Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Implement Sci. 2011 May 10;6:46. doi: 10.1186/1748-5908-6-46.
Decision aids have been developed in a number of health disciplines to support evidence-informed decision making, including patient decision aids and clinical practice guidelines. However, policy contexts differ from clinical contexts in terms of complexity and uncertainty, requiring different approaches for identifying, interpreting, and applying many different types of evidence to support decisions. With few studies in the literature offering decision guidance specifically to health policymakers, the present study aims to facilitate the structured and systematic incorporation of research evidence and, where there is currently very little guidance, values and other non-research-based evidence, into the policy making process. The resulting decision aid is intended to help public sector health policy decision makers who are tasked with making evidence-informed decisions on behalf of populations. The intent is not to develop a decision aid that will yield uniform recommendations across jurisdictions, but rather to facilitate more transparent policy decisions that reflect a balanced consideration of all relevant factors.
METHODS/DESIGN: The study comprises three phases: a modified meta-narrative review, the use of focus groups, and the application of a Delphi method. The modified meta-narrative review will inform the initial development of the decision aid by identifying as many policy decision factors as possible and other features of methodological guidance deemed to be desirable in the literatures of all relevant disciplines. The first of two focus groups will then seek to marry these findings with focus group members' own experience and expertise in public sector population-based health policy making and screening decisions. The second focus group will examine issues surrounding the application of the decision aid and act as a sounding board for initial feedback and refinement of the draft decision aid. Finally, the Delphi method will be used to further inform and refine the decision aid with a larger audience of potential end-users.
The product of this research will be a working version of a decision aid to support policy makers in population-based health policy decisions. The decision aid will address the need for more structured and systematic ways of incorporating various evidentiary sources where applicable.
决策辅助工具已在多个健康学科中开发出来，以支持循证决策，包括患者决策辅助工具和临床实践指南。然而，政策环境在复杂性和不确定性方面与临床环境不同，需要采用不同的方法来识别、解释和应用多种不同类型的证据来支持决策。由于文献中很少有研究专门为卫生政策制定者提供决策指导，本研究旨在促进将研究证据以及在目前几乎没有指导的情况下的价值观和其他非研究证据有系统地纳入决策过程。由此产生的决策辅助工具旨在帮助负责代表人群做出循证决策的公共部门卫生政策决策者。目的不是开发一个在所有管辖区产生统一建议的决策辅助工具，而是促进更透明的政策决策，反映对所有相关因素的平衡考虑。
方法/设计：该研究包括三个阶段：修改后的元叙述性综述、焦点小组的使用以及德尔菲法的应用。修改后的元叙述性综述将通过识别尽可能多的政策决策因素以及文献中被认为在所有相关学科中有用的其他方法指导特征，为决策辅助工具的初步开发提供信息。然后，第一个焦点小组将试图将这些发现与焦点小组成员在公共部门基于人群的卫生政策制定和筛选决策方面的经验和专业知识结合起来。第二个焦点小组将研究围绕决策辅助工具应用的问题，并作为对决策辅助工具草案的初步反馈和改进的意见征询。最后，德尔菲法将用于通过更大的潜在最终用户群体进一步为决策辅助工具提供信息并加以完善。
本研究的成果将是一个支持政策制定者在基于人群的卫生政策决策中使用的决策辅助工具的工作版本。该决策辅助工具将解决在适用情况下需要更具结构性和系统性的方法来整合各种证据来源的问题。
