The tangled and thorny path of science to practice: Tensions in interpreting and applying "evidence"

As Chorpita et al. discuss, implementing scientific evidence into practice is a complex process. This commentary addresses additional issues to those mentioned in their article, issues related to the nature of evidence and its interpretation. Since the evidence base is inherently subjective and ever-changing, it is critically important to describe the decision-making processes involved in the interpretation and application of evidence. Increasing efforts should also be made to consider the context at the provider, patient, system and community levels in decision-making processes about scientific evidence as well as during the implementation of evidence in practice settings. This will enable the assessment of the fit between the evidence and local populations and settings. Attention to process factors and context should ideally occur during the creation, adaptation, and implementation of evidence. Attention to the complexities of scientific evidence and the process of its systematic review and implementation into real world practice settings will improve the translation of evidence into community practice.