Systematic reviews and public health decision-making: patterns in usage and priorities for change

Session: 

Oral session: Understanding and using evidence (2)

Date: 

Monday 17 September 2018 - 14:40 to 14:50

Location: 

Carrick 3

All authors in correct order:

Kneale D1, Rojas-García A2, Thomas J1
1 EPPI-Centre, UCL Institute of Education, UCL, UK
2 Dept of Applied Health Research, UCL, UK
Presenting author and contact person

Presenting author:

Dylan Kneale

Contact person:

Dylan Kneale
Abstract text
Background:
A 2013 overhaul of the decision-making landscape in public health in England prompted critical enquiry into how research evidence, and specifically systematic reviews, are being used to shape policy and service commissioning. Previous research has found systematic reviews being used infrequently, but have revealed little about why.

Objectives:
This presentation will report on findings from a study on evidence use in local public health decision-making and seeks to:

1) describe patterns of systematic review usage and awareness;
2) understand potential barriers to effective usage; and
3) develop and co-develop recommendations for changes in systematic review practice.

Methods:
The results are mainly drawn from semi-structured interviews conducted with public health practitioners (PHPs), who occupied roles in policy-setting and commissioning in three Local Authorities, and analysed using template analysis. Findings are supplemented by results of a systematic review of evidence use studies and documentary analysis of public health strategies using qualitative comparative analysis. We also discuss the reflections of a lay research panel on our findings and the resulting recommendations.

Results:
Participants had mixed levels of awareness of systematic reviews. Based on a small sample, we observed four patterns of behaviour: 1) individuals with low levels of awareness of systematic reviews consequently had low levels of use (low awareness; low use); 2) participants who ostensibly had high levels of systematic review usage, but on further enquiry were defining any form of pooling of evidence as a systematic review (low awareness; high potential use); 3) participants who had awareness of systematic reviews, but did not use them frequently (high awareness; low use); and 4) participants who had high levels of awareness, and did incorporate review evidence where possible but usually in a limited way, because of perceived challenges in the utility of systematic reviews (high awareness; high potential use). Participant responses also helped to identify ways of increasing awareness and usage, but also more meaningful usage in public health decision-making.

Patient or healthcare consumer involvement:
Data have been collected from PHPs; lay research panel members reflect on and critically appraise the resulting recommendations.

Relevance to patients and consumers: 

Systematic reviews are considered one of the most robust sources of evidence, and yet research suggests that their use is relatively infrequent in public health decision-making. Conducting research with local public health practitioners is essential if we are to understand why systematic reviews are rarely used, and how we can increase their utility for local public health decision-making. The recommendations we make also need to work for members of the public, and we are collaborating with a lay research panel to further develop these.