van Kammen Jessika, Jansen Carin W, Bonsel Gouke J, Kremer Jan A M, Evers Johannes L H, Wladimiroff Juriy W
Netherlands Organisation for Research and Development ZonMw, The Hague.
Int J Technol Assess Health Care. 2006 Summer;22(3):302-6. doi: 10.1017/s026646230605118x.
Even when policy makers show interest and evidence-informed and convincing HTA studies are available, use of assessment products is not guaranteed. In this article, we report our experience with knowledge brokering to foster evidence-informed policy making on cost-effective treatment and reimbursement of assisted reproduction in The Netherlands.
From earlier work in the field of knowledge brokering, we foresaw the need for a deliberative strategy to manage the inherent tension between scientific rigor demanded by researchers and responsiveness to real-time needs demanded by policy makers. Therefore, we structured the process in three distinct steps: (i) agreement about the main messages from the research, (ii) analysis of the policy context and of the meaning of the main messages for the actors involved, and (iii) an invitational meeting to make recommendations for action.
One of the recommendations that would require changes in ministerial policy was followed up instantly, whereas the other recommendation is still under debate. The Dutch Society of Obstetrics and Gynecology activated the revision of two guidelines. The patient organization uses the new scientific insights in informing members and the public. Closing the loop, The Netherlands Organisation for Health Research and Development (ZonMw) funded research to close knowledge gaps that became apparent in the process.
Knowledge brokering is a promising approach to bring HTA into practice. We conclude that the methodologies to feed research results into the policy process are still in an incipient stage and need further development.
即便政策制定者表现出兴趣，且有基于证据且具有说服力的卫生技术评估（HTA）研究可用，但评估产品的使用仍无法得到保证。在本文中，我们报告了我们在知识中介方面的经验，以促进荷兰在辅助生殖的成本效益治疗及报销方面基于证据的政策制定。
从知识中介领域的早期工作中，我们预见到需要一种审议策略来管理研究人员所要求的科学严谨性与政策制定者所要求的对实时需求的响应性之间的内在紧张关系。因此，我们将该过程分为三个不同步骤：（i）就研究的主要信息达成一致，（ii）分析政策背景以及主要信息对相关行为者的意义，（iii）召开一次邀请会议以提出行动建议。
一项要求部长级政策做出改变的建议立即得到了跟进，而另一项建议仍在讨论中。荷兰妇产科学会启动了两项指南的修订。患者组织利用新的科学见解向成员和公众提供信息。形成闭环的是，荷兰卫生研究与发展组织（ZonMw）资助了研究，以填补该过程中明显出现的知识空白。
知识中介是将卫生技术评估付诸实践的一种有前景的方法。我们得出结论，将研究结果纳入政策过程的方法仍处于初期阶段，需要进一步发展。
