• Charles J Kowalski, Richard W Redman, and Adam J Mrdjenovich.
• Health and Behavioral Sciences IRB, University of Michigan, Ann Arbor, Michigan, USA.
• J Eval Clin Pract. 2021 Jun 1; 27 (3): 667676667-676.

Rationale, Aims, And ObjectivesWe consider the question "What should we do?" in the context of clinical research/practice. There are several steps along the way to providing a satisfactory answer, many of which have received considerable attention in the literature. We aim to provide a unified summary and explication of these "steps along the way". The result will be an increased appreciation for the meaning and structure of "actionable clinical knowledge".MethodsWe review the literature to identify pertinent works dealing with evidence production and translation into actionable clinical knowledge. We draw from insights in this literature about various aspects of reasoning relevant to clinical questions and integrate these into a unified approach to the processes that lead to actionable clinical knowledge.ResultsWe collect, collate, and integrate some of the work by Bauer, Carper, Goldman, Haack, McHugh and Walker, and Upshur and colleagues and obtain guidelines to aid in the evidence-to-actionable-clinical- knowledge transition.ConclusionsClinical decision-making is not infallible, and the steps we can take to minimize error are context dependent. Medical evidence, produced as it is by human effort, can never be perfect. We will be doing well by assuring that the evidence we use has been produced by a reliable process and is relevant to the question posed.© 2021 John Wiley & Sons Ltd.

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