Abstract
Even the highest quality evidence will have little impact unless it is incorporated into decision-making for health. It is therefore critical to overcome the many barriers to using evidence in decision-making, including (1) missing the window of opportunity, (2) knowledge gaps and uncertainty, (3) controversy, irrelevant and conflicting evidence, as well as (4) vested interests and conflicts of interest. While this is certainly not a comprehensive list, it covers a number of main themes discussed in the knowledge translation literature on this topic, and better understanding these barriers can help readers of the evidence to be more savvy knowledge users and help researchers overcome challenges to getting their evidence into practice. Thus, the first step in being able to use research evidence for improving population health is ensuring that the evidence is available at the right time and in the right format and language so that knowledge users can take the evidence into consideration alongside a multitude of other factors that also influence decision-making. The sheer volume of scientific publications makes it difficult to find the evidence that can actually help inform decisions for health. Policymakers, especially in low- and middle-income countries, require context-specific evidence to ensure local relevance. Knowledge synthesis and dissemination of policy-relevant local evidence is important, but it is still not enough. There are times when the interpretation of the evidence leads to various controversies and disagreements, which act as barriers to the uptake of evidence. Research evidence can also be influenced and misused for various aims and agendas. It is therefore important to ensure that any new evidence comes from reliable sources and is interpreted in light of the overall body of scientific literature. It is not enough to simply produce evidence, nor even to synthesize and package evidence into a more user-friendly format. Particularly at the policy level, political savvy is also needed to ensure that vested interests do not undermine decisions that can impact the health of individuals and populations.
Highlights
Billions of dollars are spent each year on producing research, but to what extent does all this research serve to improve health outcomes? Notwithstanding the value of creating knowledge for its own sake, it is difficult to justify spending limited resources on countless research studies, especially where there is potential for causing harm to research subjects, if this does not contribute to a deeper understanding of the world we live in and how to make it a better place [1]
Missing the window of opportunity The first step in being able to use research evidence is ensuring that it is available at the right time and in the right format [6], so that knowledge users can take the evidence into consideration alongside a multitude of other factors that influence decision-making
Readers of the scientific literature should be aware of the ways in which the research evidence can be influenced and misused for various aims and agendas
Summary
Billions of dollars are spent each year on producing research, but to what extent does all this research serve to improve health outcomes? Notwithstanding the value of creating knowledge for its own sake, it is difficult to justify spending limited resources on countless research studies, especially where there is potential for causing harm to research subjects (whether human or animal), if this does not contribute to a deeper understanding of the world we live in and how to make it a better place [1]. Some of the key themes that are often discussed include (1) missing the window of opportunity – often due to the relatively long time-frame required to generate new evidence and synthesize existing evidence and the relatively short time-frame available for making decisions, (2) knowledge gaps and uncertainty – especially the paucity of contextually-relevant evidence from local studies, (3) controversy, irrelevant and conflicting evidence – which act as smokescreens clouding the picture and making it difficult to decide how best to proceed, as well as (4) vested interests and conflicts of interest – which deliberately manipulate the evidence base to the detriment of the public’s health and wellbeing These barriers often stem from the complexity inherent to producing knowledge, the disconnect between the worlds of researchers and policymakers, intentional subverting of the evidence for political or economic gain, or a combination of the above. Missing the window of opportunity The first step in being able to use research evidence is ensuring that it is available at the right time and in the right format [6], so that knowledge users can take the evidence into consideration alongside a multitude of other factors that influence decision-making
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