Only one in five knowledge gaps identified in endocrinology clinical practice guidelines have been addressed by research, US endocrinologists report. 

Victor Montori and colleagues from the Mayo Clinic in the US discovered that in 25 Endocrine Society guidelines published between 2008 and 2014 there were 660 research recommendations, of which 131 (20 %) were supported by very low quality evidence. 

But a search of the clinicaltrials.gov database for active studies (randomized and observational) revealed that just 28 (21 %) of these knowledge gaps were addressed in 69 clinical trials.

Most of the identified clinical trials addressed knowledge gaps affecting recommendations for patients with thyroid disorders (70 %); the least dealt with were gaps in the evidence for care of patients with diabetes, obesity, and cardiovascular disease (16 %), the researchers reported in BMC Medicine .

Gaps may exist because researchers may not be aware of the gaps, or they may be responding to these gaps with basic studies that are not in the registry, they said.

“Linking the research agenda to evidence gaps in clinical practice guidelines may improve both the efficiency of the research enterprise and the translation of evidence into more confident clinical practice,” they suggested.