A Resource For Developing An Evidence Synthesis Report For Policy Making

Evidence syntheses use multidisciplinary and intersectoral sources of evidence to support policy-making. The Health Evidence Network (HEN) has supported and strengthened the use of evidence in health policy-making in the WHO European Region since 2003. The HEN synthesis report series responds to public health questions by summarizing the best available global and local findings from peer-reviewed and grey literature as well as policy options and proposes general directions strategies and actions for consideration. This resource has been developed to outline key approaches methods and considerations for a HEN evidence synthesis to support the systematic and routine use of the best available evidence for decision-making relevant to the needs of public health decision-makers. It proposes approaches that hold both scientific rigour and practical applicability for individuals and institutions that perform commission review and/or publish evidence syntheses.

The importance of evidence-informed approaches in policy formulation and implementation has long been recognized by the World Health Organization (WHO) and its Member States. With the General Programme of Work (GPW)13 and the creation of the Science Division, WHO has reinforced its science and evidence-based mandate. This guide offers staff and partner organizations a compendium of WHO tools to successfully leverage evidence for policy and impact, and promote evidence-informed decision-making for safe and effective health policy and practice at country and global levels. Through its framework, the guide will increase awareness and uptake of existing tools and best practices, and additionally facilitate collaboration between areas within the Organization and with partners across countries and regions.

Community empowerment has been frequently studied at subnational levels but it is less clear how to measure it at a national level. Mixed methods approaches would be advantageous using quantitative data from databases plus qualitative information to derive a range of variables and indicators. This report identifies assessment methods that have been used and evidence for integrating qualitative and quantitative data for national assessments. When resources are limited or there is no current practice of measurement of community empowerment the simplest approach is to combine a selection of quantitative variables and indicators available in statistical databases. When resources can be allocated a more systematic approach would supplement such accessible data with some form of rapid qualitative assessment. Ideally a formal national monitoring and evaluation system would be instituted that collects all the relevant quantitative and qualitative data and combines these into a regularly updated assessment.

The need for evidence-based decisions that take account of botheffectiveness and economics is greater now than ever. Using casestudies and illustrative examples throughout the authors describehow the activities and outputs of evidence synthesis, systematicreview, economic analysis and decision-making interact within andacross different spheres of health and social policy and practice. Expanding on the first edition the book now covers approaches toevidence synthesis that combine economics and systematic reviewmethods in the applied fields of social welfare, education andcriminal justice, as well as health care. Written by economists andhealth services researchers closely involved in developingevidence-based policy and practice it showcases currentstate-of-the-art methodology and will be an invaluable read for allpolicy-makers and practitioners using evidence to inform decisions,analysts conducting research to support decisions and studentsdiscovering the need for evidence-based decisions to incorporateeconomic perspectives and evidence.

The World Health Assembly in 2005 urged Member States to establish or strengthen knowledge transfer mechanisms to support evidence-informed health policies and health care delivery. The European Health Information Initiative was set up to strengthen the use of evidence information and research for policy-making in the WHO European Region. While good-quality health information is a key component for decision-making it needs to be packaged and communicated in an effective way to policy-makers the end-users. This report describes tools and mechanisms that can help to increase the use of health information in policy development. Packaging tools include synthesis methods such as policy briefs and visualization methods. Application tools include surveillance data and modelling/simulation to explore the behaviour and performance of processes and interventions. Dissemination and communication tools include health information-sharing platforms newsletters and person-to-person communications. Finally linkage and exchange tools such as knowledge networks facilitate the dissemination and refining of health information thus increasing the chance of its translation into policy.

Community resilience is the ability of communities and groups to adapt and thrive in response to external stressors. Building resilient communities as a strategy for population health requires assessment of personal and collective capacities alongside vulnerabilities. This report examines what quantitative and qualitative methods can be used to measure health-related community resilience at national and local levels. Evidence from a rapid review of 33 studies highlighted various methodological challenges. Measurement strategies mostly drawn from the field of community disaster resilience include population-level frameworks mixed methods assessment tools and qualitative and participatory case studies. The main conclusions are that measurement of health-related community resilience should cover multiple domains (economic social health skills political and environment) and consider local context and assets. Three stages of policy development are suggested: selection of a set of key indicators to collect data on community resilience creation of a learning network to share knowledge and tools and development of a comprehensive measurement framework.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.