Twelve myths about systematic reviews for health system policymaking rebutted

Moat, Kaelan A.; Lavis, John N.; Wilson, Mike G.; Røttingen, John-Arne; Bärnighausen, Till

doi:10.1258/jhsrp.2012.011175

Cited by 27 publications

(22 citation statements)

References 30 publications

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“…37 In contrast, other health services researchers experienced in engaging policymakers and health care managers argue that systematic reviews can be useful to these groups, and compiled a list of "myths" about the suitability of systematic reviews for use by decisionmakers. 38 They attempted to counter these myths by reviewing evidence included in the Canadian Health 8 Systems Evidence Website (www.healthsystemsevidence.org), which covers topics including governance, financial arrangements, delivery arrangements, and implementing change in health systems. While acknowledging that more systematic reviews addressing policymakers' questions are needed, they argued that systematic reviews can "level the playing field" when there are multiple stakeholders with different points of view.…”

Section: Types Of Evidence Synthesis Sought By Health Systemsmentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

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PrefaceThe Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public-and private-sector organizations in their efforts to improve the quality of health care in the United States.The reports and assessments provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments.To improve the scientific rigor of these evidence reports, AHRQ supports empiric research by the EPCs to help understand or improve complex methodologic issues in systematic reviews. These methods research projects are intended to contribute to the research base in and be used to improve the science of systematic reviews. They are not intended to be guidance to the EPC program, although may be considered by EPCs along with other scientific research when determining EPC program methods guidance.AHRQ expects that the EPC evidence reports and technology assessments will inform individual health plans, providers, and purchasers as well as the health care system as a whole by providing important information to help improve health care quality. The reports undergo peer review prior to their release as a final report.If AcknowledgmentsThe authors gratefully acknowledge the input of the late Robert Lewis Kane, M.D., who was a member of our workgroup until his unexpected death on March 6, 2017. Dr. Kane stimulated the conversation of our workgroup with his ideas and challenges, and inspired creation of the initial framework for our efforts (See Appendix B).The authors also acknowledge two health system representatives, Lucy Savitz, Ph.D., and Charles P. Friedman, Ph.D. for their feedback on our initial framework and draft report. A Framework for Conceptualizing Evidence Needs of Health Systems Structured AbstractObjectives. To develop a framework for understanding the evidence needs of health systems to inform the AHRQ EPC Program future efforts.Data sources. Three data sources were used: (a) peer-reviewed literature from a systematic search of English-language publications in MEDLINE from January 2007-April 2017, (b) original data from four programs serving health system requests for evidence syntheses, and (c) input during a face-to-face meeting at AHRQ in June 2017 from health system stakeholders and EPC investigators.Methods. Data were synthesized narratively and thematically. We developed an initial framework to guide discussion and qualitative analysis. We built consensus around themes and refinement of the framework through weekly phone conferences, electronic communications, and a face-to-face meeting of workgroup members and health systems experts. Results.From the literature review, we found that health systems seek evidence to ...

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Section: Types Of Evidence Synthesis Sought By Health Systemsmentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

View full text Add to dashboard Cite

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“…Some of these have been formally institutionalised into policymaking processes, becoming part of "governance architecture". 'Evidence-tools' are often promoted as a potential 'solution' to the difficulties in trying to achieve evidence-informed decision-making in policy settings (Gough et al, 2013;Moat et al, 2013;Welch et al, 2012). Yet, paradoxically, there is little, if any, evidence to indicate that the use of such tools actually does improve the use of evidence in policy (or, more importantly, lead to better outcomes).…”

Section: Introductionmentioning

confidence: 99%

‘Black magic’ and ‘gold dust’: the epistemic and political uses of evidence tools in public health policy making

Stewart¹,

Smith²

2015

Evidence &Amp; Policy

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Concerns about the limited influence of research on decision making have prompted the development of tools intended to mediate evidence for policy audiences. This article focuses on three examples, prominent in public health: impact assessments; systematic reviews; and economic decision-making tools (cost-benefit analysis and scenario modelling). Each has been promoted as a means of synthesising evidence for policy makers but little is known about policy actors’ experiences of them. Employing a literature review and 69 interviews, we offer a critical analysis of their role in policy debates, arguing that their utility lies primarily in their symbolic value as markers of good decision making.

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“…In health care systems with limited resources, policy makers should be able to make informed decisions about health care priorities based on scientific evidence [6]. According to service providers, insecure parents use the health care services beyond indication.…”

Section: Introductionmentioning

confidence: 99%

The effect of antenatal education in small classes on obstetric and psycho-social outcomes - a systematic review

et al. 2015

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BackgroundThe aims of antenatal education are broad and encompass outcomes related to pregnancy, birth, and parenthood. Both form and content of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes.MethodsBibliographic databases (Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO) were searched. We included randomized and quasi-randomized trials irrespective of language, publication year, publication type, and publication status. Only trials carried out in the Western world were considered in this review. Studies were assessed for bias using the Cochrane risk of bias tool. Results are presented as structured summaries of the included trials and as forest plots.ResultsWe identified 5,708 records. Of these, 17 studies met inclusion criteria. Studies varied greatly in content of the experimental and control condition. All outcomes were only reported in a single or a few trials, leading to limited or uncertain confidence in effect estimates. Given the heterogeneity in interventions and outcomes and also the high risk of bias of studies, we are unable to draw definitive conclusions as to the impact of small group antenatal education on obstetric and psycho-social outcomes.ConclusionsInsufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well-conducted randomized controlled trials with a low risk of bias.Systematic review registrationPROSPERO CRD42013004319Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0010-x) contains supplementary material, which is available to authorized users.

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Twelve myths about systematic reviews for health system policymaking rebutted

Cited by 27 publications

References 30 publications

A Framework for Conceptualizing Evidence Needs of Health Systems

A Framework for Conceptualizing Evidence Needs of Health Systems

‘Black magic’ and ‘gold dust’: the epistemic and political uses of evidence tools in public health policy making

The effect of antenatal education in small classes on obstetric and psycho-social outcomes - a systematic review

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