Author in the Room

Abstract

RANSLATING THE RESULTS OF PUBLISHED STUDIES INTO clinicalactionisachallenge.JAMAreadersknow,and weacknowledge,thatthedevilisinthedetailsintaking useful knowledge from page to patient—just as it is in moving basic scientific insights from bench to bedside. This is one of the reasons for the frustrating and recurringfindingthatimportantclinicalresearchinnovationsrarely reach all the patients who potentially could benefit. Thanks to a grant from The Robert Wood Johnson Foundation, JAMA, in partnership with the Institute for Healthcare Improvement (IHI), is pleased to announce an 18monthtestofanewresourcecalledAuthorintheRoom.This programisdesignedtohelpourreadersexplorespecific,peerreviewedarticlesdirectlywiththearticles’authorssothatthe reported clinical science can be more effectively and quickly incorporated into clinical practice. This initiative will comprise 12 conference calls, roughly 1 call per month, each call focusingonthepracticalapplicationofapotentiallyusefulresearch finding that has recently been published in JAMA. Each month, we will select aJAMAarticle containing evidence-basedideasreadyforactioninreal-worldclinicalpractice settings and will invite readers to join in a scheduled, interactive, national conference call with the author of that article. The purposes of the call will be to clarify the findings in the article, to encourage participants to take action based on those findings, and to explore detailed issues and challenges involved in implementing the changes in various clinical settings. Joining the author on each call will be a moderator and a clinician skilled in quality improvement processes who will also help coach participants on ways to incorporate the related changes into practice. Each call will be followed by a Web-based discussion group. During the evaluation phase of this program, participants will be surveyed to determine the degree to which they believe they have implemented change within their practice. The theory behind Author in the Room is that the social orgeographicaldistancebetweentheinvestigator/authorand clinician/readerisoftentoogreattoallowfortheactive,realtime discussion that can help guide evaluation and implementation. Even when clinicians have the will to act, using new knowledge requires a process of identifying the patients to whom the study results apply, having the relevant resources available when the patient is in the office, educating patients, and initiating the new treatment. Implementing these steps usually goes beyond what the printed word canoffer.Inaddition,appropriatelycautiousreadersmayhave questions about the validity, reliability, and generalizability of the published study that the author can address. TheAuthorintheRoomseriesisanattempttonarrowthe gapbetweenJAMA’sauthorsandJAMA’sreaders,toallowthe lattertoactwithmoreconfidenceandaccuracyontheadvice oftheformer.Usingmodernelectronicconferencetechnologies,individualsathundredsofsitescanbesimultaneouslylisteningtotheauthorfirsthandandcanaskquestionsandhear answers in real time. The author can leave the boundaries of theprintedpageandbecomeacoachandconsultanttothose who would use the author’s work to advance their own. Webeginthisserieswiththearticle“EffectsofEstrogenWith andWithoutProgestinTherapyonUrinaryIncontinence”by HendrixetalinthisissueofJAMA. 1 TheAuthorintheRoom interactive conference call will be on Wednesday, March 23, 2005,from2to3PMeasterntime.Wewillstudythedegreeto