Health Systems Interventions - How Reliable Is Research Evidence?

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Academic Journal
Main Category: Public Health
Article Date: 22 Mar 2012 - 10:00 PST


In order to develop strong health systems, research evidence is vital, however it is not always easy to evaluate such evidence. The last paper in the three-part series on health systems guidance in this week's PLoS Medicine deals with the issue of how much confidence can be placed in various types of research evidence. According to the authors, this is crucial to informing judgements in terms of policy options to address health systems problems.

Simon Lewin, from the Norwegian Knowledge Center for the Health Services in Oslo, Norway, and his team state that even though there are tools to evaluate evidence of the effectiveness of different health system interventions, there are currently no tools available to help judgments regarding evidence from systematic reviews on other vital factors, such as the acceptability of policy options to stakeholders, equity, and implementation feasibility.

In an associated report, David Peters and Sara Bennett from Johns Hopkins University in Baltimore, USA, who were not involved in the three-part series, explain that the series of papers offer vital contributions to enhancing the quality of evidence-informed decision-making in health systems. However, Peters and Bennett caution that it is important not to be too strict when developing strategies to create guidelines and applying evidence to policy.

According to Peters and Bennett:

"Recognizing the diversity of stakeholders and complexity of health system issues, it will be important to ensure that evidence-informed guidelines that emerge are tested with continued humility and skepticism, and that they do not become rigid models for inquiry dominated by a limited number of disciplines.

They should not serve to blind us toward the need to address a wide variety of questions and incorporate the different types of evidence brought to bear by many fields of science. Further guidance is one important way to shape policy, but we must not fail to situate it in the broader context of sustained dialogue between researchers and policy makers."

Written by Grace Rattue
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