As we have shown using examples from colorectal cancer screening and diagnosis, translation of published studies into community practice is not a simple task. A literature review may not clearly indicate which strategy is best. Even when one strategy has a definite advantage, there may be variation in its actual clinical performance. Prior to initiating a new strategy or when reconsidering an old one, questions should be asked concerning applicability to the community population, the protocols that will be used, and the training, experience, and skill of the clinicians involved in its use. After a clinical strategy is implemented, ongoing information concerning its clinical performance should be continuously collected so that deficiencies can be identified and corrected. This information may be difficult and costly to obtain, but has enormous relevance for guiding healthcare decisions and improving outcomes.