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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-04-01
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| Series: | The Lancet Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468266722000573 |
| _version_ | 1811330026212163584 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Holger J Schünemann, ProfMD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T15:55:17Z |
| format | Article |
| id | doaj.art-6892004cbc8840c4a16df3233f90314d |
| institution | Directory Open Access Journal |
| issn | 2468-2667 |
| language | English |
| last_indexed | 2024-04-13T15:55:17Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Public Health |
| spelling | doaj.art-6892004cbc8840c4a16df3233f90314d2022-12-22T02:40:44ZengElsevierThe Lancet Public Health2468-26672022-04-0174e378e390The ecosystem of health decision making: from fragmentation to synergyHolger J Schünemann, ProfMD0Marge Reinap, MA1Thomas Piggott, MD2Erki Laidmäe, MSc3Kristina Köhler, MSc4Mariliis Pōld, PhD5Brendalynn Ens, MN6Alar Irs, MD7Elie A Akl, ProfMD8Carlos A Cuello, MD9Maicon Falavigna, MD10Michelle Gibbens, MSW11Luciana Neamtiu, PhD12Elena Parmelli, PhD13Mouna Jameleddine, PharmD14Lisa Pyke, MA15Ilse Verstijnen, PhD16Pablo Alonso-Coello, MD17Peter Tugwell, MD18Yuan Zhang, PhD19Zuleika Saz-Parkinson, PhD20Tanja Kuchenmüller, MA21Lorenzo Moja, MD22Michael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, and WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada; Dipartimento di Scienze Biomediche, Humanitas University, Milan, Italy; Correspondence to: Prof Holger J Schünemann, Michael G DeGroote Cochrane Canada Centre, McMaster University Health Sciences Centre, Hamilton, ON L8S 4K1, CanadaDivision of Country Health Policies and Systems, WHO Regional Office for Europe, Copenhagen, DenmarkMichael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, and WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, CanadaDepartment of Medicines and Medical Devices, Estonian Health Insurance Fund, Tallinn, EstoniaWHO Country Office in Estonia, World Health Organization, Tallinn, EstoniaInstitute of Family Medicine and Public Health, Health Technology Assessment Unit, University of Tartu, Tartu, EstoniaCanadian Agency for Drugs and Technology in Health, Ottawa, ON, CanadaState Agency of Medicines of Estonia, Tartu, Estonia; Heart Clinic, Tartu University Hospital, Tartu, EstoniaDepartment of Internal Medicine, American University of Beirut, Beirut, LebanonMichael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, and WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada; Canadian Agency for Drugs and Technology in Health, Ottawa, ON, CanadaNational Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, BrazilCanadian Agency for Drugs and Technology in Health, Ottawa, ON, CanadaJoint Research Centre, European Commission, Ispra, ItalyJoint Research Centre, European Commission, Ispra, ItalyHealth Technology Assessment Department, National Authority for Assessment and Accreditation in Healthcare, Tunis, TunisiaCanadian Agency for Drugs and Technology in Health, Ottawa, ON, CanadaResearch and Development, International Affairs, National Health Care Institute, Diemen, NetherlandsIberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain; Centro GRADE Barcelona, Barcelona, SpainDepartment of Medicine, University of Ottawa, ON, CanadaMichael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, and WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, CanadaHealth Technology Assessment Agency, Instituto de Salud Carlos III, Madrid, SpainDepartment of Research for Health, WHO, Geneva, SwitzerlandDepartment of Health Product Policy and Standards, WHO, Geneva, SwitzerlandSummary: 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.http://www.sciencedirect.com/science/article/pii/S2468266722000573 |
| spellingShingle | 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 The ecosystem of health decision making: from fragmentation to synergy The Lancet Public Health |
| title | The ecosystem of health decision making: from fragmentation to synergy |
| title_full | The ecosystem of health decision making: from fragmentation to synergy |
| title_fullStr | The ecosystem of health decision making: from fragmentation to synergy |
| title_full_unstemmed | The ecosystem of health decision making: from fragmentation to synergy |
| title_short | The ecosystem of health decision making: from fragmentation to synergy |
| title_sort | ecosystem of health decision making from fragmentation to synergy |
| url | http://www.sciencedirect.com/science/article/pii/S2468266722000573 |
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