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Many now propose that guidelines be evidence-based, which involves supporting recommendations with rigorous research evidence (16;52;98).
From the point of view of civil law, the evidence-based recommendations could be considered as a kind of coded lex ar tis.
These scholars draw on diverse theoretical approaches and often use both qualitative and quantitative methods to conduct evidence-based analyses (6;14;17).
Further research is needed to evaluate the most effective way of delivering evidence-based interventions in general practice and incorporated into training programmes.
Even in the world of evidence-based healthcare that relies so heavily on scienti c knowledge, the importance of tacit knowledge is recognized.
If physicians are concerned with maximizing health, it is also consistent with the use of evidence-based medicine and clinical guidelines.
Therefore, it could be argued that maintaining professional competence through evidence-based practice is an ethical imperative as well as a professional one.
Another implication is that both public and private sectors should emphasize evidence-based assessments and the development of cost-effectiveness as an operational, too.
Indeed, many would assert that managers cannot do more to implement evidence-based health policy without the cooperation of doctors.
Their shared aim of bridging the gap between research and practice is very timely in light of the moves towards evidence-based practice and policy-relevant research.
By describing action research studies in their rich contextual detail, attempts to implement scienti cally derived, evidence-based practice can be explored.
Emphasis is placed on evidence-based practice and in each chapter future service developments are discussed and the potential for further investigation is highlighted.
Factors which act as barriers to practice nurses using the evidence, or which facilitate evidence-based practice, were also explored.
It is clear, however, that this study in itself cannot offer an authoritative evidence-based alternative to such assumptions.
As long as data quality in randomized multicenter trials is not validated, one could argue that the foundations of evidence-based medicine are somewhat uncertain.
