The global stock of research evidence relevant to health systems policymaking

Michael G Wilson,John N Lavis,Kaelan A Moat

doi:10.1186/1478-4505-11-32

Abstract

BackgroundPolicymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems.MethodsWe examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs for policy, overviews of systematic reviews, systematic reviews of effects, systematic reviews addressing other questions, systematic reviews in progress, systematic reviews being planned, economic evaluations, and health reform and health system descriptions. Specifically, we describe their distribution across health system topics and domains, trends in their production over time, availability of supplemental content in various languages, and the extent to which they focus on low- and middle-income countries (LMICs), as well as (for systematic reviews) their methodological quality and the availability of user-friendly summaries.ResultsAs of July 2013, HSE contained 2,629 systematic reviews of effects (of which 501 are Cochrane reviews), 614 systematic reviews addressing other questions, 283 systematic reviews in progress, 186 systematic reviews being planned, 140 review-derived products (evidence briefs and overviews of systematic reviews), 1,669 economic evaluations, 1,092 health reform descriptions, and 209 health system descriptions. Most systematic reviews address topics related to delivery arrangements (n = 2,663) or implementation strategies (n = 1,653) with far fewer addressing financial (n = 241) or governance arrangements (n = 231). In addition, 2,928 systematic reviews have been quality appraised with moderate AMSTAR ratings found for reviews addressing governance (5.6/11), financial (5.9/11), and delivery (6.3/11) arrangements and implementation strategies (6.5/11); 1,075 systematic reviews have no independently produced user-friendly summary and only 737 systematic reviews have an LMIC focus. Literature searches for half of the systematic reviews (n = 1,584, 49%) were conducted within the last five years.ConclusionsGreater effort needs to focus on assessing whether the current distribution of systematic reviews corresponds to policymakers’ and stakeholders’ priorities, updating systematic reviews, increasing the quality of systematic reviews, and focusing on LMICs.

Highlights

Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems
Regarding the year of publication, we found that 90 of the 94 (96%) evidence briefs for policy, 273 of the 283 (96%) systematic reviews in progress, all of the 186 systematic reviews being planned, 1,275 of the 1,669 (76%) economic evaluations, 423 of the 1,092 (39%) descriptions of health reforms, and 101 of the 209 (48%) descriptions of health systems were published within the last five years (Figure 2)
We have provided a detailed examination of the global stock of research evidence relevant to health systems policymaking

Summary

Introduction

Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. When the research literature has already been identified, selected, appraised and synthesized in a systematic and transparent way, health system policymakers can move directly to assessing how much confidence they can place in the review (i.e., its quality), the local applicability of the review’s findings, and what the findings mean for their setting [2]. Stakeholders, such as professional associations and citizen groups, need timely access to many types of research evidence to inform their advocacy efforts focused on health systems. Researchers and research funding agencies need systematic reviews to identify gaps in knowledge about health systems (both primary studies and systematic reviews) and domains that could benefit from overviews of systematic reviews, as well as to put the findings of any new health systems research in the context of existing research [1]

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Results

Conclusion