Knowledge transfer, and evidence informed health policy-minster's meeting
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This document discusses knowledge transfer and evidence-informed health policy. It outlines the need for evidence-based healthcare and knowledge translation between researchers and policymakers. It provides examples of the knowledge cycle and evidence hierarchy to demonstrate how research can inform policy decisions. The goal is to close the gap between knowledge generation and policy implementation to improve health outcomes.
Knowledge transfer, and evidence informed health policy-minster's meeting
- 1. Knowledge Transfer, and Evidence-Informed Health Policy Undersecretary Meeting, Feb. 26, 2009 Ghaiath M.A. Hussein MBBS, MHSc. (Bioethics) Research Directorate Federal Ministry of Health
- 2. Acknowledgement • Many the slides used in this presentation are used with permission from presentations by: • Dr. Fadi El-Jardali (AUB) • Dr. Abdul Ghaffar (RPC Advisor, WHO/EMRO) • Dr. Noha Dashash (PHC Directorate, Jeddah, KSA)
- 3. Outline of the presentation • Background • The ‘Knowledge Cycle’ • The Knowledge Transfer • Evidence-Based Healthcare • Where are we? • What we need to do? • Conclusion and Discussion
- 4. خريطة توضح حجم دول العالم من حيث النفاق على البحوث والتنمية وأكثر واقل عشر دول إنفاقا على البحوث في العالم )بالدولر لكل مواطن لكل عام(. المصدر: www.worldmapper.org
- 5. خريطة توضح حجم دول العالم من حيث عدد المقال ت العلمية المنشورة، وجدول يوضح عدد المقال ت العلمية المنشورة لكل مليون من السكان لعام 1002م. المصدر: www.worldmapper.org
- 6. The ‘Classical’ Knowledge Cycle Researchers Policy makers
- 7. What is KT? • …a process by which relevant research information is made available and accessible for practice, planning, and policy-making through interactive engagement with audiences. • Other terms include: research transfer, knowledge exchange, knowledge translation, knowledge mobilization, research uptake, research/knowledge utilization, and dissemination. Although these terms are similar and are sometimes used interchangeably
- 8. 8 What’s Evidence-Based Healthcare? Evidence-based healthcare (EBH) is the integration of best research evidence with clinical/policy expertise and patient/population values.
- 9. Why do we need to be evidence- based? • Lack of resources: we need to be sure this is the best way to spend them -Cost- containment • Quality improvement: Are we providing the best service? • Accountability (for political leadership and served population)
- 10. Components of EBM/H Individual Best Clinical External /Policy Evidence Expertise EBHC Patient/Population’s Values & Expectations 10 Modified from Huneborg, 2000
- 11. Steps of evidence based medicine • 1)Ask a question • 2)Acquire relevant articles • 3)Appraise the evidence • 4)Apply the findings • 5)Assess our performance
- 12. What is worse than having no evidence is to have bad evidence!
- 13. Hierarchy of Evidence Systematic Reviews and Meta-analysis Randomized controlled trials with definitive results RCTs with non-definitive results Cohort studies Case Control studies Cross-sectional surveys Case reports / opinions 13
- 15. Potential contribution of evidence to policy • Exposure to a wider range of validated policy options • Evaluation of the success and failure of previous policies • Ability to identify relationships between seemingly • independent factors (e.g.. Health care reform and health outcomes) • Capacity to legitimize some policies while casting doubt on others (Hanney et al, 2003) • Promote evidence based management practices
- 16. Science Decision-Making
- 17. Because what The problem you told me is Yes, absolutely how did Wheremust but You correct you be a am I? completely know? researcher Because you useless don’t know where you are, you don’t You must 30 You’re know where Yes. metres be a policy How you’re going, and above the maker you did now you’re in a ground know? blaming me balloon 17/30
- 18. A research institution is a "knowledge" factory Output: Input: information informatio n Knowledge Processing
- 19. The policy and execution grinding mill Analyses of threats and benefits Policy and Informatio Knowledge Impact n communication Processing Testing Evaluation
- 20. Many “Leaks” from research & practice Aware Accept Target Doable Recall Agree Done Valid Research If 80% achieved at each stage then 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 = 0.21
- 21. Need a ‘new look’? “In the world of research, completing the study is just the first step…making the research come alive and using it to build capacity for future science and scientists and to tell stories that capture policy-maker’s attention and ultimately lead to policy changes, are what it is all about” (O’Brien-Pallas, 2003)
- 22. Research • Generation of new knowledge • Synthesis of available information • Sharing good practices • Translation of knowledge (for improved policy and management decisions)
- 23. work social conditions environment economic conditions Diagnosis, treatment Health promotion, disease • Trained health prevention workers • Information • Clinical diagnostics • Products • Treatment/medicines • Services • Hospital services • Information Access to • Health products and services • Information • Conditions to gain/maintain good health
- 24. The spectrum of research for development Health policy and systems Social sciences and Operational Biomedical research research behavioural research research Basic research: Research on Research on Research on physical and biological policy formulation, relationship social and behavioral factors affecting sciences, including to evidence, factors influencing functioning of chemistry, pharmacology, prioritization, etc. health and their relation programmes, toxicology, to equity, access, effectiveness of genetics, etc. Research on lifestyle and health- targeting, impact health systems management, seeking behaviours, on behaviour, Research and functions, efficiency, etc. disease burdens development for effectiveness, system factors and public medicines, vaccines, affecting access, health, diagnostics, appliances, scale-up, monitoring and etc. etc. evaluation, etc. Understanding the biological nature of diseases Understanding how to test, scale-up and follow through on the Creating products to introduction of interventions to optimise their benefits prevent or treat disease states Impact 24
- 25. Stakeholders for different types of research Types of research Potential Basic Clinical Health Population stakeholders services health Patients +++ +++ Professionals +++ +++ Local administration + +++ +++ National policy- +++ +++ +++ makers Regulatory bodies +++ +++ ++ ++ Industry +++ +++ ++ + Research funders +++ +++ +++ +++ Researchers +++ +++ +++ +++ Source: Institute of Health Economics, Alberta, Canada, 2008. 25
- 26. Researchers and Policy-makers: From mutual understanding to mutual work
- 27. Matter of Fact! • “There is nothing a government hates more than to be well informed; for it makes the process of arriving at decisions much more complicated and difficult” John Maynard Keynes
- 28. Another Set of Facts! • A substantial knowledge base exists, albeit under-utilized, to improve the health of populations • Research is biased in favour of biomedical sciences and public health interventions with significant (disease-based) implications • Researchers and policy-makers are two different groups with different backgrounds, different incentives and with different roles and responsibilities
- 29. Researchers and Policy makers are two separate communities? “Researchers search for truth by using a rational model…policy makers search for a compromise, by using an intuitive model” Choi et al (2005)
- 30. Feature distinguishing (academic) research and policy-makers Researchers Policy-makers To improve the Overall goal To advance science performance of health systems Specific Tenure track positions To gain popular and objectives Publications political support Detailed reports, based on Output Press release s science Perception more Desired Respect of peers important than what outcome happens in reality Demand results in the Time factor Some studies can take years short term Cabinet and Accountable Peers and editors of medical constituents to journals
- 31. How to Bridge the gaps? Science Knowledge Brokers Decision-Making
- 34. Reza Majdzadeh
- 35. What we do now as Research Directorate? Seminars Website Train, Review, curricula Database
- 36. Steps Forward • Update the research priorities collectively • Develop a Knowledge Transfer & Evidence Synthesis Unit • Establish a Decision Support Unit • Develop and activate the Policy Forum • Policy makers need to be able to: • Identify situations where research can help • Articulate research questions for topics of policy relevant research; and • Access evidence and incorporate them in decision making
- 37. Key Messages • Policy makers need to be research-oriented • Researchers should be action-oriented • Each partner need to understand and cope with other partners • Always remember that our common and ultimate goal as researchers & policy makers if the health of our people!
Editor's Notes
- #9: By best research we mean clinically relevant research ,often from basic science of medicine, but especially from patient-centered clinical research. this new evidence invalidates previously accepted diagnostic tests &treatment and replace them with a more powerful more accurate more efficacious and safer. Clinical expertise it we mean the ability to use our clinical skills and past experience to identify each patients unique health state and diagnosis ,their individual risks and the benefits of potential interventions, their personal values and expectations Patient values: it is the preference, concerns expectations that each pts brings to the clinical encounter which must be integrated into the clinical decisions if they are to serve the patient When these 3 elements are integrated clinicians &pts form a diagnostic &therapeutic alliance which will optimizes clinical outcomes &quality of life.
- #35: The KTE TUMS model was the attaintment of this research.