Monday, February 28, 2011

[EQ] Supporting the use of Cochrane Reviews in health policy and management decision-making: Health Systems Evidence

Supporting the use of Cochrane Reviews in health policy and management decision-making:
Health Systems Evidence

Kaelan A Moat, Health Policy PhD Program, McMaster University, Hamilton, Ontario, Canada
John N Lavis, Director, McMaster Health Forum; Canada Research Chair in Knowledge Transfer and Exchange; Professor, Department of Clinical Epidemiology and Biostatistics; Member, Centre for Health Economics and Policy Analysis; Associate Member, Department of Political Science, McMaster University, Hamilton, Ontario, Canada

The Cochrane Library – February 2011

Available online at:

The idea that research evidence should play a more prominent role in health policy and health system management has been frequently promoted and widely accepted during the past decade.[1,2,3] However, bridging the gap between what has been learned through research and what is considered salient by policy-makers and stakeholders is rarely straightforward.

Nevertheless, there are several activities that have promise for better linking evidence to action.[4] One approach, sometimes called ‘facilitating user-pull’, places emphasis on creating ’one-stop shops’ for relevant, high-quality and optimally packaged systematic reviews and related products.[4] These types of efforts have recently gained more recognition and are viewed as key elements for strategies to strengthen national health systems,[5] as was noted at the First Global Symposium on Health Systems Research, held in Montreux, Switzerland, in November 2010.

Health Systems Evidence (HSE) was developed as a one-stop shop with an emphasis on policy- and management-related systematic reviews and related products. While The Cochrane Library is the one-stop shop for those with questions about clinical programmes and services or medicines, and has emerged as the one-stop shop for those with questions about public health programmes and services,[6] HSE is the only resource that answers questions about how to organise health systems in order to ensure that cost-effective programmes and services get to those who need them. It first became available as a free online resource in late 2008.

There are two key factors that drive the use of research evidence in policy-making: timeliness, and interactions between policy-makers and researchers.[7] HSE addresses the timeliness issue. With relevant reviews and review-related products categorised and presented in an accessible format, HSE enables policy-makers and stakeholders to find out quickly whether synthesised research evidence exists on a pressing issue and when the literature was last searched. HSE also provides information on the quality of the review and on the countries where the included studies were conducted, as well as links to structured, decision-relevant summaries.

The product of a collaboration between the McMaster Health Forum, McMaster University’s Program in Policy Decision-making, the Canadian Cochrane Centre, and Rx for Change, HSE is a continually updated, searchable repository of syntheses of research evidence, coded according to their relevance to governance, financial and delivery arrangements, and strategies for implementing change. Records contained in HSE are identified by:
(1) annual searches of Medline;
(2) review of each monthly issue of the Cochrane Database of Systematic Reviews;
(3) review of each weekly update from the Database of Abstracts of Reviews of Effects;
(4) review of each update of the Cochrane Qualitative Research Methods Group's database of qualitative reviews; and
(5) regular scanning of listservs and websites.

Each synthesis has links to user-friendly summaries, abstracts and full-text reports (when freely available), together with information about how recently the search for studies was conducted, the quality of the synthesis, and the countries in which the studies were conducted, helping policy-makers and managers to assess the relevance of each record.[5]…….

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