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Evidence creation – the evidence funnel

Published onApr 25, 2024
Evidence creation – the evidence funnel

On the evidence production side, there is a range of research products that enhance the systematic and transparent use of evidence. These are captured in the “evidence funnel” (see Fig. 2.1) through which evidence is refined and tailored to the needs of the evidence users.

The evidence creation domain consists of the three phases: (i) evidence inquiry (primary research), which feeds into (ii) evidence synthesis (secondary research) and culminates in the creation of (iii) evidence products (tertiary research), which are more user-friendly and help to translate the research into action.

Fig. 2.1. Evidence creation funnel

While all three phases of evidence creation (primary, secondary, and tertiary) are featured in the funnel, this guidance focuses mostly on their use for evidence application as part of the policy/action cycle. However, the creation of tertiary research (evidence products such as guidelines and EBPs) is an integral part of EIDM processes and thus features prominently in the policy/action cycle.

Evidence inquiry

Evidence inquiry (primary research) refers to primary studies or health information and represents the majority of research that is conducted worldwide. While these single studies are not best suited to be translated into policy or practice on a broad scale, they do help to determine the magnitude of the problem, assess barriers to implementation, and assess stakeholder views. They are also fed into the larger evidence base (in evidence syntheses and evidence products), including for assessment of the effectiveness, cost-effectiveness and equity impacts of potential solutions [25][39][73]. Primary research is also created as part of the evaluation of implemented solutions. This research is more likely to be used by decision-makers if it addresses important problems, is relevant to the decision-making context, is robust and implementable [50].

Fig. 2.2. “Evidence ecosystem for impact” framework*

* The framework includes the evidence funnel, the policy/action cycle, context, cross-cutting issues, and principles.

Evidence synthesis

Evidence synthesis (secondary research) synthesizes the findings of individual research studies within a larger body of evidence on the topic, based on rigorous, reproducible and transparent methodologies, to determine what is known in a given area or field and whether there are evidence gaps [74],[75]. Syntheses can use quantitative and/or qualitative methods. The most wellknown type of evidence synthesis are systematic reviews (with or without meta-analysis) and rapid reviews of the effect of interventions, programmes or policies [40],[76]. Resources related to syntheses can be found in Chapter 3 and definitions for each are in the Glossary.

Evidence products

Evidence products (tertiary research) are the most “refined” form of evidence, synthesizing secondary- and, as required, primary research [25],[39],[77],[78]. They present the evidence in a concise and user-friendly format tailored to the information needs of the end-users. Frequently, evidence products also provide explicit recommendations, with the aim of guiding stakeholders in their action, and facilitate the application of evidence [39]. The development of evidence products requires the involvement of key stakeholders, an interdisciplinary team of professionals, and co-production by researchers and users of the research [79]. For those reasons, they are more likely to be translated into policy or action. Evidence products can, for example, be:

  • targeted towards the policy cycle:

    o the development of EBPs [25] or

  • the conduct of an HTA [78],[80] or

    o the production of public health or health system guidelines [39];

  • targeted towards the action cycle

    o clinical practice guidelines [39]

    o patient decision aids [81].

In developing evidence products, several steps of the policy/action cycle are usually covered. The overlap in “steps” covered in the development of evidence products with the steps of the policy/action cycle can be seen in Table 3.5, Chapter 3 – for EBPs, guidelines and HTAs. The steps for these three evidence products include the following: identify a high-priority issue and design solutions, and some also include the step design implementation.

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