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BMC Health Services Research
Published in: BMC Health Services Research 1/2008

Open Access 01-12-2008 | Technical advance

Evidence and Value: Impact on DEcisionMaking – the EVIDEM framework and potential applications

Authors: Mireille M Goetghebeur, Monika Wagner, Hanane Khoury, Randy J Levitt, Lonny J Erickson, Donna Rindress

Published in: BMC Health Services Research | Issue 1/2008

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Abstract

Background

Healthcare decisionmaking is a complex process relying on disparate types of evidence and value judgments. Our objectives for this study were to develop a practical framework to facilitate decisionmaking in terms of supporting the deliberative process, providing access to evidence, and enhancing the communication of decisions.

Methods

Extensive analyses of the literature and of documented decisionmaking processes around the globe were performed to explore what steps are currently used to make decisions with respect to context (from evidence generation to communication of decision) and thought process (conceptual components of decisions). Needs and methodologies available to support decisionmaking were identified to lay the groundwork for the EVIDEM framework.

Results

A framework was developed consisting of seven modules that can evolve over the life cycle of a healthcare intervention. Components of decision that could be quantified, i.e., intrinsic value of a healthcare intervention and quality of evidence available, were organized into matrices. A multicriteria decision analysis (MCDA) Value Matrix (VM) was developed to include the 15 quantifiable components that are currently considered in decisionmaking. A methodology to synthesize the evidence needed for each component of the VM was developed including electronic access to full text source documents. A Quality Matrix was designed to quantify three criteria of quality for the 12 types of evidence usually required by decisionmakers. An integrated system was developed to optimize data analysis, synthesis and validation by experts, compatible with a collaborative structure.

Conclusion

The EVIDEM framework promotes transparent and efficient healthcare decisionmaking through systematic assessment and dissemination of the evidence and values on which decisions are based. It provides a collaborative framework that could connect all stakeholders and serve the healthcare community at local, national and international levels by allowing sharing of data, resources and values. Validation and further development is needed to explore the full potential of this approach.
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Metadata
Title
Evidence and Value: Impact on DEcisionMaking – the EVIDEM framework and potential applications
Authors
Mireille M Goetghebeur
Monika Wagner
Hanane Khoury
Randy J Levitt
Lonny J Erickson
Donna Rindress
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2008
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-8-270

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