scholarly journals Szisztematikus irodalmi áttekintések módszertana és jelentősége. Segítség a diagnosztikus és terápiás döntésekhez

2015 ◽  
Vol 156 (38) ◽  
pp. 1523-1531
Author(s):  
Viktória Kamarási ◽  
Gábor Mogyorósy
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Systematic Reviews ◽  
Research Question ◽  
Professional Literature ◽  
Policy Makers ◽  
Scientific Methods ◽  
Therapeutic Decisions ◽  
Specific Research Question ◽  
Made In

There is no proven effective treatment for many diseases today that proves to be one of the greatest problems of health care. Therefore, different therapeutic decisions are made in connection with the same disease by hospitals. There is a growing need for reviews which summarize the information collected from professional literature with scientific methods. The aim of the authors was to show the limitations of conventional narrative reviews, and to present the method and importance of systematic reviews to Hungarian professionals. Systematic reviews are transparent studies which are based on a predetermined protocol and collate all empirical evidence to answer a specific research question, and consequently provide more reliable results. They use explicit and systematic methods to minimize bias, and provide evidence for clinicians and policy makers to help them make diagnostic and therapeutic decisions which are essential in several fields of the health care system and health policy, too. Orv. Hetil., 2015, 156(38), 1523–1531.

Towards systematic reviews that inform health care management and policy-making

2005 ◽  
Vol 10 (1_suppl) ◽  
pp. 35-48 ◽  
Author(s):  
John Lavis ◽  
Huw Davies ◽  
Andy Oxman ◽  
Jean-Louis Denis ◽  
Karen Golden-Biddle ◽  
...  
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Policy Making ◽  
Care Management ◽  
Contextual Factors ◽  
Health Care Management ◽  
Health Care Managers ◽  
Executive Summary ◽  
Policy Makers ◽  
Care Managers

Objectives To identify ways to improve the usefulness of systematic reviews for health care managers and policy-makers that could then be evaluated prospectively. Methods We systematically reviewed studies of decision-making by health care managers and policy-makers, conducted interviews with a purposive sample of them in Canada and the United Kingdom (n=29), and reviewed the websites of research funders, producers/purveyors of research, and journals that include them among their target audiences (n=45). Results Our systematic review identified that factors such as interactions between researchers and health care policy-makers and timing/timeliness appear to increase the prospects for research use among policy-makers. Our interviews with health care managers and policy-makers suggest that they would benefit from having information that is relevant for decisions highlighted for them (e.g. contextual factors that affect a review's local applicability and information about the benefits, harms/risks and costs of interventions) and having reviews presented in a way that allows for rapid scanning for relevance and then graded entry (such as one page of take-home messages, a three-page executive summary and a 25-page report). Managers and policy-makers have mixed views about the helpfulness of recommendations. Our analysis of websites found that contextual factors were rarely highlighted, recommendations were often provided and graded entry formats were rarely used. Conclusions Researchers could help to ensure that the future flow of systematic reviews will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions. Research funders could help to ensure that the global stock of systematic reviews will better inform health care management and policy-making by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘front ends’ for potentially relevant systematic reviews.

Australian health policy makers’ priorities for research synthesis: a survey

2012 ◽  
Vol 36 (4) ◽  
pp. 401 ◽  
Author(s):  
Miranda S. Cumpston ◽  
Emma J. Tavender ◽  
Heather A. Buchan ◽  
Russell L. Gruen
Keyword(s):  
Health Policy ◽  
Professional Practice ◽  
Systematic Reviews ◽  
Policy Makers ◽  
Organisation Of Care ◽  
Australian Health ◽  
Cochrane Reviews ◽  
Regulatory Interventions ◽  
Territory Government ◽  
Cochrane Effective Practice

Objectives. Health policy making is complex, but can be informed by evidence of what works, including systematic reviews. We aimed to inform the work of the Cochrane Effective Practice and Organisation of Care (EPOC) Group by identifying systematic review topics relevant to Australian health policy makers and exploring whether existing Cochrane reviews address these topics. Methods. We interviewed 30 senior policy makers from State and Territory Government Departments of Health to identify topics considered important for systematic reviews within the scope of health services research, including professional, financial, organisational and regulatory interventions to improve professional practice and the organisation of services. We then looked for existing Cochrane reviews relevant to these topics. Results. Eighty-five priority topics were identified by policy makers, including advanced practice roles, care for Indigenous Australians, care for chronic disease, coordinating across jurisdictions, admission avoidance, and eHealth. Sixty published Cochrane reviews address these issues, and 34 additional reviews are in progress. Thirty-four topics are yet to be addressed. Conclusions. This survey has identified questions for which Australian policy makers have indicated a need for systematic reviews. Further, it has confirmed that existing reviews do address issues of importance to policy makers, with the potential to inform policy processes. What is known about the topic? Evidence-informed policy making is a complex process, requiring integration of relevant evidence in the context of multiple influences, inputs and priorities. Communication between policy makers and researchers is likely to increase the availability of relevant research evidence for policy, and improve its uptake into action. The Cochrane Effective Practice and Organisation of Care Group produces systematic reviews in areas intersecting with key policy responsibilities, including professional, financial, organisational and regulatory interventions designed to improve health professional practice and the organisation of healthcare services, and seeks to engage with policy makers to identify their research priorities. What does this paper add? This study surveyed Australian health policy makers from each of the Australian State and Territory Government Departments of Health, and identified 85 policy questions for which they considered systematic reviews of the evidence would be useful. Relevant to these topics, 60 existing published Cochrane systematic reviews were identified, as well as 34 reviews in progress, and 34 topics not yet addressed. The study also identified those published reviews that could not reach definitive conclusions, indicating that more primary research is required. What are the implications for practitioners? For researchers, areas of need for new systematic reviews have been identified. For policy makers, a suite of relevant systematic reviews have been identified that may be of use in policy processes.

scholarly journals Making sense of chronic illness – a therapeutic approach

2011 ◽  
Vol 3 (2) ◽  
pp. 136 ◽  
Author(s):  
Sue Jacobi ◽  
Rod MacLeod
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Professionals ◽  
Research Question ◽  
Phenomenological Approach ◽  
Therapeutic Strategies ◽  
Traumatic Experience ◽  
Structured Interviews ◽  
Making Sense ◽  
Made In

INTRODUCTION: A diagnosis of any chronic progressive illness can be a traumatic experience. People wonder how they will be able to cope and health care professionals wonder how they can help those so affected. The aim of the study was to discover how people find meaning when they are diagnosed with chronic illness. The research question asked is: How do people make sense of living with chronic progressive illness? METHOD: This is a qualitative study using a phenomenological approach to apply what is learned to developing therapeutic strategies in order to help those so diagnosed to find the meaning they need in order to live with resilience. Semi-structured interviews with seven people were held in order to determine how they cope with living with chronic progressive illness. The results were then used to develop some suggestions for health professionals as they seek to assist people with chronic progressive illness. FINDINGS: All participants displayed much resilience and determination which was found to emerge from three main themes: memory, hope and meaning. Memory was seen to be the link between all the themes. These are described and, arising out of the results of this study, some suggestions are made in order to assist in management. CONCLUSION: It is possible for health care professionals to assist patients to make sense of chronic illness by helping them to view their illness as part of life, and therefore a challenge to be faced rather than seeing life as dominated by illness. KEYWORDS: Chronic disease; resilience, psychological; narration; psychology, existential

Improving Quality as a Solution to the Health Care Cost Problem? Health Policy Experts and the Promotion of a Controversial Idea

2020 ◽  
Vol 45 (6) ◽  
pp. 1083-1106
Author(s):  
Ulrike Lepont
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Care Cost ◽  
Political Support ◽  
The Political ◽  
Policy Makers ◽  
Political Dimension ◽  
Delivery Of Care ◽  
Presidential Candidates ◽  
Congressional Budget Office

Abstract Context: In the late 2000s, the contention that quality improvements achieved by reforms in the delivery of care would slow the growth of costs throughout the US health care system became the predominant strategy for cost containment in the discourses and programs of all the 2008 presidential candidates. The question that this paper addresses is why, despite all of the critiques of this idea (especially those of the Congressional Budget Office), what the author terms the quality solution has remained credible enough to be a possible argument in policy makers' discourses and programs. To answer this question, the article explores the role of health policy experts—who are expected to provide credibility and legitimacy to proposals defended by policy makers—in supporting and diffusing this quality solution. Methods: The empirical research combines written sources with evidence from 78 interviews. Findings: This article highlights the political factors that explain the rise and growing prominence of the quality solution in the community of policy analysts: the political support for delivery reform–oriented research since the 1980s and also the importance of political calculations for prominent health policy experts. Conclusions: This policy history contributes to works that underscore the political dimension of policy analysis.

scholarly journals Enhancing the uptake of systematic reviews of effects: what is the best format for health care managers and policy-makers? A mixed-methods study

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Christine Marquez ◽  
Alekhya Mascarenhas Johnson ◽  
Sabrina Jassemi ◽  
Jamie Park ◽  
Julia E. Moore ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Systematic Reviews ◽  
Mixed Methods Study ◽  
Health Care Managers ◽  
Policy Makers ◽  
Care Managers

scholarly journals PRIMARY HEALTHCARE MANAGEMENT: WHAT IS DISCUSSED IN THE LITERATURE

2019 ◽  
Vol 28 ◽  
Author(s):  
Denise Elvira Pires de Pires ◽  
Lara Vandresen ◽  
Francele Machado ◽  
Rosani Ramos Machado ◽  
Felipa Rafaela Amadigi
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Primary Health Care ◽  
Financial Management ◽  
Care Management ◽  
Research Question ◽  
Health Care Management ◽  
Healthcare Management ◽  
Resources Management ◽  
Primary Health

ABSTRACT Objective: to identify what is discussed in studies published in Brazilian and international literature in the last ten years on Primary Health Care management. Method: an integrative review with a search carried out from 2006 to 2016, in the SciELO®, LILACS®, Scopus®, PubMed® and CINAHL® databases in the Portuguese, English and Spanish languages. The review followed the steps: formulation of the research question, definition of the inclusion and exclusion criteria, identification and selection of the studies, and summary of the subjects found in the studies. Resources from The Atlas.ti® software was used for data organization and analysis. Results: the corpus include 90 studies which predominantly originated from LILACS® and were performed in Brazil. The themes covered in the publications were: health policy and management in Primary Health Care, material resources management, human resources management, financial management, quality management, planning, characterization of managers, management role/ activities, challenges/difficulties in management, potentialities/facilities in management. There was a prevalence of studies that dealt with Primary Health Care management in the context of reflections on health policies and those dealing with the challenges/difficulties faced in Primary Health Care management. These findings demonstrate that the Primary Health Care model is complex and challenging, both for policymakers and for those managing it. Conclusion: the number of studies on Primary Health Care management is significant in the current literature and the predominance of health policy and difficulties in performing management issues reinforce the recognition of the centrality of the management for effective Primary Health Care.

Recent Evidence on the Changing Mix of Providers of Healthcare in England

2015 ◽  
pp. 1383-1397
Author(s):  
Greenwell Matchaya ◽  
Pauline Allen ◽  
Simon Turner ◽  
Will Bartlett ◽  
Virginie Perotin ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Coalition Government ◽  
Local Health ◽  
Policy Makers ◽  
Using Data

English health policy has promoted the diversity of providers of health care to NHS patients in recent years. Little research has been done to map the extent of actual and possible supply. Using data from four local health economies England the authors found that there was a low supply of such organisations, but that it is growing. Despite the greater emphasis placed by policy makers and researchers on non-profits, there were substantially more for-profits. This suggests they should be subject to further scrutiny, as the pressure to increase diversity of supply increases under the Coalition government.

Replication and Repetition in Systematic Reviews and Meta-analyses in Medicine

2017 ◽  
Author(s):  
Leonard Leibovici ◽  
Mical Paul
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Research Question ◽  
Controlled Trials ◽  
Single Measure ◽  
Effect Relationship ◽  
Specific Research Question ◽  
Different Populations ◽  
Meta Analyses ◽  
Expected Outcomes

This chapter discusses systematic reviews (SRs) and meta-analysis (MA). SRs are reviews of the “best available,” reliable studies focused on a specific research question. Most often, the studies included in SRs are randomized controlled trials (RCTs) that have repeated the same treatments in (usually) different situations. MA is a statistical method applied to the results gleaned from an SR that yields a single measure of the expected outcomes of repeated trials, along with an assertion of the confidence we have in that measure. This chapter argues that RCTs are never similar enough to be considered identical replicates, but they are repeated studies, usually on different populations. Comparable RCTs examine one or similar outcomes (based on a hypothesized cause-and-effect relationship), which is why comparable RCTs can be included in SRs and MAs. If SRs and MAs show convincing results, further repeated RCTs would be avoided, thus saving valuable resources. However, evidence to date suggests that this rarely occurs.

scholarly journals Epistemonikos

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Yamila M. El-Khayat
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Systematic Reviews ◽  
Nonprofit Organization ◽  
Evidence Based ◽  
Primary Language ◽  
Health Care Information ◽  
Web Technologies ◽  
Care Information ◽  
Evidence Based Health Care

Epistemonikos.org is a database of resources that provides evidence-based health care information in a central depository to assist people in making decisions for clinical or health policy questions. This database is provided free of charge and is put together by a nonprofit organization based out of Santiago, Chile, formed by individuals associated with different institutions. The database is updated continuously, by systematically searching different databases and by utilizing web technologies to store the information. The purpose and goal of this resource is to provide quick access to systematic reviews and broad combinations of reviews and primary studies in health care. Additionally, it is a multilingual database available in nine different languages, and titles and abstracts are translated and can easily be searched by providers whose primary language may not be English.

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