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[Nephrology evidence and guidelines: current tools and several still open questions]
G F M Strippoli1, C Manno, F P Schena
1Dipartimento dell'Emergenza e dei Trapianti d'Organo, Sezione di Nefrologia, Dialisi e Trapianto, Universita' degli Studi di Bari, Italy. gfmstrippoli@katamail.com
Background:
It is widely accepted that decision making should be based on evidence. Although nephrology is a relatively young discipline of internal medicine that should be quick to adopt evidence-based decision making policies, several problems are slowing the progress to an era of evidence-based nephrology. These problems may be identified as: a) an inadequate knowledge-base for problems related to the utilization of evidence-based research resources; b) the unavailability of adequate evidence sources in nephrology; and c) the small investment and funding for clinical research.
Methods:
This review outlines the major problems of evidence-based nephrology and looks particularly at the strengths and weaknesses of study designs for evidence-based nephrology. The primary guidelines for evidence-based preparation are presented together with possible strategies to meet the challenge of adopting evidence-based policies in nephrology.
Conclusions:
This challenge is particularly important now; after several years of extraordinary basic science research, we face the problem of improving clinical practice by applying this same progress in basic science. This transition has failed because of the small investment provided for clinical research.