The ecosystem of health decision making: from fragmentation to synergy

Summary: Clinicians, patients, policy makers, funders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, cove...

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Main Authors: Holger J Schünemann, ProfMD, Marge Reinap, MA, Thomas Piggott, MD, Erki Laidmäe, MSc, Kristina Köhler, MSc, Mariliis Pōld, PhD, Brendalynn Ens, MN, Alar Irs, MD, Elie A Akl, ProfMD, Carlos A Cuello, MD, Maicon Falavigna, MD, Michelle Gibbens, MSW, Luciana Neamtiu, PhD, Elena Parmelli, PhD, Mouna Jameleddine, PharmD, Lisa Pyke, MA, Ilse Verstijnen, PhD, Pablo Alonso-Coello, MD, Peter Tugwell, MD, Yuan Zhang, PhD, Zuleika Saz-Parkinson, PhD, Tanja Kuchenmüller, MA, Lorenzo Moja, MD
Format: Article
Language:English
Published: Elsevier 2022-04-01
Series:The Lancet Public Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2468266722000573
Description
Summary:Summary: Clinicians, patients, policy makers, funders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, coverage decisions, selection of essential medicines and diagnostics, quality assurance and improvement schemes, and policy and evidence briefs. The criteria and methods that these actors use in their work differ (eg, the role economic analysis has in decision making), but these methods frequently overlap and exist together. Under the aegis of WHO, we have brought together representatives of different areas to reconcile how the evidence that influences decisions is used across multiple health system decision levels. We describe the overlap and differences in decision-making criteria between different actors in the health sector to provide bridging opportunities through a unifying broad framework that we call theory of everything. Although decision-making activities respond to system needs, processes are often poorly coordinated, both globally and on a country level. A decision made in isolation from other decisions on the same topic could cause misleading, unnecessary, or conflicted inputs to the health system and, therefore, confusion and resource waste.
ISSN:2468-2667