Department of Infectious Disease Epidemiology, Imperial College London, London, UK
Department of Health Policy, The London School of Economics and Political Science, London, UK.
BMJ Glob Health. 2021 Sep;6(9). doi: 10.1136/bmjgh-2021-006827.
While epidemiological and economic evidence has the potential to provide answers to questions, guide complex programmes and inform resource allocation decisions, how this evidence is used by global health organisations who commission it and what organisational actions are generated from the evidence remains unclear. This study applies analytical tools from organisational science to understand how evidence produced by infectious disease epidemiologists and health economists is used by global health organisations. A conceptual framework that embraces evidence use typologies and relates findings to the organisational process of action generation informs and structures the research. Between March and September 2020, we conducted in-depth interviews with mathematical modellers (evidence producers) and employees at global health organisations, who are involved in decision-making processes (evidence consumers). We found that commissioned epidemiological and economic evidence is used to track progress and provides a measure of success, both in terms of health outcomes and the organisations' mission. Global health organisations predominantly use this evidence to demonstrate accountability and solicit funding from external partners. We find common understanding and awareness across consumers and producers about the purposes and uses of these commissioned pieces of work and how they are distinct from more academic explorative research outputs. Conceptual evidence use best describes this process. Evidence is slowly integrated into organisational processes and is one of many influences on global health organisations' actions. Relationships developed over time and trust guide the process, which may lead to quite a concentrated cluster of those producing and commissioning models. These findings raise several insights relevant to the literature of research utilisation in organisations and evidence-based management. The study extends our understanding of how evidence is used and which organisational actions are generated as a result of commissioning epidemiological and economic evidence.
虽然流行病学和经济学证据有可能为问题提供答案、指导复杂的项目并为资源分配决策提供信息，但委托方（全球卫生组织）如何使用这些证据，以及从证据中产生了哪些组织行动，目前仍不清楚。本研究应用组织科学的分析工具来理解传染病流行病学家和卫生经济学家所产生的证据是如何被全球卫生组织使用的。一个包含证据使用分类法的概念框架，将研究结果与组织行动生成过程联系起来，为研究提供了信息和结构。在 2020 年 3 月至 9 月期间，我们对数学建模师（证据生产者）和参与决策过程的全球卫生组织员工（证据消费者）进行了深入访谈。我们发现，委托进行的流行病学和经济学证据用于跟踪进展情况，并衡量健康结果和组织使命的成功程度。全球卫生组织主要使用这些证据来展示问责制，并从外部合作伙伴那里寻求资金。我们发现，消费者和生产者之间对于这些委托工作的目的和用途以及它们与更具学术探索性的研究成果的区别有共同的理解和认识。概念性证据使用最能描述这一过程。证据逐渐融入组织流程，是影响全球卫生组织行动的众多因素之一。随着时间的推移而发展的关系和信任指导着这一过程，这可能导致产生和委托模型的人相当集中。这些发现提出了一些与组织研究利用和循证管理文献相关的重要见解。该研究扩展了我们对委托进行流行病学和经济学证据如何使用以及由此产生哪些组织行动的理解。
