Value assessments and considerations are those of a small group of stakeholders, which is often the case in the policy decisionmaking process.
In this age of the ascendancy of health outcomes research, where statistical analysis dominates health policy decisionmaking, "evidence" is tantamount to measure and not meaning.
As a support for policy decisionmaking, the framework was field-tested with the reimbursement advisory committee of a private health plan in South Africa using a cervical cancer screening tool as a case study [ 24].
Cost-effectiveness analysis (CEA), an economic method that aims to maximize efficiency, is the paradigm that currently dominates many healthcare policy decisionmaking processes.
Indeed, the proposal is broadly sympathetic to proposals for community-based participatory research, but would seek to extend its scope to specialized care delivery, expand its aims in terms of patient involvement in policy advocacy and institutional decisionmaking, and ideally try to promote partnership between community health practices and academic medical centers.
To a degree, adaptive policy tools #3 and #4 can be used toward this purpose, but most directly, such autonomous tools include: (#5) enabling self-organization and social networking; (#6) decentralizing decisionmaking to the lowest and most effective jurisdictional level; and (#7) promoting variation in policy responses.
By contributing to a better-informed patient community more active in policy advocacy and the management of their care, and with more options and resources for communicating and collaborating with patient advocates in decisionmaking roles the present proposal would thus advance the ISSCR's goal of fostering a more inclusive public discussion with a greater influence on policy outcomes.
The EVIDEM framework was field-tested in the private healthcare sector of South Africa with a clinical policy and decisionmaking committee of a major health plan.
The panel was designed to include relevant stakeholders, with a focus on experts in the disease to explore relationships between policy and clinical decisionmaking.
It follows that mistakes were made in the decisionmaking at the time by both the Leicestershire police in 2002 and the CPS in 1991 and 2007.
