scholarly journals Evidence-Based Policy Making: Balancing Rigor With Real-World Health Care for Veterans and Military Personnel

2015 ◽  
Vol 76 (5) ◽  
pp. 339-342
Author(s):  
A. Kilbourne ◽  
D. Atkins
Keyword(s):  
Health Care ◽  
Military Personnel ◽  
Real World ◽  
Policy Making ◽  
World Health ◽  
Evidence Based ◽  
Evidence Based Policy

Toward Evidence-Based Policy Making to Reduce Wasteful Health Care Spending

JAMA ◽  
2019 ◽  
Vol 322 (15) ◽  
pp. 1460 ◽  
Author(s):  
Karen E. Joynt Maddox ◽  
Mark B. McClellan
Keyword(s):  
Health Care ◽  
Policy Making ◽  
Health Care Spending ◽  
Evidence Based ◽  
Evidence Based Policy

Evidence-based policy making in health care: what it is and what it isn't

2005 ◽  
Vol 10 (2) ◽  
pp. 118-121 ◽  
Author(s):  
Richard Cookson
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Policy Making ◽  
Observational Studies ◽  
Large Scale ◽  
Policy Outcomes ◽  
Controlled Trials ◽  
Evidence Based ◽  
Ivory Tower ◽  
Evidence Based Policy

In this paper, I aim to re-establish the meaning and importance of the concept of 'evidence-based policy making' (EBP) in health care. The term EBP is often misunderstood as being either vacuous (who thinks that public policy should not be based on evidence?), unrealistic (the naive product of ivory tower thinking) or conservative (an excuse permanently to delay reform). It need be none of these things. EBP should be thought of as a set of rules and institutional arrangements designed to encourage transparent and balanced use of evidence in public policy making. As well as controlled trials and observational studies, a broad range of theoretical and empirical evidence about human behaviour may be relevant to predicting policy outcomes - including stakeholder opinions and other sources of intelligence that might not qualify as scientific research. Gradual progress towards EBP, properly understood, has the potential to facilitate open democracy and to improve policy outcomes. The argument is illustrated using examples based on large-scale policies of health care reform in England, where progress towards EBP over the last decade has been real but modest.

Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care

2009 ◽  
Vol 102 (12) ◽  
pp. 1234-1240 ◽  
Author(s):  
Horst Gerlach ◽  
Viola Hach-Wunderle ◽  
Eberhard Rabe ◽  
Hanno Riess ◽  
Heike Carnarius ◽  
...  
Keyword(s):  
Health Care ◽  
Deep Vein Thrombosis ◽  
Ambulatory Care ◽  
Real World ◽  
Diagnostic Methods ◽  
World Health ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Work Up ◽  
Current Guidelines

SummaryCurrent guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.

Can Complexity Move UK Policy beyond ‘Evidence-Based Policy Making’ and the ‘Audit Culture’? Applying a ‘Complexity Cascade’ to Education and Health Policy

2011 ◽  
Vol 60 (1) ◽  
pp. 20-43 ◽  
Author(s):  
Robert Geyer
Keyword(s):  
Health Policy ◽  
Policy Making ◽  
Policy Response ◽  
Evidence Based ◽  
Visual Metaphor ◽  
Negative Effects ◽  
Audit Culture ◽  
Education And Health ◽  
Evidence Based Policy ◽  
The Uk

For much of the twentieth century UK public policy has been based on a strong centralist, rationalist and managerialist framework. This orientation was significantly amplified by New Labour in the 1990s and 2000s, leading to the development of ‘evidence-based policy making’ (EBPM) and the ‘audit culture’ – a trend that looks set to continue under the current government. Substantial criticisms have been raised against the targeting/audit strategies of the audit culture and other forms of EBPM, particularly in complex policy areas. This article accepts these criticisms and argues that in order to move beyond these problems one must not only look at the basic foundation of policy strategies, but also develop practical alternatives to those strategies. To that end, the article examines one of the most basic and common tools of the targeting/audit culture, the aggregate linear X-Y graph, and shows that when it has been applied to UK education policy, it leads to: (1) an extrapolation tendency; (2) a fluctuating ‘crisis–success' policy response process; and (3) an intensifying targeting/auditing trend. To move beyond these problems, one needs a visual metaphor which combines an ability to see the direction of policy travel with an aspect of continual openness that undermines the extrapolation tendency, crisis–success policy response and targeting/auditing trend. Using a general complexity approach, and building on the work of Geyer and Rihani, this article will attempt to show that a ‘complexity cascade’ tool can be used to overcome these weaknesses and avoid their negative effects in both education and health policy in the UK.

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