Policy-relevant research: When does it matter?

Abstract

Summary:Evidence-based medicine is most meaningful to policy makers when research questions are clearly informed by strategic health policy questions. In Washington State workers' compensation, key structural characteristics allow for the conduct of effective policy-relevant research. These include clear authority and a stable funding stream, a formal relationship between a policy agency and a University, development of appropriate research capacity, development of research questions related to strategic goals, and a robust data source. The research conducted relies on computerized medical bills and work disability records, medical records, structured telephone surveys to collect data on pain, functional status, quality of life, and computerized data on employment status. The types of policy-relevant research include identification of factors leading to preventable disability, outcomes research of specific procedures, technology assessment, and "real-time" research that addresses rapidly emerging questions. Health policy changes implemented from research have been substantial in Washington State workers' compensation, including: 1) noncoverage or partial coverage decisions for emerging technologies not proven to be of value to injured workers, 2) formal treatment guidelines and utilization review criteria for invasive, expensive, or marginally effective procedures, 3) disability prevention efforts, and 4) relatively rapid changes in policy as emerging patterns suggest harmful outcomes from existing treatments (e.g., schedule II opioids). Key structural characteristics must be in place to conduct policy-relevant research effectively. The workers' compensation system in Washington State is a single-payer system with other unique properties that have allowed the emergence of these structural characteristics and the conduct of research linked to the strategic goals of policy makers.

How Contexts and Issues Influence the Use of Policy‐Relevant Research Syntheses: A Critical Interpretive Synthesis

“…The fourth mechanism that can influence users’ views of evidence briefs results from factors that increase trust between the producers and the users of evidence briefs, minimizing the users’ demand for information that justifies confidence in the validity, rigor, and trustworthiness of an evidence brief while increasing the likelihood that explicit action‐oriented messages are viewed as helpful. For example, when interactions are ongoing and institutionalized, trust can develop between those preparing and those reading briefs, obviating the need for information that promotes confidence in the source and increasing the expectation that clear, action‐oriented decision support is provided (a context‐driven institutional factor) (Ayuk and Ali Marouani ; Bekker et al ; Bellew, Bauman, and Brown ; Bero and Jadad ; Best et al ; Cherney and Head ; Colby et al ; Crosswaite and Curtice ; Durrant ; Elliot and Popay ; Franklin et al ; Hanney et al ; Hyder et al ; Kapiriri, Norheim, and Heggenhougen ; Kennedy et al ; Kiefer et al ; Kouri ; Landry ; Lavis et al , ; Logar ; Lomas ; Madden ; McCaughey ; McGregor and Brophy ; Mubyazi and Gonzalez‐Block ; Oxman et al ; Pope, Mays, and Popay ; Teerawattananon ; Theobald and Nhlema‐Simwaka ; Tran et al ). Although related, this mechanism differs from the third mechanism (the creation of a need for confidence‐instilling information), in that it is linked to trust in the producers of briefs themselves, which then spurs (or depresses) the demand for specific content such as recommendations (when producers are trusted) or information about the methods used (when producers are not trusted as much).…”

‘I'm Sad To Be Glad’. An Analysis of Farmers’ Pride in Flanders

“…Firstly, between 2001 and 2006 strategic policy questions guided the research of the Flemish Policy Research Centre for Sustainable Agriculture (STEDULA) 5 . Our centre aimed at the maximum alignment of its policy‐relevant research with policymakers’ strategic goals and looked for stakeholder advice and consent regarding the relevance of research to policy (Franklin et al. 2004).…”

The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions

“…In recent years, there has been a call for increasing linkages between researchers and policymakers within the health policy field 22–24. It is argued that policymakers can benefit from researchers in crafting evidence-based policies that have more possibility of providing desired outcomes, while researchers can benefit from having their research used in a timely and constructive fashion.…”