TRANSLATION OF COMPARATIVE EFFECTIVENESS RESEARCH – A CONCEPTUAL FRAMEWORK TO GUIDE POLICY-MAKERS

Purpose: Systematic reviews focusing on comparative effectiveness research are designed to be health policy relevant but barriers may exist for policy-makers to incorporate this information into decision-making and it is important to understand what policy-makers’ information needs are. The literature suggests that there is a gap between what policy-makers need for decision-making and what researchers actually provide. The purpose of this study was to develop a conceptual framework that identifies domains of information that policy-makers would find of relevance for incorporation of evidence for decision-making.

Method: This was a two part study including a systematic review and a qualitative study using one to one semi-structured interviews. We conducted the systematic review of the literature to identify policy-makers’ information needs. The findings of the systematic review were incorporated into an interview topic guide and policy-makers involved in coverage decisions were interviewed. Using the framework approach, the data generated were analyzed with coding of emergent themes. Findings from both parts were used to develop the conceptual framework.

Result: The systematic review and the qualitative study indicate that policy-makers’ information needs varies according to the type of decision being made and topic. Six main themes were identified: (1) current situation; (2) interpretation of the evidence; (3) effect on system’s efficiency; (4) relationship between outcomes and costs; (5) policy implications; and (6) Other, including elements such as information on subgroups and patient acceptability. The content of each theme and how these six themes interact with each other will be presented.

Conclusion: Results indicate that the translation of comparative effectiveness reviews can be improved by the provision of further contextual information in addition to the effectiveness data. These results are important to understand the usefulness of comparative effectiveness reviews and how it meets policy-makers’ needs in the United States.