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BMJ Qual Saf. 2011 Apr;20 Suppl 1:i52-7. doi: 10.1136/bmjqs.2010.046532.

Clarity and strength of implications for practice in medical journal articles: an exploratory analysis.

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  • 1Colorado Foundation for Medical Care, 2318 Ashboro Drive, Chevy Chase, MD 20815, USA.



To examine how leading clinical journals report research findings, aiming to assess how they frame their implications for medical practice and to compare that literature's patterns with those of the management literature.


Clinically relevant research articles from three leading clinical journals (N Engl J Med, JAMA, and Ann Intern Med).


Review of wording of a sequential sample from 2010, with categorisation, comparison among journals, and comparison with management literature.


Clinical journals usually state that one approach did or did not differ from another approach (35 of 51 articles, 68.6%), but they recommended a specific course of action ('therefore, x should be done') in just 25.5%. One article gave instruction on how to implement the changes. Two-thirds of the reports called for further research. Half used tentative language. Management research articles nearly always specified who should use the information and drew from over 60 types of potential users, whereas the clinical literature named the audience in only 23.5% of clinicians.


Authors and editors of the clinical literature could test being more clear and direct in presenting implications of research findings for practice, including stating when the findings do not justify changes in practice.

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