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. 2009 Aug;5(1):66-86.

The Use of Research Evidence in Two International Organizations' Recommendations about Health Systems

Steven J Hoffman  1 , John N Lavis, Sara Bennett
Affiliations

The Use of Research Evidence in Two International Organizations' Recommendations about Health Systems

Steven J Hoffman et al. Healthc Policy. 2009 Aug.

Abstract
in English, French

Background: Little is known about the extent to which research evidence informs the development of recommendations by international organizations.

Methods: We identified specific World Health Organization (WHO) and World Bank recommendations on five topics (contracting, healthcare financing, health human resources, tuberculosis control and tobacco control), catalogued the related systematic reviews and assessed the recommendations to determine their consistency with the systematic reviews that were available at the time of their formulation.

Findings: Only two of the eight publications examined were found to cite systematic reviews, and only five of 14 WHO and two of seven World Bank recommendations were consistent with both the direction and nature of effect claims from systematic reviews. Ten of 14 WHO and five of seven World Bank recommendations were consistent with the direction of effect claims only.

Conclusion: WHO and the World Bank - working with donor agencies and national governments - can improve their use of (or at least, their reporting about their use of) research evidence. Decision-makers and clinicians should critically evaluate the quality and local applicability of recommendations from any source, including international organizations, prior to their implementation.

Contexte :: On ne sait pas vraiment à quel point les données de recherche renseignent la formulation des recommandations émises par les organismes internationaux.

Méthode :: Nous avons identifié des recommandations précises formulées par l'Organisation mondiale de la santé (OMS) et par la Banque mondiale au sujet des cinq points suivants : la sous-traitance, le financement des services de santé, les ressources humaines dans le domaine de la santé, la lutte contre la tuberculose et la lutte contre le tabagisme. Nous avons répertorié les revues systématiques pertinentes et nous avons évalué les recommandations afin de déterminer si elles sont cohérentes avec les éléments des revues systématiques qui étaient disponibles au moment de leur formulation.

Résultats :: Seulement deux des huit publications examinées citaient des revues systématiques et seulement cinq des 14 recommandations de l'OMS et deux des sept recommandations de la Banque mondiale étaient cohérentes avec la direction et la nature des effets décrits par les revues systématiques. Dix des 14 recommandations de l'OMS et cinq des sept recommandations de la Banque mondiale étaient seulement cohérentes avec la direction des effets décrits.

Conclusion :: L'OMS et la Banque mondiale, qui toutes deux travaillent avec des organismes donateurs et des gouvernements nationaux, peuvent améliorer leur utilisation des données de recherche (ou, du moins, leur façon d'indiquer une telle utilisation). Quelle que soit la source d'une recommandation, y compris si elle provient d'un organisme international, les décideurs et les cliniciens devraient en faire une évaluation critique en matière de qualité et d'application à l'échelle locale, avant de la mettre en application.

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