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Commentary April 15, 2009

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

Anthony P. Weiss; Jenny Guidi; Maurizio Fava

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

Article Abstract

There is a well-known gap between the clinicaloutcomes achieved within randomized controlled Ttrials (RCTs) and those seen in real-world clinical practice.This phenomenon, sometimes called the "efficacyeffectiveness"gap, has been cited as a potential barrierto achieving optimal benefit from available treatments.The time lag between medical discovery and routineimplementation can at times be extraordinarily long (suchas the 264-year gap between the first use and the routineuse of lemon juice for treatment of scurvy), with currentestimates suggesting an average 17-year lapse betweeninitial publication and widespread clinical practice.