Evidence-based policy-making
-
R. Andrew Moore
Abstract
There is no large literature on evidence-based policy-making. We do know that one of the most difficult decisions is about the dependability of evidence we use to make policy. Unless the evidence can fulfil the criteria of quality, validity, and size, then it has the potential to mislead us, whatever study designs or methods have been used. The best examples of evidence-based policy-making come from development of care pathways, in which multidisciplinary groups merge best-available evidence with what is possible in local circumstances. These care pathways almost always have the ability to deliver better care for patients, with less fuss for professionals and at lower cost to the community. They may be the single best way of improving healthcare.
References
1. Ware RE, Francis HW, Read KE. The Australian government's review of positron emission tomography: evidence-based policy-making in action. Med J Aust 2004; 180:627–32.10.5694/j.1326-5377.2004.tb06125.xSearch in Google Scholar
2. Ioannides JP. Contradicted and initially stronger effects in highly cited clinical research. J Am Med Assoc 2005; 294:218–28.10.1001/jama.294.2.218Search in Google Scholar
3. Ioannides JP. Why most published research findings are false. PLoS Med 2005; 2:e124.10.1371/journal.pmed.0020124Search in Google Scholar
4. Moore RA, McQuay HJ. Bandolier's little book of understanding evidence. Oxford: Oxford University Press, 2006. In press.Search in Google Scholar
5. Melchart D, Linde K, Berman B, White A, Vickers A, Allais G, et al. Acupunture for idiopathic headache. The Cochrane Database of Systematic Reviews 2001, Issue 1. Art. No.: CD001218.DOI:10.1002/14651858.CD001218.10.1002/14651858.CD001218Search in Google Scholar
6. Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. Br Med J 2000; 321:1493–7.10.1136/bmj.321.7275.1493Search in Google Scholar
7. Rigg JR, Jamrozik K, Myles PS, Silbert BS, Peyton PJ, Parsons RW, et al., MASTER Anaesthesia Trial Study Group. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet 2002; 359:1276–82.10.1016/S0140-6736(02)08266-1Search in Google Scholar
8. Sprangers MA, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB, et al. Which chronic conditions are associated with a better or poorer quality of life? J Clin Epidemiol 2000; 53:895–907.10.1016/S0895-4356(00)00204-3Search in Google Scholar
9. Thomson R, Parkin D, Eccles M, Sudlow M, Robinson A. Guidelines on anticoagulant treatment for atrial fibrillation in Great Britain: variation in content and implications for treatment. Br Med J 1998; 316:509–13.10.1136/bmj.316.7130.509Search in Google Scholar
10. Heidenrich PA, McLellan M. Trends in outcomes for acute myocardial infarction: 1975–1995. Am J Med 2001; 110:165–74.10.1016/S0002-9343(00)00712-9Search in Google Scholar
11. Harrop J, Donnelly R, Rowbottom A, Holt M, Scott AR. Improvements in total mortality and lipid levels after acute myocardial infarction in an English Health District (1995–1999). Heart 2002; 87:428–32.10.1136/heart.87.5.428Search in Google Scholar PubMed PubMed Central
12. Visentin M. Towards a pain-free hospital. J Headache Pain 2002; 3:59–61.10.1007/s101940200019Search in Google Scholar
13. Al-Eidan FA, McElnay JC, Scott MG, Kearney MP, Corrigan J, McConnell JB. Use of a treatment protocol in the management of community-acquired lower respiratory tract infection. J Antimicrob Chemother 2000; 45:387–94.10.1093/jac/45.3.387Search in Google Scholar
14. Benenson R, Magalski A, Cavanaugh S, Williams E. Effects of a pneumonia clinical pathway on time to antibiotic treatment, length of stay, and mortality. Acad Emerg Med 1999; 6:1243–8.10.1111/j.1553-2712.1999.tb00140.xSearch in Google Scholar
15. Tsai AC, Morton SC, Mangione CM, Keeler EB. A meta-analysis of interventions to improve care for chronic illness. Am J Manage Care 2005; 11:478–88.Search in Google Scholar
16. Care pathways. Bandolier 2003 (www.jr2.ox.ac.uk/bandolier/Extraforbando/Forum2.pdf).Search in Google Scholar
17. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcomes. Am J Surg 2002; 183:630–41.10.1016/S0002-9610(02)00866-8Search in Google Scholar
18. Stephen AE, Berger DL. Shortened length of stay and hospital cost reduction with implementation of an accelerated clinical care pathway after elective colon resection. Surgery 2003; 133:277–82.10.1067/msy.2003.19Search in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Foreword
- Evidence-based policy-making
- Clinical Governance – from rhetoric to reality?
- Realising the developmental potential of Clinical Governance
- Re-energising Clinical Governance through Integrated Governance
- Clinical Governance: from clinical risk management to continuous quality improvement
- Involvement of patients in Clinical Governance
- Teaching and Continuing Professional Development: an Italian experience
- New National Healthcare Information System
- Clinical Governance and Laboratory Medicine: is the Electronic Medical Record our best friend or sworn enemy?
- Technology to improve quality and accountability
- Clinical Governance and evidence-based laboratory medicine
- ISO 15189:2003 – Quality management, evaluation and continual improvement
- External Quality Assessment: an effective tool for Clinical Governance in Laboratory Medicine
- Errors in clinical laboratories or errors in laboratory medicine?
- Laboratory request appropriateness in emergency: impact on hospital organization
- Point-of-care-testing and Clinical Governance
- Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
Articles in the same Issue
- Foreword
- Evidence-based policy-making
- Clinical Governance – from rhetoric to reality?
- Realising the developmental potential of Clinical Governance
- Re-energising Clinical Governance through Integrated Governance
- Clinical Governance: from clinical risk management to continuous quality improvement
- Involvement of patients in Clinical Governance
- Teaching and Continuing Professional Development: an Italian experience
- New National Healthcare Information System
- Clinical Governance and Laboratory Medicine: is the Electronic Medical Record our best friend or sworn enemy?
- Technology to improve quality and accountability
- Clinical Governance and evidence-based laboratory medicine
- ISO 15189:2003 – Quality management, evaluation and continual improvement
- External Quality Assessment: an effective tool for Clinical Governance in Laboratory Medicine
- Errors in clinical laboratories or errors in laboratory medicine?
- Laboratory request appropriateness in emergency: impact on hospital organization
- Point-of-care-testing and Clinical Governance
- Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
