Good clinical practice can and must include comparative effectiveness research.

Abstract

Key components of self‐improving healthcare systems are their ability to collect baseline data, identify opportunities for improvement, design and implement strategies for change, and measure the effectiveness and other outcomes of the intervention, in a ‘virtuous cycle’ of continuous improvement. Nowhere is this more clearly outlined than in the process of clinical trials of new interventions. The concept of development and implementation of new evidence is straightforward, but can be very difficult to achieve in practice. Cultural and infrastructural issues present significant barriers to achieving the ideal of continuous and consistent derivation of evidence to support changes in practice.