Evidence Based Policy

This commentary considers the potential role of patient and public involvement in implementation. Developing an analytical thread from the resource-based view of the Firm, we argue that this involvement may create unique resources that have the capacity to enhance the impact of implementation activity for healthcare organisations.

The attention for the use of evidence in the policy process has received renewed attention in recent years with explicit calls for ‘evidence-based policy’ (EBP). This idea is not new, and goes back at least to Lasswell’s call for a ‘policy science’ which would explicitly apply interdisciplinary research to policy problems (Lasswell 1951, 1970). The problématique of evidence use raises a number of questions on how knowledge is recognised and mobilised in the policy process. These questions were addressed in a panel on EBP at the Interpretive Policy Analysis conference in Tilburg, The Netherlands, in July 2012. The panel was grounded in the study of policy making as practice (Colebatch 2005, 2006; Colebatch et al. 2011).  Some of the papers from this panel have already been published (Pearce et al., 2014); four more are presented here. Three of the papers in this special issue are case studies of contemporary policy practices in United Kingdom (UK), Sweden and Australia, the fourth investigates the way in which the demand for EBP is mobilised by a movement that advocates randomized Controlled Trials as the preferable form of knowledge in policy practice. We briefly introduce these four articles, discuss what we learn from them, and suggest what questions remain to be investigated. We conclude by arguing that while the EBP discourse is inherently naive about the realities of public policy, its dominance continues to exert real influence on policy practices, academic research and democratic participation.

Background: Property rights to natural resources comprise a major policy instrument in efforts to advance sustainable resource use and conservation. Debate over the relative effectiveness of different property rights regimes in reaching these goals remains controversial. A large, diverse, and rapidly growing body of literature investigates the links between property rights regimes and environmental outcomes, but has not synthesized theoretical and policy insights within specific resource systems and especially across resource systems. Methods: We conducted a systematic review following CEE Guidelines in which we collected empirical evidence from the past two decades on the environmental impacts of property rights regimes in fisheries, forests and range-lands in developing countries. We used a bundle of rights approach to assess the impacts of state, private, and community property regimes, as well as mixed regimes and open access conditions. Outcomes were classified as positive, negative, neutral or undetermined. We also collected information on contextual and other factors thought to influence effect of property rights regimes on environmental outcomes. The search covered 90 online databases and three languages, resulting in a total of 34,984 screened titles. Results: This review identified 103 articles consisting of 374 property regime studies: 55% of the studies related to forestry, 31% to fisheries, and 14% to rangelands. The majority of the studies comprised case–control studies but presented limited information on the baseline condition of the resource system. Only 26 studies used before-after-control-impact (BACI) design. We found that property regime comparisons differed across resource domains with, for example, the majority of fisheries studies using comparison to an open access situation while forest and rangeland studies were more mixed in regime comparisons. After critical appraisal of included studies, only 80 studies were accepted for the narrative synthesis. The key contextual factors largely associated with reported positive environmental outcomes across the three resource systems included monitoring and enforcement systems, resource use pressure , and the presence or absence of clear, stable and legitimate rights (i.e. 'positive regime characteristics'). Conclusions: A key overall finding was that the evidence base was insufficiently robust to draw consistent conclusions about the environmental impacts of different property rights regimes within or across resource systems. The majority of studies reported that any regime is likely to perform better than an open access regime, whereas the performance of state, community, private and mixed regimes was much more ambiguous. Future research on property rights regimes would benefit from more rigorous study designs and more cohesive multidisciplinary research methods. In particular, studies emphasizing a natural science approach could better describe property rights regime characteristics and contextual factors while contributions by teams with a stronger social science emphasis should take care to provide more rigorous empirical data on environmental outcomes.

Background: Systematic reviews are increasingly used to inform health policy-making. The conflicts of interest (COI) of the authors of systematic reviews may bias their results and influence their conclusions. This may in turn lead to misguided public policies and systems level decisions. In order to mitigate the adverse impact of COI, scientific journals require authors to disclose their COIs. The objective of this study was to assess the frequency and different types of COI that authors of systematic reviews on health policy and systems research (HSPR) report. Methods: We conducted a cross sectional survey. We searched the Health Systems Evidence (HSE) database of McMaster Health Forum for systematic reviews published in 2015. We extracted information regarding the characteristics of the systematic reviews and the associated COI disclosures. We conducted descriptive analyses. Results: Eighty percent of systematic reviews included authors' COI disclosures. Of the 160 systematic reviews that included COI disclosures, 15% had at least one author reporting at least one type of COI. The two most frequently reported types of COI were individual financial COI and individual scholarly COI (11% and 4% respectively). Institutional COIs were less commonly reported than individual COIs (3% and 15% respectively) and non-financial COIs were less commonly reported than financial COIs (6% and 14% respectively). Only one systematic review reported the COI disclosure by editors, and none reported disclosure by peer reviewers. All COI disclosures were in the form of a narrative statement in the main document and none in an online document. Conclusion: A fifth of systematic reviews in HPSR do not include a COI disclosure statement, highlighting the need for journals to strengthen and/or better implement their COI disclosure policies. While only 15% of identified disclosure statements report any COI, it is not clear whether this indicates a low frequency of COI versus an underreporting of COI, or both. Citation: Bou-Karroum L, Hakoum MB, Hammoud MZ, et al. Reporting of financial and non-financial conflicts of interest in systematic reviews on health policy and systems research: a cross sectional survey. Int J Health Policy Manag. Implications for policy makers • Health policy and systems research (HSPR) journals should strengthen and/or better implement their conflicts of interest (COI) disclosure policies. • The disclosure and management of COI may help increase the credibility and trust in systematic reviews by policy-makers. • Given the potential influence of COI on research, practice and policy, governments and funding agencies are called to support research in this field. Implications for the public Disclosure represents a first step in transparency that allows readers to consider whether conflicts may have influenced conduct of a review and the conclusions that review authors present.