The ecosystem of health decision making: from fragmentation to synergy

Clinicians, patients, policy makers, funders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, coverage deci...

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Bibliographic Details
Published in:The Lancet. Public health 2022-04, Vol.7 (4), p.e378-e390
Main Authors: Schünemann, Holger J, Reinap, Marge, Piggott, Thomas, Laidmäe, Erki, Köhler, Kristina, Pōld, Mariliis, Ens, Brendalynn, Irs, Alar, Akl, Elie A, Cuello, Carlos A, Falavigna, Maicon, Gibbens, Michelle, Neamtiu, Luciana, Parmelli, Elena, Jameleddine, Mouna, Pyke, Lisa, Verstijnen, Ilse, Alonso-Coello, Pablo, Tugwell, Peter, Zhang, Yuan, Saz-Parkinson, Zuleika, Kuchenmüller, Tanja, Moja, Lorenzo
Format: Article
Language:English
Subjects:
Administrative Personnel
Decision Making
Ecosystem
Humans
Technology Assessment, Biomedical
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Summary:Clinicians, patients, policy makers, funders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, coverage decisions, selection of essential medicines and diagnostics, quality assurance and improvement schemes, and policy and evidence briefs. The criteria and methods that these actors use in their work differ (eg, the role economic analysis has in decision making), but these methods frequently overlap and exist together. Under the aegis of WHO, we have brought together representatives of different areas to reconcile how the evidence that influences decisions is used across multiple health system decision levels. We describe the overlap and differences in decision-making criteria between different actors in the health sector to provide bridging opportunities through a unifying broad framework that we call theory of everything. Although decision-making activities respond to system needs, processes are often poorly coordinated, both globally and on a country level. A decision made in isolation from other decisions on the same topic could cause misleading, unnecessary, or conflicted inputs to the health system and, therefore, confusion and resource waste.
ISSN:2468-2667
2468-2667
DOI:10.1016/S2468-2667(22)00057-3