In this episode, Dr. Kaveh Shonjania argues that despite the billions of dollars spent on clinical and quality improvement research, most of the interventions that are studied are shown not to work and those that do work produce only marginal benefits for some patients.Dr. Shojania is the Vice Chair of Quality and Innovation for the Department of Medicine at the University of Toronto and past Editor-in-Chief of BMJ Quality and Safety. He joins Drs. Blair Bigham and Mojola Omole to discuss a study published in CMAJ recently, entitled Inappropriate Use of Clinical Practices in Canada: A Systematic Review, in which the authors sifted through 174 studies to identify ineffective clinical practices that are either overused, effective practices that are underused, or other practices that are just misused..  Dr. Shojania wrote a short commentary related to the study, entitled What problems in health care quality should we target as the world burns around us? In which he called for health research resources to be shifted more towards research on the social determinants of health, for a greater return on investment.  Drs. Bigham, Omole and Shojaniadiscuss how this might actually work in practice.