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Policymakers' and other stakeholders' perceptions of key considerations for health system decisions and the presentation of evidence to inform those considerations: an international survey.

Vogel JP, Oxman AD, Glenton C, Rosenbaum S, Lewin S, Gülmezoglu AM, Souza JP - Health Res Policy Syst (2013)

Bottom Line: All components of our evidence summary were rated as important by over 90% of respondents.Survey respondents were supportive of the DECIDE framework for health system decisions and the use of succinct summaries of the estimated size of effects and the quality of evidence.It is uncertain whether the findings of this survey represent the views of policymakers with little or no healthcare and research experience.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia.

ABSTRACT

Background: The DECIDE framework was developed to support evidence-informed health system decisions through evidence summaries tailored to health policymakers. The objective of this study was to determine policymakers' perceptions regarding the criteria in the DECIDE framework and how best to summarise and present evidence to support health system decisions.

Methods: We conducted an online survey of a diverse group of stakeholders with health system decision experience from 15 countries and the World Health Organization. We asked about perceptions of criteria relevant to making health system decisions, use of evidence, grading systems, and evidence summaries.

Results: We received 112 responses (70% response rate). Most respondents had healthcare (85%) and research (79%) experience. They (99%) indicated that systematic consideration of the available evidence would help to improve health system decision-making processes and supported the use of evidence from other countries (94%) and grading systems (81%). All ten criteria in the DECIDE framework were rated as important in the decision-making process. Respondents had divergent views regarding whether the same (38%) or different (45%) grading systems should be used across different types of health decisions. All components of our evidence summary were rated as important by over 90% of respondents.

Conclusions: Survey respondents were supportive of the DECIDE framework for health system decisions and the use of succinct summaries of the estimated size of effects and the quality of evidence. It is uncertain whether the findings of this survey represent the views of policymakers with little or no healthcare and research experience.

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Survey responses rating the importance of components of a summary of evidence.
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Figure 3: Survey responses rating the importance of components of a summary of evidence.

Mentions: Most respondents agreed that a system of grading evidence would either definitely (59.7%) or probably (33.3%) improve health system decision-making processes (Table 2). When asked whether such grading systems should be the same for clinical and health system decisions, 38.4% said it should or probably should be the same, 45.3% indicated that different grading systems should or probably should be used for clinical and health system decisions, and 16.3% were neutral. This disagreement was also reflected in comments. Some respondents stated that using the same grading system improves consistency, transparency, and reproducibility, while others stated that they are fundamentally different types of decisions and evidence, requiring different grading systems. Two respondents (both from DECIDE partner countries) indicated an overall dislike of evidence grading systems. Respondent ratings on the importance of components of a summary of evidence are described in Figure 3. There was general agreement that all of the summary components were important or probably important, ranging from 79% (confidence intervals for effect estimates) to 96% (description of the quality of the evidence). All comments were in broad support, including several highlighting the need for clarity, simplicity, and brevity. Others suggested the use of disability-adjusted life years (DALYs) and number needed to treat (NNT) as important measures of effect.


Policymakers' and other stakeholders' perceptions of key considerations for health system decisions and the presentation of evidence to inform those considerations: an international survey.

Vogel JP, Oxman AD, Glenton C, Rosenbaum S, Lewin S, Gülmezoglu AM, Souza JP - Health Res Policy Syst (2013)

Survey responses rating the importance of components of a summary of evidence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672010&req=5

Figure 3: Survey responses rating the importance of components of a summary of evidence.
Mentions: Most respondents agreed that a system of grading evidence would either definitely (59.7%) or probably (33.3%) improve health system decision-making processes (Table 2). When asked whether such grading systems should be the same for clinical and health system decisions, 38.4% said it should or probably should be the same, 45.3% indicated that different grading systems should or probably should be used for clinical and health system decisions, and 16.3% were neutral. This disagreement was also reflected in comments. Some respondents stated that using the same grading system improves consistency, transparency, and reproducibility, while others stated that they are fundamentally different types of decisions and evidence, requiring different grading systems. Two respondents (both from DECIDE partner countries) indicated an overall dislike of evidence grading systems. Respondent ratings on the importance of components of a summary of evidence are described in Figure 3. There was general agreement that all of the summary components were important or probably important, ranging from 79% (confidence intervals for effect estimates) to 96% (description of the quality of the evidence). All comments were in broad support, including several highlighting the need for clarity, simplicity, and brevity. Others suggested the use of disability-adjusted life years (DALYs) and number needed to treat (NNT) as important measures of effect.

Bottom Line: All components of our evidence summary were rated as important by over 90% of respondents.Survey respondents were supportive of the DECIDE framework for health system decisions and the use of succinct summaries of the estimated size of effects and the quality of evidence.It is uncertain whether the findings of this survey represent the views of policymakers with little or no healthcare and research experience.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia.

ABSTRACT

Background: The DECIDE framework was developed to support evidence-informed health system decisions through evidence summaries tailored to health policymakers. The objective of this study was to determine policymakers' perceptions regarding the criteria in the DECIDE framework and how best to summarise and present evidence to support health system decisions.

Methods: We conducted an online survey of a diverse group of stakeholders with health system decision experience from 15 countries and the World Health Organization. We asked about perceptions of criteria relevant to making health system decisions, use of evidence, grading systems, and evidence summaries.

Results: We received 112 responses (70% response rate). Most respondents had healthcare (85%) and research (79%) experience. They (99%) indicated that systematic consideration of the available evidence would help to improve health system decision-making processes and supported the use of evidence from other countries (94%) and grading systems (81%). All ten criteria in the DECIDE framework were rated as important in the decision-making process. Respondents had divergent views regarding whether the same (38%) or different (45%) grading systems should be used across different types of health decisions. All components of our evidence summary were rated as important by over 90% of respondents.

Conclusions: Survey respondents were supportive of the DECIDE framework for health system decisions and the use of succinct summaries of the estimated size of effects and the quality of evidence. It is uncertain whether the findings of this survey represent the views of policymakers with little or no healthcare and research experience.

Show MeSH