Closing the Efficacy-Effectiveness Gap: Translating Both the What and the How From Randomized Controlled Trials to Clinical Practice

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There is a well-known gap between the clinical outcomes achieved within randomized controlled T trials (RCTs) and those seen in real-world clinical practice. This phenomenon, sometimes called the “efficacyeffectiveness” gap, has been cited as a potential barrier to achieving optimal benefit from available treatments. The time lag between medical discovery and routine implementation can at times be extraordinarily long (such as the 264-year gap between the first use and the routine use of lemon juice for treatment of scurvy), with current estimates suggesting an average 17-year lapse between initial publication and widespread clinical practice.

J Clin Psychiatry 2009;70(4):446-449