Unleashing the potential: the imperative of political support for health technology assessment in Iran.

Health Technology Assessment (HTA) is essential for evidence-based healthcare decision-making, yet its integration into Iran's healthcare system faces political and logistical challenges. Despite HTA's potential to improve resource allocation, limited awareness, data gaps, and competing priorities hinder its implementation. This commentary emphasizes the need for political support, advocating capacity-building, collaboration, and alignment with long-term health policies. Leveraging international partnerships and monitoring outcomes can enhance HTA's role in improving healthcare in Iran and contributing to global health advancements.

Enhancing environmental policy through evidence synthesis: a review of the Environmental Evidence for the Future (EEF) Initiative.

The Environmental Evidence for the Future (EEF) Initiative emerged in response to the challenges and opportunities presented by the UK's decision to leave the European Union and its associated Environmental Frameworks. The Natural Environment Research Council (NERC), working closely with the Collaboration for Environmental Evidence (CEE) and UK stakeholders, developed the initiative to identify and address crucial evidence gaps, offering a long-term vision for environmental policy and sustainability. The EEF Initiative progressed through three stages: strategic priority identification, NERC panel award selection, and the production of Systematic Maps of existing evidence. The first stage involved collaborative workshops across the UK to identify key knowledge gaps in environmental science. The subsequent prioritisation resulted in 65 challenges across 10 thematic areas. The second stage saw NERC initiating, with CEE support, an open call for research proposals emphasising the use of evidence synthesis methodology. The selection process, balancing topic importance and applicant expertise, led to funding for five projects. The final stage involved the production of Systematic Maps of existing evidence based on the CEE Guidelines and Standards, providing a structured overview of existing literature on specific topics. The EEF Initiative demonstrated effective collaboration between UKRI (NERC), an independent non-profit (CEE), academia, and government agencies, addressing critical environmental challenges through rigorous evidence synthesis methodologies. The programme enhanced understanding and utilisation of these methodologies within the research community. Key lessons include the importance of inclusive priority-setting, differentiation between broad policy questions and specific Systematic Map questions, recognition of the value of Systematic Maps, and the role of experience in evidence synthesis teams. As policymakers and researchers navigate environmental policies in a resource-constrained environment, the EEF Initiative highlights the cost-effectiveness and efficiency of systematic mapping and review processes for evidence-based decision-making. The success of funding through NERC sets a precedent for future thematic evidence focused programmes, emphasising the need for continued support in developing synthesis skills among researchers and encouraging direct government commissions for targeted and responsive evidence. The EEF Initiative serves as a model for effective collaboration, providing valuable insights into addressing evidence gaps and shaping evidence-based policymaking in an ever-evolving environmental landscape.

A methodology for planning, implementation and evaluation of skills intelligence management - results of a design science project in technology organisations.

Introduction: The evolving labour market requirements amidst digital transformation necessitate robust skills intelligence for informed decision-making and adaptability. Novel technologies such as Big Data, Machine Learning, and Artificial Intelligence have significant potential for enhancing skills intelligence. Methods: This study bridges the gap between theory and practice by designing a novel software artefact for skills intelligence management. With its systematic framework for identifying skills intelligence elements, an assessment instrument, and an implementation methodology, the artefact ensures a thorough approach to skills intelligence management. Results: The artefact was demonstrated in 11 organisations. Feedback collected from interviews, focus group sessions, and observations (N = 19) indicated that the artefact is a feasible starting point for implementing or systematising skills intelligence management. Participants suggested improvements but concurred that the systematic approach enhances skills intelligence data collection and quality. Discussion: The study shows that the artefact facilitates the application of advanced technologies in skills intelligence management. Additionally, it contributes a set of principles for effective skills intelligence management, fostering a broader conversation on this critical topic. Participants' feedback underscores the artefact's potential and provides a basis for further refinement and application in diverse organisational contexts.

The Impact of Additive Population(s), Intervention, Comparator(s), and Outcomes in a European Joint Clinical Health Technology Assessment.

OBJECTIVES: To assess the potential number of European Union (EU) population(s), intervention, comparator(s), and outcomes (PICOs) based on European Network for Health Technology Assessment 21 (EUnetHTA 21) guidance and to explore further evidence-based opportunities to produce more predictable and workable EU PICOs. METHODS: The consolidated EU PICOs of 2 future hypothetical medicines in first-line non-small cell lung cancer (1L NSCLC) and third line multiple myeloma (3L MM) were derived using published health technology assessment reports of 2 recent medicines in similar indications based on EUnetHTA 21 proposed guidance. Sensitivity analysis assessed the impact of additional PICO requests. The number of analyses requested was estimated. RESULTS: In 1L NSCLC and 3L MM, 6 and 9 EU Member States (MS), respectively, had published health technology assessment reports. PICO consolidation resulted in 10 PICOs for 1L NSCLC and 16 PICOs for 3L MM, increasing to 14 and 18 PICOs, respectively, when England's National Institute for Health and Care Excellence scope was included to proxy remaining MS. A minimum of 280 and 720 analyses would be requested, exponentially increasing as additional outcome measures and subgroups are requested. CONCLUSIONS: The PICO approach outlined by EUnetHTA 21 results in a significant number of analysis requests and substantial resources. Use of complementary analyses alongside evidence-based methods to derive PICOs and engaging with the health technology developer throughout the process would create a workable EU PICO that is predictable and most impactful for the EU, resulting in a timely and high-quality assessment report that is more usable at a MS level.

Letter to editor: Scalp incision technique for decompressive hemicraniectomy: Comparative systematic review and meta­analysis of the reverse question mark versus alternative retroauricular and Kempe incision techniques of published cases.

The "Letter to the Editor" titled "Scalp incision technique for decompressive hemicraniectomy: comparative systematic review and meta-analysis of the reverse question mark versus alternative retroauricular and Kempe incision techniques of published cases" provides a detailed analysis of different scalp incision techniques in decompressive hemicraniectomy procedures. While commendable for its systematic approach and valuable insights, the letter has several limitations, including a lack of transparency in the search strategy, failure to address potential sources of bias, and a narrow focus on technical aspects without considering broader outcome domains and practical considerations. Despite these limitations, the letter underscores the importance of evidence-based decision-making in neurosurgical practice and calls for further research to address these gaps.

A Practical Significance Bias in Laypeople's Evaluation of Scientific Findings.

People often rely on scientific findings to help them make decisions-however, failing to report effect magnitudes might lead to a potential bias in assuming findings are practically significant. Across two online studies (Prolific; N = 800), we measured U.S. adults' endorsements of expensive interventions described in media reports that led to effects that were small, large, or of unreported magnitude between groups. Participants who viewed interventions with unreported effect magnitudes were more likely to endorse interventions compared with those who viewed interventions with small effects and were just as likely to endorse interventions as those who viewed interventions with large effects, suggesting a practical significance bias. When effect magnitudes were reported, participants on average adjusted their evaluations accordingly. However, some individuals, such as those with low numeracy skills, were more likely than others to act on small effects, even when explicitly prompted to first consider the meaningfulness of the effect.

Supporting National Immunization Technical Advisory Groups (NITAGs) in development of evidence-based vaccine recommendations and NITAG assessments - New tools and approaches.

Increasing opportunities for prevention of infectious diseases by new, effective vaccines and the expansion of global immunization programs across the life course highlight the importance and value of evidence-informed decision-making (EIDM) by National Immunization Technical Advisory Groups (NITAGs). The U.S. Centers for Disease Control and Prevention (CDC) and Task Force for Global Health (TFGH) have developed and made available new tools to support NITAGs in EIDM. These include a toolkit for conducting facilitated training of NITAGs, Secretariats, or work groups on the use of the Evidence to Recommendations (EtR) approach to advise Ministries of Health (MoH) on specific vaccine policies, and an eLearning module on the EtR approach for NITAG members, Secretariat and others. The CDC and TFGH have also supported final development and implementation of the NITAG Maturity Assessment Tool (NMAT) for assessing maturity of NITAG capabilities in seven functional domains. The EtR toolkit and eLearning have been widely promoted in collaboration with the World Health Organization (WHO) Headquarters and Regional Offices through workshops engaging over 30 countries to date, and the NMAT assessment tool used in most countries in 3 WHO regions (Americas, Eastern Mediterranean, African). Important lessons have been learned regarding planning and conducting trainings for multiple countries and additional ways to support countries in applying the EtR approach to complete vaccine recommendations. Priorities for future work include the need to evaluate the impact of EtR training and NMAT assessments, working with partners to expand and adapt these tools for wider use, synergizing with other approaches for NITAG strengthening, and developing the best approaches to empower NITAGs to use the EtR approach.

"Research ends with publication": a qualitative study on the use of health policy and systems research in Ethiopia.

BACKGROUND: Decision-making about the design and implementation of health care policies should be supported by research evidence. This article reports on a qualitative study on the experiences of both research institutes and policymakers in Ethiopia in generating and using research evidence to inform health policy decision-making. METHODS: Semi-structured interviews were conducted from January through March 2020, with representatives of research institutes and with policymakers in Ethiopia. The data collected during the interviews were analyzed thematically. RESULTS: Half of the institutions represented had engaged in health policy and systems research (HPSR). These institutes' capacities were limited by multiple factors, including unsupportive research environments; the limited number of researchers with extensive experience; high turnover among senior researchers; lack of staff motivation mechanisms; underdeveloped research culture; limited technical and analytical capacity among researchers; lack of core funding for HPSR; ineffective financial management; and, lack of connections with health policy platforms. Research institutes also lacked the capacity in strategic packaging of findings to influence policy decision-making, although some programs have recently improved in this area. Meanwhile, there lacked a culture of using evidence in policymaking settings. In general, we found that policymakers had poor attitudes towards the quality or value of the evidence, and had little capacity to interpret evidence and apply findings to policy options. As a result, much of the research produced by the institutes have only been relevant academically, with little impact on policy. However, respondents reported that the environment is slowly changing, and the recent creation of a Research Advisory Council at the Ministry of Health offers a promising model. CONCLUSIONS: Despite some recent changes, in Ethiopia researchers and policymakers alike often tend to consider health policy and systems research (HPSR) to be not very valuable since the findings generated are rarely used for evidence-informed policy development. Research institutes and researchers need to strengthen their technical, analytical, and administrative capacities (through, among other efforts, seeking more funding for research, and better incentives to attract, retain and build skills among qualified researchers); they also need to improve their understanding of the evidence-to-policy cycle and how to engage effectively with policymakers.

A Lean Operation Management Model for Public Hospital is Constructed Based on Evidence Based Deci-sion-Making / 中国医院管理

Comprehensively improving the new efficiency of high-quality development of public hospitals is the key top-level design for deepening the reform of public hospitals during the"14th Five-Year Plan"period.In view of the changes in the macro environment faced by public hospitals in recent years,such as the cancellation of the addi-tion of pharmaceutical consumables and the deep promotion of the reform of payment methods,as well as the out-standing problems existing at the micro level of public hospital operation,such as the separation of diagnosis and treatment business from economic operation activities,extensive decision-making methods,unreasonable alloca-tion of resources and urgent optimization of processes.By referring to relevant theories such as value management theory,a new"trinity"public hospital lean operation management model based on"integration of industry and fi-nance,lean operation and evidence-based decision-making"is explored and constructed.It breaks the relatively parallel operation barriers of clinical diagnosis and treatment business and economic operation management,innovates a new method of linear staff management with the integration of industry and finance,gives full play to the role of experts in governing hospitals,and integrates the professional committee system driven by"technology+manage-men"into the hospital decision-making staff system to provide data evidence-based basis for assisting the hospital leadership to make scientific decisions.

Drug Selection and Evaluation in Medical Institutions： A Scoping Review / 中国实验方剂学杂志

ObjectiveBy analyzing the current situation of drug selection and evaluation in medical institutions in the world，we aim to understand the development of relevant selection methods and tools，provide reference basis for drug selection in traditional Chinese medicine （TCM） medical institutions，and promote the optimization of drug catalogs in TCM medical institutions. MethodBased on the method of scoping review，the eight databases were systematically searched，the included documents were screened，extracted and analyzed，and the research results were graphically displayed. ResultA total of 23 articles were included in this study，including 13 in Chinese and 10 in English，involving 23 methods or tools related to drug selection. Of the 14 methods or tools from Chinese medical institutions，the earliest one was published in 2012，and five were published in 2022. The published methods or tools involved different levels of hospitals，different drug varieties，different evaluation angles，etc.，such as the drug selection methods of one county hospital and one township hospital， methods and tools for different types of drugs such as antibacterial drugs，ibuprofen preparations，proton pump inhibitors and hypoglycemic drugs used in pediatric intensive care units， Chinese patent medicine selection tools， tools for evaluation from the perspective of pharmacoeconomics， and universal tools for selecting domestic medical institutions. The nine drug selection tools of foreign medical institutions were from the European，American，Asian and African countries. It was first published in 1955. The contents included the formulation standards that medical institutions should follow for drug prescription sets，the management formulation and update of hospital prescription sets，and drug evaluation tools. ConclusionOn the whole，the drug selection methods and institutional methods of foreign medical institutions developed earlier than those in China. In recent years，Chinese medical institutions have paid high attention to drug selection and released various types of drug selection tools. However，the standardization should be further improved in the future.

The Journey of Data Within a Global Data Sharing Initiative: A Federated 3-Layer Data Analysis Pipeline to Scale Up Multiple Sclerosis Research.

BACKGROUND: Investigating low-prevalence diseases such as multiple sclerosis is challenging because of the rather small number of individuals affected by this disease and the scattering of real-world data across numerous data sources. These obstacles impair data integration, standardization, and analysis, which negatively impact the generation of significant meaningful clinical evidence. OBJECTIVE: This study aims to present a comprehensive, research question-agnostic, multistakeholder-driven end-to-end data analysis pipeline that accommodates 3 prevalent data-sharing streams: individual data sharing, core data set sharing, and federated model sharing. METHODS: A demand-driven methodology is employed for standardization, followed by 3 streams of data acquisition, a data quality enhancement process, a data integration procedure, and a concluding analysis stage to fulfill real-world data-sharing requirements. This pipeline's effectiveness was demonstrated through its successful implementation in the COVID-19 and multiple sclerosis global data sharing initiative. RESULTS: The global data sharing initiative yielded multiple scientific publications and provided extensive worldwide guidance for the community with multiple sclerosis. The pipeline facilitated gathering pertinent data from various sources, accommodating distinct sharing streams and assimilating them into a unified data set for subsequent statistical analysis or secure data examination. This pipeline contributed to the assembly of the largest data set of people with multiple sclerosis infected with COVID-19. CONCLUSIONS: The proposed data analysis pipeline exemplifies the potential of global stakeholder collaboration and underlines the significance of evidence-based decision-making. It serves as a paradigm for how data sharing initiatives can propel advancements in health care, emphasizing its adaptability and capacity to address diverse research inquiries.

Dissemination of public health research evidence and guidelines to Australian Early Childhood Education and Care staff: Views about source, content and format.

ISSUE ADDRESSED: Effective dissemination of public health research and evidence-based guidelines to Early Childhood Education and Care (ECEC) staff is critical for promoting research transfer and uptake and achieving positive outcomes for children. METHODS: A cross-sectional study was conducted during August 2021 to March 2022, with a sub-sample of Australian ECEC services participating in a larger survey completed online and via Computer-Assisted Telephone Interview. Survey items assessed: influential source for receiving research, type of content that would influence decisions to adopt research and preferred formats for receiving research. RESULTS: Overall, 993 service managers or staff from 1984 (50.0%) invited and eligible services completed the larger survey. Of these, 463 randomly allocated services (46.7%) had staff complete the dissemination items. The Australian Children's Education and Care Quality Authority, ECEC agencies and Government Departments were most frequently selected as influential sources of research evidence. Staff were most interested in content providing evidence-based recommendations for future actions and descriptions of health issues addressed. Workshops or conferences and webinars were the preferred format for receiving research. CONCLUSIONS: Findings highlight the importance of tailoring dissemination strategies to meet ECEC staff needs and engaging influential sources to disseminate research evidence. SO WHAT?: Understanding dissemination preferences of ECEC staff is crucial for supporting uptake of evidence-based health promotion in this setting. By developing tailored strategies based on ECEC preferences, research transfer and evidence-based decision making can be supported more effectively. These findings contribute to bridging the evidence-practice gap and improving the quality of care and health outcomes for children in ECEC settings.

Comparative Analysis of Three Predictive Models of Performance Indicators with Results-Based Management: Cancer Data Statistics in a National Institute of Health.

Predictive models play a crucial role in RBMs to analyze performance indicator results to manage unexpected events and make timely decisions to resolve them. Their use in Mexico is deficient, and monitoring and evaluation are among the weakest pillars of the model. In response to these needs, the aim of this study was to perform a comparative analysis of three predictive models to analyze 10 medical performance indicators and cancer data related to children with cancer. To accomplish these purposes, a comparative and retrospective study with nonprobabilistic convenience sampling was conducted. The predictive models were exponential smoothing, autoregressive integrated moving average, and linear regression. The lowest mean absolute error was used to identify the best model. Linear regression performed best regarding nine of the ten indicators, with seven showing p < 0.05. Three of their assumptions were checked using the Shapiro-Wilk, Cook's distance, and Breusch-Pagan tests. Predictive models with RBM are a valid and relevant instrument for monitoring and evaluating performance indicator results to support forecasting and decision-making based on evidence and must be promoted for use with cancer data statistics. The place numbers obtained by cancer disease inside the main causes of death, morbidity and hospital outpatients in a National Institute of Health were presented as evidence of the importance of implementing performance indicators associated with children with cancer.

Assessment of data demand for informed-decisions among health facility and department heads in public health facilities of Amhara Region, northwest Ethiopia.

BACKGROUND: Evidence-based decision-making is a foundation of health information systems; however, routine health information is not mostly utilized by decision makers in the Amhara region. Therefore, this study aimed to explore the facility and department heads' perceptions towards the demand for and use of routine health information for decision making. METHODS: A phenomenological qualitative study was done in eight districts of the Amhara region from June 10/2019 to July 30/2019. We obtained written informed consent and recruited 22 key informants purposively. The research team prepared a codebook, assigned codes to ideas, identified salient patterns, grouped similar ideas, and developed themes from the data. Thus, data were analyzed thematically using OpenCode software. RESULTS: The study revealed that health workers collected many data, but little was demanded and utilized to inform decisions. The majority of respondents perceived that data were collected merely for reporting. Lack of skills in data management, analysis, interpretation, and use were the technical attributes. Individual attributes included low staff motivation, carelessness, and lack of value for data. Poor access to data, low support for Health Information System, limited space for archiving, and inadequate finance were related to organizational attributes. The contextual (social-political) factors also influenced the use of eHealth applications for improved data demand and use among health care providers. CONCLUSION: In this study, health workers collect routine health data merely for reporting, and they did not demand and use it mostly to inform decisions and solve problems. Technical, individual, organizational, and contextual attributes were contributors to low demand and use of routine health data. Thus, we recommend building the technical capacity of health workers, introducing motivation mechanisms and ensuring accountability systems for better data use.

Proposing the "Value- and Evidence-Based decision making and Practice" (VEDMAP) framework for Priority-Setting and knowledge translation in low and Middle-Income Countries: A novel framework for Decision-Making in Low-and middle income countries like Malawi.

The existence and availability of evidence on its own does not guarantee that the evidence will be demanded and used by decision and policy makers. Decision and policy-makers, especially in low-income settings, often confront ethical dilemmas about determining the best available evidence and its utilization. This dilemma can be in the form of conflict of evidence, scientific and ethical equipoise and competing evidence or interests. Consequently, decisions are made based on convenience, personal preference, donor requirements, and political and social considerations which can result in wastage of resources and inefficiency. To mitigate these challenges, the use of "Value- and Evidence-Based Decision Making and Practice" (VEDMAP) framework is proposed. This framework was developed by Joseph Mfutso-Bengo in 2017 through a desk review. It was pretested through a scoping study under the Thanzi la Onse (TLO) Project which assessed the feasibility and acceptability of using the VEDMAP as a priority setting tool for Health Technology Assessment (HTA) in Malawi. The study used mixed methods whereby it conducted a desk review to map out and benchmark normative values of different countries in Africa and HTA; focus group discussion and key informant interviews to map out the actual (practised) values in Malawi. The results of this review confirmed that the use of VEDMAP framework was feasible and acceptable and can bring efficiency, traceability, transparency and integrity in decision- policy making process and implementation.

Drilling for 'New Oil' in Care Integration - Co-Production of the Concept and Specification of an Integrated Data Centre for Policy Decision Making, Care Planning, and Research in Estonia.

Introduction: Care integration needs to take place on different levels, including that of infrastructure and especially data infrastructure. Only integrated data allow for policy making, care planning, research, and evaluation that spans across different sectors of care and support. Methods: In the course of an EU-funded reform initiative on integrated care, the Estonian government and various agencies have developed a concept for an integrated data centre, bringing together information from social, medical, and vocational support services. The concept was developed in co-production with many stakeholders. A test data set from all covered sectors, including the pseudonymised data of 17,945 citizens of an Estonian municipality, was created and analysed as a proof-of-concept exercise. Results: The co-production approach resulted in a set of requirements and use cases as well as a specification of premises, processes, and data flows for the data centre. The analysis of the test dataset showed the principal feasibility of the dataset for the intended purposes. Conclusion: The concept development phase showed that an integrated data centre for Estonia is feasible per se and helped to specify concrete actions required for its realisation. Strategic and financial decisions from the Estonian Reform Steering Committee are now needed to create the data centre.

Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review.

BACKGROUND: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes in isolated reports throughout the literature. However, a comprehensive summary and review of the extent and type of evidence-based practices (EBPs) and their associated outcomes across clinical settings are lacking. AIMS: The purpose of this scoping review was to provide a thorough summary of published literature on the implementation of EBPs on patient outcomes in healthcare settings. METHODS: A comprehensive librarian-assisted search was done with three databases, and two reviewers independently performed title/abstract and full-text reviews within a systematic review software system. Extraction was performed by the eight review team members. RESULTS: Of 8537 articles included in the review, 636 (7.5%) met the inclusion criteria. Most articles (63.3%) were published in the United States, and 90% took place in the acute care setting. There was substantial heterogeneity in project definitions, designs, and outcomes. Various EBPs were implemented, with just over a third including some aspect of infection prevention, and most (91.2%) linked to reimbursement. Only 19% measured return on investment (ROI); 94% showed a positive ROI, and none showed a negative ROI. The two most reported outcomes were length of stay (15%), followed by mortality (12%). LINKING EVIDENCE TO ACTION: Findings indicate that EBPs improve patient outcomes and ROI for healthcare systems. Coordinated and consistent use of established nomenclature and methods to evaluate EBP and patient outcomes are needed to effectively increase the growth and impact of EBP across care settings. Leaders, clinicians, publishers, and educators all have a professional responsibility related to improving the current state of EBP. Several key actions are needed to mitigate confusion around EBP and to help clinicians understand the differences between quality improvement, implementation science, EBP, and research.

COVID-19 literature surveillance-A framework to manage the literature and support evidence-based decision-making on a rapidly evolving public health topic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to a rapid surge of literature on severe acute respiratory syndrome coronavirus 2 and the wider impacts of the pandemic. Research on COVID-19 has been produced at an unprecedented rate, and the ability to stay on top of the most relevant evidence is top priority for clinicians, researchers, public health professionals and policymakers. This article presents a knowledge synthesis methodology developed and used by the Public Health Agency of Canada for managing and maintaining a literature surveillance system to identify, characterize, categorize and disseminate COVID-19 evidence daily. Methods: The Daily Scan of COVID-19 Literature project comprised a systematic process involving four main steps: literature search; screening for relevance; classification and summarization of studies; and disseminating a daily report. Results: As of the end of March 2022 there were approximately 300,000 COVID-19 and pandemic-related citations in the COVID-19 database, of which 50%-60% were primary research. Each day, a report of all new COVID-19 citations, literature highlights and a link to the updated database was generated and sent to a mailing list of over 200 recipients including federal, provincial and local public health agencies and academic institutions. Conclusion: This central repository of COVID-19 literature was maintained in real time to aid in accelerated evidence synthesis activities and support evidence-based decision-making during the pandemic response in Canada. This systematic process can be applied to future rapidly evolving public health topics that require the continuous evaluation and dissemination of evidence.