In the EVPI calculation, it can be estimated how often making the decision based on current evidence could be wrong, and also how many QALYs (and costs) would be lost by choosing the strategy that is expected to be most cost-effective, given current evidence, when in fact one of the other strategies is truly the most cost-effective.
From the reviews on intervention studies no strong evidence based recommendations could be given.
For example, consideration could be given to changing criteria for awarding higher scores for infection control such that achieving higher scores was evidence based and could be feasible for all hospitals.
The failure to promote use of evidence based suturing methods could be viewed as further evidence of a widespread and persistent lack of priority accorded to promote midwifery skills and competencies in perineal management, despite concerns over rising negligence claims for the consequences of poor care [ 8].
Two evidence based solutions that could be applied to improve this are the predefining of hiring criteria and innovations that allow women flexibility in scheduling their working days and years.
As we previously reported, 16 there was also no evidence that the potential heterogeneity and inconsistency across the evidence base could be explained by baseline mean age, baseline mean LDL cholesterol concentration, or publication year.
For some national-level actors, there was an implicit trust that the advice that international partners provide, whether through informal advice or formal guidelines, was based on evidence and could be trusted while at the same time, the need for pilot projects to either test or legitimize the interventions precluded indiscriminate adoption.
Updating the study with more recent data and investigating the 100 mg/day dose (which, as discussed above, seems to be emerging as the likely preferred dose on the current evidence base) could be valuable.
A priori, we decided that an evidence base could be considered sufficient to permit a quantitative estimate if there were at least three studies and also if at least 75% of the included studies had reported effect sizes or had provided sufficient information for the calculation of effect sizes.
