It’s exciting to see what can be done for health when you run a study under ideal conditions, but rarely are those conditions present in everyday life. These ideal condition studies only work when they can inform practice in less-than-ideal conditions.
There is something exciting about seeing what happens when you have a study executed under nearly ideal conditions. When the staff are well-trained, the participants are compensated and looked after, and there is plenty of resources free to do the proper follow-ups. It is wonderful to see what can happen.
But I find this to be frustrating and, in some ways, bordering on unethical if the results are not translated appropriately. There are studies that clearly do not have the ability to be translated well. If you gave every student their own personal 24/7 tutor to help them through secondary school they might do amazingly well, but there is no school board anywhere that could adopt that model.
We still do the equivalent of that in health sciences. We load up projects that operate in a bubble to show what can be done with a lot of resources and then give recommendations like the need for “adequate resources” at the end of the written study.
Are we really advancing science when we do this or just creating a larger gap between evidence and practice?