Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
Department of Public Health Policy and Systems/Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK.
BMJ Glob Health. 2022 Apr;7(4). doi: 10.1136/bmjgh-2021-008268.
The exceptional production of research evidence during the COVID-19 pandemic required deployment of scientists to act in advisory roles to aid policy-makers in making evidence-informed decisions. The unprecedented breadth, scale and duration of the pandemic provides an opportunity to understand how science advisors experience and mitigate challenges associated with insufficient, evolving and/or conflicting evidence to inform public health decision-making.
To explore critically the challenges for advising evidence-informed decision-making (EIDM) in pandemic contexts, particularly around non-pharmaceutical control measures, from the perspective of experts advising policy-makers during COVID-19 globally.
We conducted in-depth qualitative interviews with 27 scientific experts and advisors who are/were engaged in COVID-19 EIDM representing four WHO regions and 11 countries (Australia, Canada, Colombia, Denmark, Ghana, Hong Kong, Nigeria, Sweden, Uganda, UK, USA) from December 2020 to May 2021. Participants informed decision-making at various and multiple levels of governance, including local/city (n=3), state/provincial (n=8), federal or national (n=20), regional or international (n=3) and university-level advising (n=3). Following each interview, we conducted member checks with participants and thematically analysed interview data using NVivo for Mac software.
Findings from this study indicate multiple overarching challenges to pandemic EIDM specific to interpretation and translation of evidence, including the speed and influx of new, evolving, and conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, and adapting evidence from other contexts; multiple forms of evidence and perspectives needed for EIDM; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are made and applied.
Findings suggest the urgent need for global EIDM guidance that countries can adapt for in-country decisions as well as coordinated global response to future pandemics.
在 COVID-19 大流行期间，科研成果异常丰富，需要科学家担任顾问角色，为决策者提供帮助，以便他们根据证据做出决策。这场大流行前所未有地波及范围广、规模大、持续时间长，这为我们提供了一个机会，可以了解科学顾问在为公共卫生决策提供信息时，如何应对和缓解证据不足、不断变化和/或相互矛盾的证据所带来的挑战。
从全球参与 COVID-19 循证决策咨询的政策制定者的角度，批判性地探讨大流行背景下循证决策咨询（EIDM）所面临的挑战，特别是在非药物控制措施方面。
我们对 27 名科学专家和顾问进行了深入的定性访谈，这些专家和顾问在 COVID-19 期间参与了 EIDM，代表了四个世卫组织区域和 11 个国家（澳大利亚、加拿大、哥伦比亚、丹麦、加纳、中国香港、尼日利亚、瑞典、乌干达、英国、美国）。参与者在不同层面和多个层面参与了决策，包括地方/城市（n=3）、州/省（n=8）、联邦/国家（n=20）、区域或国际（n=3）和大学层面的咨询（n=3）。在每次访谈之后，我们都与参与者进行了成员检查，并使用 NVivo for Mac 软件对访谈数据进行了主题分析。
本研究结果表明，大流行循证决策面临着多个普遍挑战，这些挑战具体表现为对证据的解释和翻译，包括新出现的、不断变化的和相互矛盾的证据的速度和大量涌入；对科学诚信和证据误解的担忧；评估和产生证据的能力有限，以及从其他背景下调整证据；循证决策需要多种形式的证据和观点；需要在不确定的情况下快速做出决策；以及决策的制定和应用缺乏透明度。
研究结果表明，迫切需要制定全球循证决策指导，各国可以据此制定国内决策，并协调应对未来的大流行。
