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循证卫生政策 2 - 支持使用研究证据的组织调查。

Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

机构信息

Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, HSC-2D3, Hamilton, ON L8N 3Z5, Canada.

出版信息

Implement Sci. 2008 Dec 17;3:54. doi: 10.1186/1748-5908-3-54.

Abstract

BACKGROUND

Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs).

METHODS

We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone.

RESULTS

We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about uptake, and roughly the same proportions do not systematically evaluate their usefulness or impact in other ways.

CONCLUSION

The findings from our survey, the most broadly based of its kind, both extend or clarify the applicability of the messages arising from previous surveys and related documentary analyses, such as how the 'principles of evidence-based medicine dominate current guideline programs' and the importance of collaborating with other organizations. The survey also provides a description of the history, structure, processes, outputs, and perceived strengths and weaknesses of existing organizations from which those establishing or leading similar organizations can draw.

摘要

背景

之前对支持制定循证卫生政策的组织进行的调查主要集中在制作临床实践指南 (CPG) 或进行卫生技术评估 (HTA) 的组织上。只有极少数调查至少部分关注那些在国际、国家和州或省一级直接支持将研究证据用于制定卫生政策的单位(即政府支持单位,或 GSUs),这些单位在某种程度上是成功的或创新的,或者支持在中低收入国家(LMICs)使用研究证据。

方法

我们借鉴了来自世界各地的许多人和组织,包括我们的项目参考小组,以生成要调查的组织列表。我们修改了最初由欧洲评估指南、研究和评价(AGREE)合作开发的问卷,并为制作 CPG 和 HTA 的组织和 GSUs 分别改编了一个版本的问卷。我们通过电子邮件向 176 个组织发送了问卷,并定期通过电子邮件和电话与未回复的组织进行跟进。

结果

我们收到了 152 个(86%)组织的完整问卷。超过一半的组织(特别是 HTA 机构)报告说,来自其他国家的例子有助于建立他们的组织。参与选择主题或开展服务的目标用户比例,GSUs 高于 CPG 或 HTA 制作组织。大多数组织的全职等效人员(FTE)很少(五个或更少)。超过五分之四的组织报告为小组提供或使用系统评价。GSUs 倾向于对研究证据使用广泛的明确评估过程,但没有一个组织像制作 CPG、HTA 或两者都优先考虑证据质量那样频繁地使用。有一半到三分之二的组织没有系统地收集关于采用情况的数据,大致相同比例的组织没有以其他方式系统地评估其有用性或影响。

结论

我们的调查结果是同类调查中最广泛的一次,既扩展或澄清了以前的调查和相关文献分析所产生的信息的适用性,例如“循证医学的原则主导当前指南计划”的重要性以及与其他组织合作的重要性。该调查还描述了现有组织的历史、结构、流程、产出以及感知到的优势和劣势,这为那些正在建立或领导类似组织的人提供了参考。

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