
Clinical equipoise represents a state in which “there is no prevailing viewpoint among experts in the clinical field regarding which of the alternatives to be checked is superior”.(44)These are sometimes to decide if it should be considered as clinical equipoise or not, who the experts will be and for what endpoints they are examining.(54) However, in clinical equipoise cases, where differences between two drugs are insignificant, this is especially hard to do either in placebo-controlled studies or when a new drug is facing an active drug. Along with this, the thought of the clinical equipoise should also be considered within the mindset of the personalized research as well because the preliminary evidence leads to the different type of patients’ responses upon one type of treatment.(55) And, an advanced system of health care should somehow also make a way to judge the patient’s preferences that should be given the utmost priority.(56) While accessing investigational drugs in new randomized controlled trials may be the only option for patients to improve their health outcomes, this cannot be guaranteed. However, reviews on this matter have been not always reliable in terms of the beneficial trial effect. An autonomy based and nonmaleficence research model requires patients to receive inclusive data on the study and to realize that altruism rather than potential clinical benefits will guide their participation.(57) Granting people’s moral responsibility to participate in research makes an important contribution to establishing an interconnected learning healthcare system, where between clinical research and medical care the boundaries gradually disappear.(58)
Bati et al. reported that in connection with modern research on the human microbiome, a number of studies were conducted and it was established that with the help of personalized (directed) correction of the intestinal microbiota, it is possible to prevent the occurrence of non-communicable diseases, such as type 2 diabetes type, disorders of lipid metabolism, obesity, etc.(59) Rahman et al.(60) investigated the role of clinical research in improving the patient health specially in the field of obstetrics and gynaecology. They reported that Clinical research participation enhances patient care, and it is also the duty of a healthcare professional to keep them abreast of the recent interventions and to modify existing interventions, when there is significant evidence in favour of new ones. A good clinician combines the expertise of a single physician and the best evidence base, and both of them are invaluable. Applying evidence-based medicine implies personal care of patients and making the decision about further course of treatment concerning to specific situation. Sound judgement is ultimately what evidence-based medicine means in practice. Health Systems Research has been found to be a useful instrument for these decision makers at all levels, supplying them with good data for well-informed decision making, and policy-making. Researchers should guarantee the supply of evidence suitable for healthcare management and policymaking by including health managers and policy makers in their production and the provision of information most relevant for the purpose of decisions and policies. This ongoing research will add new dimensions of healthcare provision for poor people in developing countries.
Nowadays, all clinical experiments have to be integrated into a regular clinical workflow. The concept of doing “Randomized Database Studies” that was presented fifteen years ago as the possible answer to attribute some key strength of randomized controlled trials (i.e., initial randomization) to the registries (i.e., naturalistic follow-up). Sacristan et al.(61). discussed the growing importance of evaluating drugs’ effects in real clinical practice, highlighting two primary methods: RCT and databases analyses (DA). RCT has been considered the gold standard, its strict condition, however, may or may not lead to a wider applicability. A benefit of DBA is a large variety of the cases facilitating the examination of real-life practice. However, the main pitfall of this method is the possible comparison bias associated with the lack of randomization. Even though attempts are made to handle limitations, there are still problems in providing a golden mean between internal and external validity. Proposes a panel containing randomization modules in order to make the “Randomized database studies” using both experimental and observational methods as well as standardized clinical practice and advanced patient records system.(62,63,64)
Limitation
The other major drawback of our study is that it is an overview in form of narrative review covering majority of observational studies. The data from the summarized trials is apportioned into paragraphs and compared to each other without being pooled together. Therefore, true objectivity and subjects combined as one are impossible. A narrative review is the most recent publication that presents a complete roundup of the published evidence. Such a case can be also used for complete examination of evidence. Since it fully disregards the hypothesis with which it is in disagreement, it does not guarantee that what is now believed to be true is actually true.
CONCLUSION
This narrative review has demonstrated the invaluable place of clinical research in medical research development. Whilst identifying the challenges to turn research-based evidence into real world application, the review also studied the effective approaches to reduce this gap. Evidence-based practice can be promoted through rigorous clinician education, strong guidelines, and technological support that will enable the maximization of the gains revealed by clinical research benefiting the patients. Such a continuous process of research, dissemination, and execution is at the core of providing an optimal patient outcome and improving overall population health.
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FINANCING
The authors did not receive financing for the development of this research.
CONFLICT OF INTEREST
The author declare that there is no conflict of interest.
AUTHORSHIP CONTRIBUTION
Conceptualization: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Data curation: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Formal analysis: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Research: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Methodology: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Project management: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Drafting- original draft: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.
Writing - proofreading and editing: Viktoriia Bati, Dmytro Teslenko, Olha Yuryk, Yevhenii Avtomieienko, Liudmyla Bashkirova.