On-going efforts are required to address substantive
knowledge gaps and to encourage the uptake of evidencedbased
approaches where such evidence is assessed as
strong. As noted recently, “the bond that tethers our patient
to our treatment is a fragile one” [[121], page 178]. At times
this could be rephrased to say that the bond that tethers
assessing clinicians to the evidence is equally fragile. There
is a universal problem transferring research evidence into
clinical practice, and this overview aims to reduce that
‘leakage’ [122] between research and practice.
While not above criticism themselves, a number of
practice guidelines are available that outline in some detail
the required and desired assessment investigations,
and at least draw clinicians’ attention to the quality and
limitations of evidence. These include the Australasian
[123] (currently undergoing review), North American
[124], and the British [101] guidelines. The latter of
these (and the most recently published) appeared just
under a decade ago, but a recent review of the literature
indicates that these guidelines are as relevant today as
they were in 2004, (http://www.nice.org.uk/nicemedia/
live/10932/55781/55781.pdf, downloaded 17 Sept 2012).