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Previous Volume 349:2273-2274 December 4, 2003 Number 23 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In his Shattuck Lecture (Aug. 28 issue),¹ Dr. Lenfant highlights the deep chasm between research findings and their application to real-world practice. However, he may be overstating the generalizability of most research findings and therefore our understanding of the potential impact this science can have in real-world practice. Most interventional research is performed in very controlled settings, with intentional minimization of variance in base-line factors in order to prove efficacy. For example, clinical trials purposely exclude relatively noncompliant and sick participants. This results in overestimation of the size of the effect that may be achieved in community-based . . . [Full Text of this Article]

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