plueme/wizJson huggingface dataset:
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 15. Disseminating and implementing guidelines 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 15th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectivesIn this review we address strategies for the implementation of recommendations in health care.MethodsWe examined overviews of systematic reviews of interventions to improve health care delivery and health care systems prepared by the Cochrane Effective Practice and Organisation of Care (EPOC) group. We also conducted searches using PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key questions and answers
What should WHO do to disseminate and facilitate the uptake of recommendations?


WHO should choose strategies to implement their guidelines from among those which have been evaluated positively in the published literature on implementation research


Because the evidence base is weak and modest to moderate effects, at best, can be anticipated, WHO should promote rigorous evaluations of implementation strategies.



What should be done at headquarters, by regional offices and in countries?


Adaptation and implementation of WHO guidelines should be done locally, at the national or sub-national level.


WHO headquarters and regional offices should support the development and evaluation of implementation strategies by local authorities.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 14. Reporting guidelines 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 14th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectivesWe reviewed the literature on reporting guidelines and recommendations.MethodsWe searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key questions and answersThere is little empirical evidence that addresses these questions. Our answers are based on logical arguments and standards put forward by other groups.
What standard types of recommendations or reports should WHO use?


WHO should develop standard formats for reporting recommendations to facilitate recognition and use by decision makers for whom the recommendations are intended, and to ensure that all the information needed to judge the quality of a guideline, determine its applicability and, if needed, adapt it, is reported.


WHO should develop standard formats for full systematically developed guidelines that are sponsored by WHO, rapid assessments, and guidelines that are endorsed by WHO.


All three formats should include the same information as full guidelines, indicating explicitly what the group preparing the guideline did not do, as well as the methods that were used.


These formats should be used across clinical, public health and health systems recommendations.



How should recommendations be formulated and reported?


Reports should be structured, using headings that correspond to those suggested by the Conference on Guideline Standardization or similar headings.


The quality of evidence and strength of recommendations should be reported explicitly using a standard approach.


The way in which recommendations are formulated should be adapted to the specific characteristics of a specific guideline.


Urgent attention should be given to developing a template that provides decision makers with the relevant global evidence that is needed to inform a decision and offers practical methods for incorporating the context specific evidence and judgements that are needed.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the ninth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectivesWe reviewed the literature on grading evidence and recommendations in guidelines.MethodsWe searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct a full systematic review ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key questions and answers
Should WHO grade the quality of evidence and the strength of recommendations?
• Users of recommendations need to know how much confidence they can place in the underlying evidence and the recommendations. The degree of confidence depends on a number of factors and requires complex judgments. These judgments should be made explicitly in WHO recommendations. A systematic and explicit approach to making judgments about the quality of evidence and the strength of recommendations can help to prevent errors, facilitate critical appraisal of these judgments, and can help to improve communication of this information.
What criteria should be used to grade evidence and recommendations?
• Both the quality of evidence and the strength of recommendations should be graded. The criteria used to grade the strength of recommendations should include the quality of the underlying evidence, but should not be limited to that.• The approach to grading should be one that has wide international support and is suitable for a wide range of different types of recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, which is currently suggested in the Guidelines for WHO Guidelines, is being used by an increasing number of other organizations internationally. It should be used more consistently by WHO. Further developments of this approach should ensure its wide applicability.
Should WHO use the same grading system for all of its recommendations?
• Although there are arguments for and against using the same grading system across a wide range of different types of recommendations, WHO should use a uniform grading system to prevent confusion for developers and users of recommendations.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 7. Deciding what evidence to include 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the seventh of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectivesWe reviewed the literature on what constitutes "evidence" in guidelines and recommendations.MethodsWe searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key question and answersWe found several systematic reviews that compared the findings of observational studies with randomised trials, a systematic review of methods for evaluating bias in non-randomised trials and several descriptive studies of methods used in systematic reviews of population interventions and harmful effects.
What types of evidence should be used to address different types of questions?
• The most important type of evidence for informing global recommendations is evidence of the effects of the options (interventions or actions) that are considered in a recommendation. This evidence is essential, but not sufficient for making recommendations about what to do. Other types of required evidence are largely context specific.• The study designs to be included in a review should be dictated by the interventions and outcomes being considered. A decision about how broad a range of study designs to consider should be made in relationship to the characteristics of the interventions being considered, what evidence is available, and the time and resources available.• There is uncertainty regarding what study designs to include for some specific types of questions, particularly for questions regarding population interventions, harmful effects and interventions where there is only limited human evidence.• Decisions about the range of study designs to include should be made explicitly.• Great caution should be taken to avoid confusing a lack of evidence with evidence of no effect, and to acknowledge uncertainty.• Expert opinion is not a type of study design and should not be used as evidence. The evidence (experience or observations) that is the basis of expert opinions should be identified and appraised in a systematic and transparent way.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 6. Determining which outcomes are important 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the sixth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectivesWe reviewed the literature on determining which outcomes are important for the development of guidelines.MethodsWe searched five databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct a complete systematic review ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key questions and answersWe did not find a systematic review that addresses any of the following key questions and we found limited relevant research evidence.
What methods should WHO use to identify important outcomes?
• Methods of outcome identification should be transparent and explicit.• The consultation process should start with identification of all relevant outcomes associated with an intervention.• Those affected, including consumers, should be involved in the selection of outcomes.• A question driven approach (what is important?) is preferable to a data driven approach (what data are at hand?) to identify important outcomes.
What type of outcomes should WHO consider and how should cultural diversity be taken account of in the selection of outcomes?
• Desirable (benefits, less burden and savings) and undesirable effects should be considered in all guidelines.• Undesirable effects include harms (including the possibility of unanticipated adverse effects), greater burden (e.g. having to go to the doctor) and costs (including opportunity costs).• Important outcomes (e.g. mortality, morbidity, quality of life) should be preferred over surrogate, indirect outcomes (e.g. cholesterol levels, lung function) that may or may not correlate with patient important outcomes.• Ethical considerations should be part of the evaluation of important outcomes (e.g. impacts on autonomy).• If the importance of outcomes is likely to vary across cultures, stakeholders from diverse cultures should be consulted and involved in the selection of outcomes.
How should the importance of outcomes be ranked?
• Outcomes should be ranked by relative importance, separated into benefits and downsides.• Information from research on values and preferences should inform the ranking of outcomes whenever possible.• If the importance of outcomes is likely to vary across cultures, ranking of outcomes should be done in specific settings.• If evidence is lacking for an important outcome, this should be acknowledged, rather than ignoring the outcome.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: 5. Group processes 
abstract:BackgroundThe World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the fifth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.ObjectiveIn this review we address approaches to facilitate sound processes within groups that develop recommendations for health care.MethodsWe searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.Key question and answer
What should WHO do to ensure appropriate group processes?
Various strategies can be adopted to ensure that the group processes in play when panels are developing recommendations are inclusive, so that all voices can be heard and all arguments given fair weight, including• the use of formal consensus development methods, such at the Nominal Group Technique or the Delphi method• the selection of a group leader who is qualified and responsible for facilitating an appropriate group process.
location: nan, 'Global 
year: 2006 source: BMC 
title: Improving the use of research evidence in guideline development: introduction 
abstract:In 2005 the World Health Organisation (WHO) asked its Advisory Committee on Health Research (ACHR) for advice on ways in which WHO can improve the use of research evidence in the development of recommendations, including guidelines and policies. The ACHR established the Subcommittee on the Use of Research Evidence (SURE) to collect background documentation and consult widely among WHO staff, international experts and end users of WHO recommendations to inform its advice to WHO. We have prepared a series of reviews of methods that are used in the development of guidelines as part of this background documentation. We describe here the background and methods of these reviews, which are being published in Health Research Policy and Systems together with this introduction.
location: nan, 'Global 
year: 2006 source: BMC 
title: Best practices in use of research evidence to inform health decisions 
abstract:The WHO Advisory Committee on Health Research (ACHR) is committed to the notion that WHO should exemplify best practice in use of research evidence to inform decisions about health. A major ongoing initiative of the ACHR is the Sub-committee on the Use of Research Evidence (SURE). This group is examining WHOs roles and responsibilities in the use of health research to inform decisions about health. WHOs leadership has expressed strong support for this initiative. The series of articles being published in Health Research Policy and Systems, which examine the methods used by WHO and other organisations to formulate recommendations about health, is part of the background documentation SURE has produced to inform ACHRs advice to WHO.It is critical that health policy makers look to research, not ignorance, as the basis for action in health, and that health professionals look to evidence, not opinion, as the basis for delivery of care.
location: nan, 'Global 
year: 2006 source: BMC 
title: Building health research systems to achieve better health 
abstract:Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes.
Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS.This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above priorities on which we hope to feature further articles in HARPS and thus contribute to an informed debate on how best to achieve such progress.
location: nan, 'Global 
year: 2006 source: BMC 
title: Evaluation of a 'virtual' approach to commissioning health research 
abstract:BackgroundThe objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme – the 'Health of Londoners Programme' – in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions.MethodsA naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process.ResultsThe virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven.ConclusionThere is potential for using computer-mediated communication within the research commissioning process. This may enhance access, effectiveness and transparency of decision-making but further development is needed for this to be fully realised, including attention to process as well as the computer-mediated medium.
location: nan, 'Global 
year: 2006 source: BMC 
title: Global response to pandemic flu: more research needed on a critical front 
abstract:If and when sustained human-to-human transmission of H5N1 becomes a reality, the world will no longer be dealing with sporadic avian flu borne along migratory flight paths of birds, but aviation flu – winged at subsonic speed along commercial air conduits to every corner of planet Earth. Given that air transportation is the one feature that most differentiates present day transmission scenarios from those in 1918, our present inability to prevent spread of influenza by international air travel, as reckoned by the World Health Organization, constitutes a major weakness in the current global preparedness plan against pandemic flu. Despite the lessons of SARS, it is surprising that aviation-related health policy options have not been more rigorously evaluated, or scientific research aimed at strengthening public health measures on the air transportation front, more energetically pursued.
location: nan, 'Global 
year: 2006 source: BMC 
title: Theory and practice – a case study of coordination and ownership in the Bangladesh health SWAp 
abstract:BackgroundIn the past decade the sector-wide approach (SWAp) model has been promoted by donors and adopted by governments in several countries. The purpose of this study is to look at how partners involved in the health SWAp in Bangladesh define ownership and coordination, in their daily work and to analyse the possible implications of these definitions.MethodologyThe study object was a process of decision-making in the Government of Bangladesh in 2003. Information was collected through participant observations, interviews and document review.ResultsDuring the study period the Government of Bangladesh decided to reverse a decision to unify the two wings of the Ministry of Health and Family Welfare. The decision led to disagreements with development partners, which had serious implications for cooperation between key actors in the Bangladesh health sector leading to deteriorated relationships and suspension of donor funds. The donor community in itself was also in disagreement which led to inconsistencies in the dialogue between the development partners and the Government of Bangladesh.ConclusionThe case shows that main actors in the Bangladesh health SWAp interpret ownership and coordination, fundamental aspects of SWAp, differently. As long as work ran smoothly, the different definitions did not create any problems, but when disagreements arose they became an obstacle. It is concluded that partners in development should devote more effort to their working relationships and that responsibilities within a SWAp need to be more clearly delineated.