This article is part of the supplement: SUPPORT Tools for evidence-informed health Policymaking (STP) .

Guide

SUPPORT Tools for evidence-informed health Policymaking (STP) 5: Using research evidence to frame options to address a problem

John N Lavis¹ , Michael G Wilson² , Andrew D Oxman³ , Jeremy Grimshaw⁴ , Simon Lewin⁵ and Atle Fretheim⁶

¹  Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, and Department of Political Science, McMaster University, 1200 Main St. West, HSC-2D3, Hamilton, ON, Canada L8N 3Z5

²  Health Research Methodology PhD Program and Department of Clinical Epidemiology and Biostatistics, 1200 Main St. West, HSC-2D1 Area, Hamilton, ON, Canada L8N 3Z5

³  Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway

⁴  Clinical Epidemiology Program, Ottawa Health Research Institute, Administration Building, Room 2-017, 1053 Carling Ave., Ottawa, ON, Canada K1Y 4E9

⁵  Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway; Health Systems Research Unit, Medical Research Council of South Africa

⁶  Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway; Section for International Health, Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo, Norway

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Health Research Policy and Systems 2009, 7(Suppl 1):S5doi:10.1186/1478-4505-7-S1-S5

Published:	16 December 2009

Abstract

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers.

Policymakers and those supporting them may find themselves in one or more of the following three situations that will require them to characterise the costs and consequences of options to address a problem. These are: 1. A decision has already been taken and their role is to maximise the benefits of an option, minimise its harms, optimise the impacts achieved for the money spent, and (if there is substantial uncertainty about the likely costs and consequences of the option) to design a monitoring and evaluation plan, 2. A policymaking process is already underway and their role is to assess the options presented to them, or 3. A policymaking process has not yet begun and their role is therefore to identify options, characterise the costs and consequences of these options, and look for windows of opportunity in which to act. In situations like these, research evidence, particularly about benefits, harms, and costs, can help to inform whether an option can be considered viable. In this article, we suggest six questions that can be used to guide those involved in identifying policy and programme options to address a high-priority problem, and to characterise the costs and consequences of these options. These are: 1. Has an appropriate set of options been identified to address a problem? 2. What benefits are important to those who will be affected and which benefits are likely to be achieved with each option? 3. What harms are important to those who will be affected and which harms are likely to arise with each option? 4. What are the local costs of each option and is there local evidence about their cost-effectiveness? 5. What adaptations might be made to any given option and could they alter its benefits, harms and costs? 6. Which stakeholder views and experiences might influence an option's acceptability and its benefits, harms, and costs?