The report by Grimshaw et al. (2004) systematically reviews the effectiveness and costs of different strategies for disseminating and implementing clinical guidelines. The study aims to estimate the resource implications of these strategies and develop a framework for deciding when it is efficient to develop and introduce clinical guidelines. The review includes 235 studies with 309 comparisons, focusing on single and multifaceted interventions. Overall, most comparisons showed improvements in care, but there was significant variation. Single interventions like reminders, educational materials, and audit and feedback were commonly evaluated, while multifaceted interventions involving educational outreach showed modest to moderate improvements. Economic data were reported in only 29.4% of comparisons, and most studies used process measures for their primary endpoint. The feasibility and resource requirements of different strategies were assessed through interviews with key informants, who noted that only dissemination of educational materials and short educational meetings were generally feasible within current resources. The study concludes that there is an imperfect evidence base to support decisions about which strategies are efficient under different circumstances, and further research is needed to develop a coherent theoretical framework and estimate the efficiency of strategies in different contexts.The report by Grimshaw et al. (2004) systematically reviews the effectiveness and costs of different strategies for disseminating and implementing clinical guidelines. The study aims to estimate the resource implications of these strategies and develop a framework for deciding when it is efficient to develop and introduce clinical guidelines. The review includes 235 studies with 309 comparisons, focusing on single and multifaceted interventions. Overall, most comparisons showed improvements in care, but there was significant variation. Single interventions like reminders, educational materials, and audit and feedback were commonly evaluated, while multifaceted interventions involving educational outreach showed modest to moderate improvements. Economic data were reported in only 29.4% of comparisons, and most studies used process measures for their primary endpoint. The feasibility and resource requirements of different strategies were assessed through interviews with key informants, who noted that only dissemination of educational materials and short educational meetings were generally feasible within current resources. The study concludes that there is an imperfect evidence base to support decisions about which strategies are efficient under different circumstances, and further research is needed to develop a coherent theoretical framework and estimate the efficiency of strategies in different contexts.