Perspectives on the production, and use, of rapid evidence in decision making during the COVID-19 pandemic- a mixed methods study

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

3D.1

Presenter:

Andrew W Murphy

Twitter:

@mkelly_galway

Co-authors:

Barbara Clyne, Lisa Hynes, Colette Kirwan, Máire McGeehan, Paula Byrne, Martha Killilea, Susan M Smith, Mairin Ryan, Claire Collins, Michelle O’Neill, Emma Wallace, Andrew W Murphy

Author institutions:

National University of Ireland Galway , RCSI University of Medicine and Health Sciences, Health Information and Quality Authority, PPI Ignite National University of Ireland Galway,

Problem

Evidence-based decision making and practice are central to optimising population health, particularly during health emergencies. However, the relationship between provision of research evidence and subsequent decision-making is complex. In the context of a pandemic, factors such as scientific uncertainty and lack of clear and rapidly available evidence, may negatively impact decisions-making. In order to provide timely evidence many organisations have moved from the traditional systematic review to rapid evidence products, such as rapid reviews or rapid response briefs. To date this change in practice has not been well evaluated. Therefore this study aimed to describe and explore perceptions of the provision and use of rapid evidence synthesis, to support decision making, by two innovative national Irish projects. These projects were developed, de-novo and expeditiously in the face of the growing emergency, to provide evidence syntheses for policy makers (known as The Policy Project) and evidence based clinical recommendations for front-line general practitioners (GPs) (known as The GP Project), in the context of the COVID-19 global pandemic

Approach

Using a convergent parallel mixed methods study design (March - August 2020), 25 semi-structured interviews were conducted with a purposive sample of 14 Evidence-Providers (EPs: those who generated and disseminated rapid evidence) and 11 Service-Users (SUs: GPs and policy makers, who utilised the evidence). Interviews were transcribed verbatim and thematically analysed. Quantitative data were summarised descriptively. Data were analysed separately and triangulated during the interpretation phase of the research

Findings

The Policy Project comprised 27 EPs, producing 30 reports across 1,432 person-work-days. The GP project comprised 10 members from three organisations, meeting 49 times, and posting evidence based answers to 126 questions, from front-line GPs. Four unique themes were generated. ‘The Work’ highlighted that a structured but flexible, organisational approach to producing evidence was essential. Ensuring quality of evidence products was challenging, particularly in the context of absent or poor-quality evidence. ‘The Use’ highlighted that across both projects, rapid evidence products were considered invaluable to decision making. Trust and credibility of EPs were key, however, communication difficulties were highlighted by SUs (e.g. website functionality). ‘The Team’ emphasised that a highly skilled team, working collaboratively, is essential to meeting the substantial workload demands of evidence production and tight turnaround time. ‘The Future’ highlighted that investing in resources, planning and embedding evidence synthesis support, is crucial to national emergency preparedness.

Consequences

The findings demonstrate that providing rapid evidence support is crucial to support national policy decision making, and to inform direct patient clinical care in general practice, during a pandemic. The credibility of EPs, a close relationship with SUs and having a highly skilled and adaptable team to meet the workload demands were identified as key strengths that optimised the utilisation of rapid evidence.

Submitted by:

Maureen Kelly

Funding acknowledgement:

BC is funded by Health Research Board (HRB) Emerging Investigator Award (EIA-2019-09). Funding was provided, for transcription costs, by the Irish College of General Practitioners (ICGP), the Academic Departments of General Practice in Ireland (AUDGPI) and the HRB Primary Care Clinical Trials Network in Ireland (PCCTNI).