At a time when policymakers are grappling with major changes to the U.S. health care system, they are also being inundated with information. Interest groups, constituents and party supporters are just some of the groups vying for policymakers’ attention, each with their own set of studies, reports and issue briefs. It is not surprising, then, that in an environment where competing priorities and short deadlines are the norm, the task of identifying reliable, unbiased evidence and incorporating it into decision-making remains a significant challenge.
Systematic reviews are emerging as an important tool for helping address this problem. By identifying, analyzing and synthesizing the available research studies on a particular reform or intervention, a systematic review can serve as a type of one-stop shop for a busy policymaker. As John Lavis and colleagues have observed, systematic reviews can assist policymakers in clarifying policy problems, framing potential solutions, and assessing the impacts of different options.
In a recent article published in the Journal of Health Services Research and Policy, a group of researchers from McMaster University (Canada), University of Oslo (Norway) and Harvard University de-bunk 12 myths about systematic reviews that can discourage reviews’ use by policymakers. The authors draw on their own professional experiences, as well as the material available in Health Systems Evidence (HSE), a continuously updated repository of syntheses of health systems research maintained by the McMaster Health Forum at McMaster University in Ontario.
Take, for example, the myth that systematic reviews can only address questions about the effectiveness of interventions. According to the authors, 15 percent of the more than 1,700 systematic reviews in HSE address questions other than the effectiveness of health system reforms and interventions. These reviews may help policymakers understand other considerations related to an intervention, such as the magnitude of a particular health challenge or the potential harms associated with an intervention.
The authors also tackle the myth that easily-digestible summaries of systematic reviews are rarely available. In fact, 72 percent of the systematic reviews in HSE have links to at least one free, user-friendly summary designed for policymaker and stakeholder audiences. In a similar vein, the authors note that HSE contains 23 overviews of systematic reviews. These overviews lay out the evidence on specific health system domains, helping decision-makers assess the outcomes of potential policy options and identify gaps in knowledge.
At AcademyHealth, getting timely, relevant research into the hands of decision-makers is at the heart of our recently-launched Translation and Dissemination Institute. One of our initial priorities is an assessment of best practices that will draw from both health services research (HSR) and fields as diverse as political science, social marketing and adult education in order to identify what works in research translation and dissemination. Another early priority is what we’re calling the Listening Project – an effort to learn what delivery system leaders and federal and state policymakers say they need from the HSR community. (Disclosure: Lavis is on the planning committee for the Institute.)
At the 2013 National Health Policy Conference, we heard policymakers talk about the importance and value of evidence. Systematic reviews are one way to bring that research forward.