Political interpretation of scientific evidence: Case study of breast cancer screening policies around the world

Rennert, G.

doi:10.1016/s0959-8049(02)80017-x

Cited by 3 publications

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“…For example, comparative approaches would be particularly fruitful to test hypotheses about the effects of more or less centralised political or administrative systems on the use of evidence. A number of multi-country studies relevant to our issues of interest were included in our review, but we found no studies that explicitly tested hypotheses in such a way and only 5 studies in which the use of a comparative approach was associated with a more explicit engagement with political and institutional analysis [33], [43], [66], [78], [82]. Similarly, we found only 4 studies that examined comparatively the effects of political and institutional change on evidence use practices within the same country [37], [42], [69], [74].…”

Section: Discussionmentioning

confidence: 99%

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

2013

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BackgroundThere is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making.MethodsWe conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review.Findings56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies.ConclusionsThis review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches beyond the current remit of public health or knowledge utilisation studies.

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Section: Discussionmentioning

confidence: 99%

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

2013

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“…This number must have increased markedly, as at present at least twenty-three European countries have already implemented or are currently establishing nationwide MS programs (19). There is marked variability among these programs in terms of age-groups included, frequency and method of screening, and, when mammography is selected, the number of views taken (20). Rennert (20) explained these differences in decision making by inherent differences between the countries in structure of the health-care system, in the commitment to public health activities, and in opinions and health habits of the relevant population.…”

Section: Discussionmentioning

confidence: 99%

Why did some Danish counties introduce breast cancer screening and others not? An exploratory study of four selected counties

Hjulmann

Vondeling

Bech

2008

Int J Technol Assess Health Care

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The four counties have based their decision making on the introduction of MS on different combinations of a limited number of factors that have been differentially weighted. The pattern of relevant factors in both counties not introducing MS is rather similar. The study elucidates the role of complementary factors to evidence in decision making. Of interest, recent public sector reforms have resulted in the decision to have MS implemented nationwide.

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“…Screening programmes have been crucial in the control of several chronic infectious diseases such as tuberculosis, and are currently widespread for the detection of risk factors for cardiovascular disease, such as hyperlipidaemias and hypertension 2 , 3 . Screening programmes for breast and cervical cancer in women and for prostate cancer in men are in place in many countries, but they are the recurrent subject of debate regarding their effectiveness in reducing morbidity and mortality from these neoplasms 4–12 …”

Section: Introductionmentioning

confidence: 99%

Screening for gastric cancer: does it make sense?

Genta¹

2004

Aliment Pharmacol Ther

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SUMMARYGastric cancer remains the second most frequent and lethal malignancy worldwide, with a wide range of incidence rates in different populations. Reducing its incidence is a priority in many high-risk countries, and screening programmes are often advocated as an option. An effective screening programme should have the following characteristics: (i) the disease should be common in the population, otherwise the individual benefit will not offset the risk, cost and inconvenience of screening of the rest of the population; (ii) the diagnostic test(s) used should be safe, simple, inexpensive and reliable; and (iii) effective treatment should be available. With respect to gastric cancer, these conditions are not fulfilled completely in any population and therefore populationbased screening does not appear to be a viable approach to the prevention of this neoplasia. In contrast, gastroscopic screening in selected high-risk subjects would seem appropriate. A more effective strategy, particularly in high-incidence populations, could be the widespread screening and treatment for Helicobacter pylori infection. This could result in the virtually complete elimination of chronic gastritis and its associated conditions, including most peptic ulcers, primary gastric B-cell lymphomas and a major portion of gastric epithelial tumours.

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Political interpretation of scientific evidence: Case study of breast cancer screening policies around the world

Cited by 3 publications

References 0 publications

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

Why did some Danish counties introduce breast cancer screening and others not? An exploratory study of four selected counties

Screening for gastric cancer: does it make sense?

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