Rapid reviews to support clinical priority setting decisions

Dr Vivek MuthuMedical Director, Bazian Ltd

King’s Fund, London17th July 2006

2 18 April 2023

Questions to answer today

- Why do we need knowledge support for commissioning?

- What does knowledge support really mean?- What effects does it have on commissioning?- What is the role of the librarian in all of this?

3 18 April 2023

The big picture

2̶The end of affordable, equitable healthcare could be around the corner2̶Fortunately, there is a way out; thanks to knowledge support

4 18 April 2023

Why?From To

It increases 5 year survival by 3.5%. Side effects are uncertain. It costs an extra £5,000. What is the best policy for all our patients, given these facts?

No. They shouldn’t.

Everyone should have it.

5 18 April 2023

True knowledge support: A transforming effect…

From To

Decisions made in ignorance of fundamental facts

Adversarial contests

Focus on entrenched positions

Fragile policies

Unsustainable, suboptimal healthcare

Decisions that are properly informed

Negotiated agreements

Focus on shared interests

Robust policies

Affordable, optimal healthcare

6 18 April 2023

What is true knowledge support?

Evidology n.[Latin: videre to discern, comprehend; evidere to appear plainly]

A new medical specialty that enables scientific research to be incorporated systematically into healthcare decisions

7 18 April 2023

A new medical specialty….

Radiology Outpatients Evidology Occupational Health

8 18 April 2023

Why is evidology a specialty?Not this… But this…

A librarian working on his/her own

Search and delivery of research papers

A summary of papers’ conclusions

Expectation that user will interpret

An optional service that enquirers use at their discretion

A helpful service

A collaborative, multidisciplinary service

Engagement and consultation

Critical appraisal of methods

Written interpretive reports

An essential step in decision-making

An accountable service

9 18 April 2023

Vs.

10 18 April 2023

Case study: brachytherapy

Consultative question setting

EB search(validated and reproducible)

Critical appraisal

Detailed analysisand interpretation

User-friendlyreporting

11 18 April 2023

The result…

2̶A truly evidence-based, rigorous, transparent, duly diligent decision making process2̶One that saves time, saves money, emotional energy2̶A robust, defensible, well-accepted policy decision

12 18 April 2023

Summary

2̶True knowledge support is a medical specialty: evidology2̶Evidology is here to stay 2̶Librarianship is necessary but not sufficient (evidology is a multidisciplinary specialty)

13 18 April 2023

Thank you