scholarly journals The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Development ◽  
Digital Health ◽  
Resource Planning ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

scholarly journals 18.H. Workshop: Bringing evidence during public health emergencies: addressing the challenge through HTA

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Emergency Preparedness ◽  
Public Health Emergency ◽  
Decision Makers ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
Response Planning ◽  
Emergency Preparedness And Response ◽  
Public Health Emergency Preparedness

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The process of including evidence in public health decision-making and for evidence-informed policy, in preparation, and during public health emergencies, is not systematic and is complicated by many barriers as the absences of shared tools and approaches for evidence-based preparedness and response planning. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability and to implement coordinated evidence-based response plans. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. As a multidisciplinary, standardized and evidence-based decision-making tool, Health Technology Assessment (HTA) represents and approach that can inform public health emergency preparedness and response planning processes; it can also provide meaningful insights on existing preparedness structures, working as bridge between scientists and decision-makers, easing knowledge transition and translation to ensure that evidence is effectively integrated into decision-making contexts. HTA can address the link between scientific evidence and decision-making in public health emergencies, and overcome the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines. It may allow a 360° perspective, providing a comprehensive view to decision-making in preparation and during public health emergencies. The objective of the workshop is to explore and present how HTA can be used as a shared and systematic evidence-based tool for Public Health Emergency Preparedness and Response, in order to enable stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. Key messages There are many barriers and no shared mechanisms to bring evidence in decision-making during public health emergencies. HTA can represent the tool to bring evidence-informed actions in public health emergency preparedness and response.

Evidence-Based Decision-Making for a Public Health Emergency in China: Easier Said Than Done

2020 ◽  
Vol 50 (6-7) ◽  
pp. 720-724
Author(s):  
Liwei Zhang ◽  
Kelin Chen ◽  
Ji Zhao
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Local Government ◽  
Local Governments ◽  
Scientific Evidence ◽  
Behavioral Pattern ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Governance Reform ◽  
Evidence Based Decision Making

This article aims to argue that evidence-based decision-making for a public health emergency is “easier said than done” reflected on COVID-19 response in China. For the local government, the behavioral pattern is prone to blame-avoiding instead of making decision following scientific evidence and experts’ advice. However, such behavior is not based on completely subjective judgment but a rational choice for the local government. Some consequences associated with China’s response to COVID-19 reveals an inflexible administrative system. Therefore, China’s governance reform should focus on empowering local governments with more flexibility and resilience, which enables local governments to make independent and scientific decisions in an emergency.

Evidence-Based Decision-Making (Part 1): Origins and Evolution in the Health Sciences

2009 ◽  
Vol 24 (4) ◽  
pp. 298-305 ◽  
Author(s):  
David A. Bradt
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based Medicine ◽  
Strategic Decision ◽  
Systematic Research ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Strength Of Evidence ◽  
Based Medicine ◽  
Evidence Based Decision Making

AbstractEvidence is defined as data on which a judgment or conclusion may be based. In the early 1990s, medical clinicians pioneered evidence-based decision-making. The discipline emerged as the use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine required the integration of individual clinical expertise with the best available, external clinical evidence from systematic research and the patient's unique values and circumstances. In this context, evidence acquired a hierarchy of strength based upon the method of data acquisition.Subsequently, evidence-based decision-making expanded throughout the allied health field. In public health, and particularly for populations in crisis, three major data-gathering tools now dominate: (1) rapid health assessments; (2) population based surveys; and (3) disease surveillance. Unfortunately, the strength of evidence obtained by these tools is not easily measured by the grading scales of evidence-based medicine. This is complicated by the many purposes for which evidence can be applied in public health—strategic decision-making, program implementation, monitoring, and evaluation. Different applications have different requirements for strength of evidence as well as different time frames for decision-making. Given the challenges of integrating data from multiple sources that are collected by different methods, public health experts have defined best available evidence as the use of all available sources used to provide relevant inputs for decision-making.

Evidence-Based Decision Making in Public Health

1999 ◽  
Vol 5 (5) ◽  
pp. 86-97 ◽  
Author(s):  
Ross C. Brownson ◽  
James G. Gurney ◽  
Garland H. Land
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Evidence Based Decision Making

scholarly journals Rugged landscapes: complexity and implementation science

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Joseph T. Ornstein ◽  
Ross A. Hammond ◽  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Quality Improvement ◽  
Evolutionary Biology ◽  
Public Health Practice ◽  
Evidence Based ◽  
Health Practice ◽  
Context Specific ◽  
Evidence Based Programs ◽  
Evidence Based Decision Making

Abstract Background Mis-implementation—defined as failure to successfully implement and continue evidence-based programs—is widespread in public health practice. Yet the causes of this phenomenon are poorly understood. Methods We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches—Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM). Results The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM. Conclusions The model’s results emphasize the importance of adapting one’s approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.

scholarly journals A Framework for Evidence-Based Decision Making in Large-Scale Food Fortification Programs

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1802-1802
Author(s):  
Valerie Friesen ◽  
Mduduzi Mbuya ◽  
Lynnette Neufeld ◽  
Frank T Weiringa
Keyword(s):  
Decision Making ◽  
Large Scale ◽  
Program Design ◽  
Decision Makers ◽  
Evidence Based ◽  
Food Fortification ◽  
Impact Pathway ◽  
Gates Foundation ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Objectives The use of evidence on program performance and potential for impact for decision making in food fortification programs is limited and often done in isolation from other micronutrient interventions. We present a framework for fortification stakeholders responsible for making program recommendations and decisions to facilitate and document evidence-based decision making. Methods First, we reviewed the literature to define the key decision makers and decisions necessary for effective fortification program design and delivery, informed by a clear impact pathway. Then we classified decisions by domain, identified data sources and criteria for their assessment, and adapted the GRADE Evidence to Decision framework to summarize the results. Finally, we considered how the framework would apply to different country programs to test its utility. Results Policymakers, particularly government ministries, and the food producers themselves are the most important decision makers in a fortification program, while technical support agencies, donor agencies, and the research community play important roles in translating data and evidence into contextualized recommendations that meet the needs of different decision makers. The main fortification decision types were classified into five domains across the impact pathway: 1) program design (need, food vehicle(s)); 2) program delivery (compliance, quality, coverage); 3) program impact (nutrient intake and status); 4) overlapping micronutrient interventions and/or under-served populations; and 5) decisions to continue or stop programs. Important criteria for the assessment of each decision type included priority, benefits/risks, equity, acceptability, and feasibility among others. Country examples illustrated the importance of coordinating decision-making in the context of overlapping micronutrient interventions to ensure continued safety and impact over time. Conclusions This framework is a practical tool to enable evidence-based decision making by fortification stakeholders. Using evidence in a systematic and transparent way can enable more effective program design, delivery, and ultimately health impacts. Funding Sources Bill & Melinda Gates Foundation.

Perceptions of Evidence-Based Decision-Making Among Full-Time Teachers and Senior Undergraduates in Public Health: A Nationwide Survey in Taiwan

2020 ◽  
Vol 32 (4) ◽  
pp. 209-214
Author(s):  
Yi-Hao Weng ◽  
Chun-Yuh Yang ◽  
Ya-Wen Chiu
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Scale Up ◽  
Nationwide Survey ◽  
School Curriculum ◽  
Evidence Based ◽  
Full Time ◽  
Teachers And Students ◽  
Evidence Based Decision Making ◽  
Structured Questionnaire

Using current best evidence to make decisions can improve outcomes of public health. Thus, establishing the capacities of evidence-based public health (EBPH) has become one of the core competences. To better scale up EBPH movement, efforts should focus on introduction of EBPH into school curriculum. However, data indicating the extent to which EBPH is used in universities are scant. In the current study, we conducted a nationwide questionnaire survey to investigate the perceptions toward EBPH among full-time teachers and senior undergraduates at all universities with a Department of Public Health in Taiwan. A structured questionnaire was distributed by post to all potential participants of nine universities in 2017. Questions included items related to awareness, knowledge, skills, behaviors, and barriers of EBPH. Results showed teachers were more aware of EBPH than students. In addition, teachers more often had sufficient knowledge and skills of EBPH, and more often applied the findings to decision-making after critical appraisal than students. Furthermore, personal barriers toward EBPH were more common in students than teachers. In conclusion, there are differences in awareness, knowledge, skills, behaviors, and barriers of EBPH between teachers and students. The data suggest that an initiative of systematically teaching EBPH to undergraduates is important.

scholarly journals Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Laura Yarber ◽  
Carol A. Brownson ◽  
Rebekah R. Jacob ◽  
Elizabeth A. Baker ◽  
Ellen Jones ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Train The Trainer ◽  
Evidence Based Decision Making
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