Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies

Haby et al. Implementation Science (2016) 11:117 DOI 10.1186/s13012-016-0472-9 METHODOLOGY Open Access Designing a rapid response program to support evidence-informed decisionmaking in the Americas region: using the best available evidence and case studies Michelle M. Haby1,2*, Evelina Chapman3, Rachel Clark4, Jorge Barreto5, Ludovic Reveiz6 and John N. Lavis7,8 Abstract Background: The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? Methods: The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidenceinformed decision-making, (ii) supplementary literature in relation to the “shortcuts” that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. Results: There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a “user-pays” model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. Conclusions: When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making. * Correspondence: 1 Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, México 2 Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia Full list of author information is available at the end of the article © 2016 Haby et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Haby et al. Implementation Science (2016) 11:117 Background While research evidence is only one of many inputs into decision-making when it comes to health policy [1], it is important to try to maximize its usefulness and uptake. A range of programs and efforts already exist to promote the uptake of research evidence into policy and practice. These include efforts to conduct systematic reviews of the evidence (e.g., the Cochrane Collaboration) as well as efforts to package research evidence, including systematic reviews to inform policy and practice (e.g., Evidence-Informed Policy Network (EVIPNet), Health Technology Assessment agencies). However, while extremely useful, these programs are often not able to provide access to research quickly nor answer specific policy questions in a timely way. There is a wide literature describing the barriers and facilitators to the consideration of research evidence in decision-making that can inform the design of a rapid response program to address this gap [2–6]. The most frequently reported barriers to evidence uptake are poor access to good quality relevant research and the lack of timely and relevant research output [5, 7]. The most frequently reported facilitators are collaboration between researchers and policymakers, improved relationships and skills [5], and research that accords with the beliefs, values, interests or practical goals, and strategies of decision-makers [8]. What is a rapid response program and what types of programs already exist? A rapid response program that provided rapid reviews of the results of high-quality research evidence, which was contextualized and targeted to the needs of decisionmakers, with a fast turn-around time, and that included interaction between researchers and decision-makers could overcome some of the barriers and facilitate the uptake of research into policy and practice. When describing and designing a “rapid response program,” it is important to consider (1) the product offered; (2) the strategies utilized to facilitate the uptake of the product into decision-making; and (3) how the program is operationalized to ensure that it runs smoothly. These three things together will determine if the rapid response program meets its intended purpose, i.e., to facilitate the use of high-quality research in health decision-making. The number of rapid response programs offering such a service is increasing [9, 10]. The authors of a recent study surveyed 29 rapid response programs internationally [10]. Within, and across, these programs, there was a wide variation in the program objectives, types of questions answered, and processes and methods used [10]. The primary objectives for producing rapid reviews (the main product of rapid response programs) reported by respondents were to inform decision-making with regard to funding health care technologies, services, and Page 2 of 12 policy and program development [10]. The rapid reviews answered many types of questions—clinical effectiveness (55.2 %), clinical efficacy (41.4 %), cost-effectiveness and/ or cost savings (41.4 %), and safety (31.0 %)—and were used to support clinical practice guideline preparation (17.2 %) for either a health care technology or service. Some rapid response programs focused exclusively on questions centered on health system interventions, health services delivery, health care policy, coverage of a technology, operational ef (...truncated)