What can we learn from local government research systems?

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Andrew Booth, Emma Hock and Alison Scope

This blog post is based on the Evidence & Policy article, ‘Examining research systems and models for local government: a systematic review’.

Local government has been unfairly characterised as a black hole when it comes to getting evidence into practice. While it is true that work remains to be done to cultivate interest in research across local government, our recent review found plenty of evidence of academia, local officials and other partners collaborating to make a difference around the generation and use of locally-meaningful research.  

What seems to be less common, however, are coordinated approaches to organising research activity within and across an entire local government system. What can we learn from diverse approaches that harness mechanisms across different local government systems?

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Exploring evidence use in an Irish health service context

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Susan Calnan

This blog post is based on the Evidence & Policy article, ‘Experiences and perceptions of evidence use among senior health service decision makers in Ireland: a qualitative study.’

How do senior health service decision makers use evidence to inform their work and decision-making and what types of evidence do they use? What are the potential barriers and facilitators to research use by health service decision makers and are there ways to improve its usage?

We wanted to explore these questions in our qualitative study published in Evidence & Policy, which was conducted in Ireland’s national health service, the Health Service Executive (HSE). Our focus was on senior decision makers working in the organisation’s Healthcare Strategy, Clinical and Operations divisions, where evidence use has the potential to inform the quality and delivery of health services and workforce planning.

We conducted semi-structured interviews with 17 participants between August 2021 and January 2022.

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What knowledge informs policy decisions? And how can we measure it?

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Jonas Videbæk Jørgensen

This blog post is based on the Evidence & Policy article, ‘Knowledge Utilisation Analysis: measuring the utilisation of knowledge sources in policy decisions.’

Using research-based knowledge to inform policy decisions constitutes a key ambition in most modern democracies. As such, enhancing the utilisation and impact of research has gained widespread attention among scholars and policymakers, with a range of initiatives to promote it. But how often is research-based knowledge used in policy decisions? And what kinds of knowledge have the strongest impact? Despite years of scholarship on the topic, measuring knowledge utilisation remains a significant challenge. In a new Evidence & Policy article, I discuss existing measures of knowledge utilisation and present a new approach called ‘Knowledge Utilisation Analysis’ (KUA).

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Four approaches to navigating boundaries in co-produced health research

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Chris Ackerley and Ellen Balka

This blog post is based on the Evidence & Policy article, ‘Navigating boundaries in coproduced research: a situational analysis of researchers’ experiences within integrated knowledge translation projects.’

Increasingly, researchers are collaborating with partners outside of academia – including patients, practitioners and policymakers – to create evidence that aims to be more useful and usable in practice. In the Canadian health sector, this kind of research coproduction is often called integrated knowledge translation (IKT).

A central idea in research coproduction is that bringing together people with different expertise is more likely create impactful evidence. Yet, collaborators’ differences can also present practical challenges for research projects.

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We need a balanced approach to research ethics if we want our research to help everyone

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Michael Sanders and Vanessa Hirneis

This blog post is based on the Evidence & Policy article, ‘Consent, assent and randomised evaluations’.

The last decade or so have seen an explosion in the number of randomised controlled trials conducted in schools in the UK, and a similar, if less stratospheric, rise elsewhere in the world. The rise in the UK can be attributed in large part not to methodological interest by education academics, but the creation of the Education Endowment Foundation. Forming part of the UK Government’s “What Works” network aimed at improving evidence-informed decision-making in policy and overseeing a budget of more than £100 million, the EEF has funded hundreds of randomised trials of different interventions to boost children’s and young people’s attainment.

Enthusiasts of randomised trials argue that they provide the best and simplest (or least statistically burdensome) way of findings out which interventions work. However, opponents, often those responsible for designing and delivering interventions, consider them unethical because they necessitate withholding a potentially beneficial intervention from young people. In our paper, we consider another aspect of the ethics of randomised trials with young people – consent.

Informed consent is the cornerstone of postwar research, and aims to ensure that people are not experimented on against their will. As a principle, it is hard to argue with and should be at the centre of our thinking about how to run these kinds of trials.

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Naturopaths place a stronger emphasis on the patient’s experience of their health compared to information from other health professionals when making clinical decisions

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Prof Amie Steel, Dr Iva Lloyd, Prof Matthew Leach and Dr Vicky Ward

This blog post is based on the Evidence & Policy article, ‘Naturopaths’ behaviours, attitudes and perceptions towards the use of knowledge and information sources’.

The modern health landscape is dominated by the evidence-based practice paradigm which asks health professionals to prefer research evidence over other forms of knowledge and information when providing care to their patients. However, clinicians from most areas of health – including general practice and allied health – have argued that the realities of practice are not so simple. While this ‘messiness’ of clinical practice is documented for many mainstream health professions, there has been little to no research examining how clinicians from traditional medicine systems use knowledge and information in their practice, until now.

An international survey of naturopaths was recently published in Evidence and Policy which found they used a diverse range of knowledge and information sources when making clinical decisions. The survey respondents practice naturopathy, a traditional medicine system originating from Europe but now practiced in 108 countries across all world regions. Naturopathy uses a highly patient-centred and holistic clinical approach that prioritises preventive health and wellness, and patient education and empowerment.

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Research by opioid manufacturers distorted authorship and overstated findings

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Brian Gac, Hanna D. Yakubi and Dorie E. Apollonio

This blog post is based on the Evidence & Policy article, ‘Issues arising from the study design, conduct, and promotion of clinical trials funded by opioid manufacturers: a review of internal pharmaceutical industry documents’.

From 1999 to 2021, opioid overdoses caused over one million deaths in the US. The pharmaceutical industry has been held legally responsible in some cases for overstating the benefits and understating the risks of opioid use, leading to overprescribing that contributed to these deaths. Opioid manufacturers sponsor clinical trials to generate scientific evidence that supports use of their products to gain regulatory approval, and to use in commercial materials to promote drug sales. Previous research has found industry sponsored research may use dubious research practices to generate findings that justify use. Three examples of such research practices include inappropriate use of enriched enrollment trial design, ghost authorship, and overstatement of research findings.

In our recently published Evidence and Policy article, we identified research practices used in clinical trials funded by opioid manufacturers that created the perception that opioids were safe, non-addictive and effective in treating pain. Since 2005, confidential documents made public in litigation against pharmaceutical companies have been collected in the Opioid Industry Document Archive (OIDA) at the University of California San Francisco for storage in perpetuity. In January 2020, OIDA made available the first 503 documents that later become part of the larger OIDA, totaling over 62,000 pages, that were released as part of the Oklahoma litigation in a discrete collection named the Oklahoma Opioid Litigation Documents. These documents included clinical trial reports, witness declarations, internal corporate communications and marketing strategies regarding opioids, and served as the primary data source for the study.

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Are there gendered trends in research authorship at Evidence & Policy?

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William L. Allen, Associate Editor

Gender differences in academic publications: why it matters

Across fields, there are concerns about the extent to which gender disparities exist in academic journal publications. Several studies of professional social science—including in economics, political science, and sociology—indicate women remain underrepresented in the pages of top journals. Inequalities in this regard may be particularly consequential because peer-reviewed publications remain one of the most important factors that contribute to success in applications for academic jobs, promotions, and grants.

While there are several reasons for this pattern, including authors’ perceptions of where their kinds of work are more likely to be favorably received, the simple fact of its presence has been enough motivation for some journal editorial teams to explicitly measure and report on the gender breakdown of both submissions and published work where possible.

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Evidence informed ‘evidence informed policy and practice’

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David Gough, Chris Maidment and Jonathan Sharples

This blog post is based on the Evidence & Policy article, ‘Enabling knowledge brokerage intermediaries to be evidence-informed.’

Research evidence can be useful (alongside lots of other information) in informing policy, practice and personal decision making. But does this always happen? It tends to be assumed that if research is available and relevant then it will be used in an effective self-correcting ‘evidence ecosystem’, but in many cases the ‘evidence ecosystem’ may be dysfunctional or not functioning at all. Potential users may not demand relevant evidence, not be aware of the existence of relevant research, or may misunderstand it use and relevance.

Knowledge brokerage intermediary (KBIs) agencies (such as knowledge clearinghouses and What Works Centre) aim to improve this by enabling the engagement between research use and research production. We believe that KBIs are essential innovations for improving research use. In this blog, we suggest four ways that they might be further developed by having a more overt focus on the extent that they themselves are evidence informed in their work, as we explore in our Evidence & Policy article.

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The role of intermediaries in evidence-based policymaking: insights from the education system in Israel

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Barak Ariel and Hagit Sabo-Brants

This blog post is based on the Evidence & Policy article, ‘Building bridges in place of barriers between school practitioners and researchers: on the role of embedded intermediaries in promoting evidence-based policy’.

The Israeli education system provides insights into the importance of intermediaries in evidence-based policymaking. Effective intermediaries can bridge the gap between research and practice by fostering collaboration and facilitating knowledge transfer between researchers, policymakers, and practitioners. The ideal intermediary should have the respect of both researchers and practitioners and a comprehensive understanding of both worlds. Practitioners should be involved in selecting and implementing intermediaries to meet their needs. Applying intermediaries in policymaking can result in more efficient and effective policies that benefit researchers and practitioners.

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