Doing no harm: Addressing the quality of evidence in translating research to practice in preliminary research fields

Abstract

Background: Current evidence appraisal rating systems, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, are oriented toward and anchored by randomized controlled trials (RCTs) as the gold standard methodology. In many fields, this standard of evidence is rarely, if ever, met. Often, research at the clinical application end of the translational process is embedded in real world practice that does not lend itself to RCTs and is characterised by more pragmatic research using mixed methodologies. Arguably, accountability through research evaluation is even more important in such cases where research design is preliminary and clinical impact is, often, already a reality. Further, practice translation must be privileged as the central goal of the research synthesis under such circumstances in that the destination of all clinical science is the person of the patient..

Methods: In response to these demand characteristics, a practitioner-informed research framework was used to drive and pilot development of an evidence quality grading system that could accommodate a disparate and oblique evidence base. Reid’s person-centered framework was used to establish whether clinician-derived criteria for quality research practice had been met.

Results: This brief report presents the Quality of Evidence Rating System (QERS) in the hope of facilitating discussion about accountability pathways for translational scientist-practitioners.

Conclusion: The QERS provides a scaffold to help when looking for evidence that researchers have consciously addressed the issues of evidence quality when reporting their research in the published literature.