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This is the second in a series of eight articles analysing the gap between research and practiceSeries editors: Andrew Haines and Anna DonaldThere is increasing interest in providing evidence based health care—that is, care in which healthcare professionals, provider managers, those who commission health care, the public, and policymakers consistently consider research evidence when making decisions. 1 2 Purchasers, for example, should be able to influence the organisation and delivery of care (such as for cancer3 and stroke services4) and the type and content of services (such as using chiropractic for back pain or dilatation and curettage and drug treatment for menorrhagia5). Policymakers should ensure that policies on treatment reflect and are consistent with research evidence, and that the incentive structure within the health system promotes cost effective practice. They must also ensure that there is an adequate infrastructure for monitoring changes in practice and for producing, gathering, summarising, and disseminating evidence. Clinicians determine the day to day care patients receive in healthcare systems, and user groups (for example, patients, their families, and their representatives) are also beginning to play an important role in influencing healthcare decisions.6The factors described below should be considered when deciding whether to act on or promote the implementation of research findings. Summary points

When to act on the evidence