It's not always easy to let go of time-honoured practices which are shown to be ineffective or even harmful. A considerable literature has grown up around how to encourage clinicians to align their routine practice with robust scientific evidence.1 Much of this 'implementation' or 'translation' research has focused on explaining and overcoming underuse of effective interventions.2 The landmark CareTrack study of the quality of healthcare in Australia3 estimated that just over 40% of eligible patients do not receive evidence-based care. On the flip side, widespread use of ineffective interventions, which may consume up to 30% of healthcare budgets,4 has received much less attention at a time when healthcare systems are required, by fiscal constraints, to maximise health benefit for every dollar spent.
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