Are you translating research into clinical practice? What to think about when it does not seem to be working.

The value of clinical research can be lost in translation and implementation. One often overlooked issue is whether clinicians can determine if their patient is similar to research participants and, ipso facto, whether the clinician treating that patient will have the same effects as what was reported in a research study. We present five questions and clinical tips for clinicians. The characteristics of a research study’s participants can be considered their ‘clinical phenotype’. The field dedicated to more precisely matching treatments to clinical phenotypes is ‘precision medicine’.1 Defining clinical phenotypes is a challenge in musculoskeletal research because a gold standard diagnostic test is commonly absent. For example, the single leg decline squat is provocative for anterior knee pain but is not diagnostic for patellar tendinopathy.2 Even where clinicians agree that a patient group has the same condition (eg, rotator cuff tendinopathy), different clinical phenotypes (eg, positive vs negative empty can test) within that group means the population is heterogenous. This may mean that subgroups of patients will respond differently to interventions. ### Clinical tip Do not rely on the title or abstract of a paper. Review the methods section for details on more precise clinical phenotypes (or not), including how the condition was diagnosed and other features, such as physical activity, education, cognitive or socioeconomic characteristics.3 Does your patient …