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National Framework for Communicable Disease Control

United Nations News Centre

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Decision Making: Overcoming Serious Indecisiveness

Public health decision-makers are often overwhelmed with large quantities of data, evidence, reviews and sum-maries. As the volume of information increases, the need for trusted sources of synthesis becomes greater.1 If we recognize the need for good methods of summarizing research that address policy makers ’ information needs in a reliable and timely manner, then how do we agree on what those methods are? This is a lively debate, resonant of earlier debates on alterna-tive designs for evaluating interven-tions, that was polarized for many years

What information consumes is rather obvious: it consumes the attention of its recipients

Cost-benefit analysis, considered by some to be the ‘gold standard’ in health promotion effectiveness evidence, are rarely conducted or available; there are, however, a growing number of synthesis reports available (e.g., The Evidence of Health Promotion Effectiveness by the International Union for Health Promotion and Education) which demonstrate that these investments in health do pay dividends and have clear relevance in health, social, economic and political terms.An ongoing challenge is to develop ever more reliable and valid measures of health intervention success and to improve the quality and range of evidence available to guide decision making.There are a number of collections of recommended interventions, based on various review methodologies.

Dumb Scientist – Abrupt climate change

Euthanasia, Physician-Assisted Suicide, and Other …

As opposed to trial patients, real-world patients generally have a worse prognosis, more comorbidities, and are older. Therefore, there is a growing interest in real-world evidence to complement evidence from trials. However, RW-CEA is complicated by incomparability issues. Failure to account for these issues may lead to biased results and incorrect conclusions. This workshop focuses on three methods: PSM, DES, and data synthesis. The potentials and pitfalls of each method will be discussed by sharing theoretical and empirical insights based on our experiences in performing RW-CEA. First, the potential of PSM will be illustrated by matching real-world patients to create comparable groups for a RW-CEA in non-Hodgkin lymphoma. Second, the DES method will be explained using examples from two disease models spanning multiple lines of treatment (two and three treatment lines in renal-cell carcinoma and multiple myeloma, respectively). Third, data synthesis will be clarified using a RW-CEA for chronic lymphocytic leukemia in which trial data was used to determine progression-free survival and registry data was used to determine post-progression survival. The workshop will focus on the extent to which the three methods provide useful, valid and reliable information to healthcare decision makers, facilitate evidence-based decision-making, and ultimately improve health outcomes. An interactive discussion will encourage audience participation to contribute to further understanding whether it is feasible to calculate real-world cost-effectiveness.

Research capacity is embedded in functions and processes, supporting surveillance, epidemiological and laboratory investigations, policy design and evaluation, and the translation of information into evidence. Public health decision-makers can depend on the timely availability of reliable data.

epic3: National Evidence-Based Guidelines for …

Evidence syntheses, or systematic reviews, of reliable evaluations should be a key source of knowledge for all decision-makers who want to answer the question: What is likely to happen if we do this, rather than something else? In the humanitarian sector, decisions, choices and policies impact on the health and wellbeing of thousands, if not millions, of people and those responsible have a duty to ensure that the evidence they use is reliable and robust. This requires the use of appropriate methodologies; firstly to evaluate humanitarian action, and then to bring together the findings of those evaluations. It will mean that the best possible use is made of what happened in the past to predict what will happen in the future, and ensure that humanitarian action does what those who fund it and those who implement it want it to do: prevent and alleviate the suffering of people in need in humanitarian and disaster risk reduction contexts.

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