Medical Decision Making

Abstract

Background: There is often a disparity between the published findings from randomized clinical trials and their application In clinical practice. The Clinical Quality Improvement Network (CQIN), a voluntary partnership of Individuals and institutions interested In promoting improvements in practice through a shared vision and collaboration, uses a practical approach of continuous quality improvement techniques to minimize variation in treatment patterns and to Improve patient care. This process consists of Identifying best clinical practice by literature review, particularly of results of large randomized clinical trials, measurement of current patterns of practice by retrospective data review, development of explicit critical management paths and wide dissemination of these clinical guidelines, and repeat data collection to measure changes and to Infer causality of change. In acute myocardial infarction, we found that at Initial review the utilization of proven efficacious medical therapy has been suboptimal, and that there appears to be a systematic underutilization particularly In females and the elderly.