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| Health Evidence | |
|---|---|
| Name | Health Evidence |
| Field | Public health, Medicine, Epidemiology |
| Related | World Health Organization, Centers for Disease Control and Prevention, National Institutes of Health |
Health Evidence
Health Evidence refers to systematically gathered information used to inform decisions in World Health Organization policy, United States Department of Health and Human Services, National Institutes of Health research, Centers for Disease Control and Prevention programs and clinical care in institutions like Mayo Clinic, Johns Hopkins Hospital and Massachusetts General Hospital. It underpins guidelines from bodies such as the U.S. Preventive Services Task Force, National Institute for Health and Care Excellence and professional associations including the American Medical Association and American College of Physicians, and informs responses to events like the COVID-19 pandemic and the Ebola virus epidemic in West Africa.
Health Evidence encompasses primary data from studies conducted at sites such as Harvard Medical School, Stanford University School of Medicine, and Imperial College London, administrative records from systems like Medicare (United States), and surveillance data from agencies like the European Centre for Disease Prevention and Control and Public Health England. It spans clinical outcomes measured in trials at Cleveland Clinic and observational cohorts like the Framingham Heart Study, as well as economic assessments used by organizations such as the Organisation for Economic Co-operation and Development. The scope includes evidence for interventions evaluated in trials such as Randomized controlled trials, observational analyses exemplified by work at Johns Hopkins Bloomberg School of Public Health, and implementation research undertaken by groups like the Bill & Melinda Gates Foundation.
Primary sources include randomized trials published in journals like The Lancet, The New England Journal of Medicine, and JAMA, cohort studies from centers such as Framingham Heart Study and Nurses' Health Study, and case series from hospitals like Mount Sinai Hospital. Secondary sources encompass systematic reviews from entities such as the Cochrane Collaboration, meta-analyses appearing in BMJ, and guidelines from National Institute for Health and Care Excellence and U.S. Preventive Services Task Force. Surveillance and administrative sources consist of datasets from World Health Organization repositories, Centers for Disease Control and Prevention surveillance networks, and national registries like the United Kingdom Biobank. Other sources include qualitative evidence produced by teams at institutions like London School of Hygiene & Tropical Medicine and modeling studies from groups such as Imperial College London.
Randomized controlled trials conducted at organizations like Dana-Farber Cancer Institute and crossover designs used in research at Vanderbilt University Medical Center generate high-level causal evidence. Observational methods—cohort studies exemplified by Framingham Heart Study, case-control designs used in investigations at Karolinska Institutet, and ecological analyses from groups at World Bank research units—provide real-world insights. Diagnostic accuracy studies from laboratories like Mayo Clinic Laboratories and prognostic modeling performed by teams at Johns Hopkins University use biostatistical approaches developed in conjunction with entities such as the American Statistical Association. Implementation science methods applied by researchers at University of California, San Francisco and mixed-methods studies from University College London integrate quantitative and qualitative techniques.
Quality appraisal employs tools like the Cochrane Risk of Bias Tool, the GRADE approach promoted by networks including the GRADE Working Group, and reporting standards such as CONSORT for trials and STROBE for observational studies. Systematic review centers at McMaster University and University of Oxford apply critical appraisal checklists to studies from journals like The Lancet and The New England Journal of Medicine. Regulatory agencies such as the European Medicines Agency and Food and Drug Administration assess evidence quality for approvals, while health technology assessment agencies like National Institute for Health and Care Excellence use economic models to judge cost-effectiveness.
Evidence synthesis methods include meta-analysis techniques formalized in works by researchers associated with Cochrane Collaboration and statistical methodology developed at London School of Hygiene & Tropical Medicine. Guideline development follows procedures used by World Health Organization, U.S. Preventive Services Task Force, and specialty societies like the American Heart Association and American Diabetes Association, incorporating systematic reviews and stakeholder input from organizations such as the Patient-Centered Outcomes Research Institute. Implementation of guidelines has been studied in trials at institutions including Massachusetts General Hospital and evaluated by policy bodies like the Organisation for Economic Co-operation and Development.
Clinicians in settings such as Mayo Clinic and Cleveland Clinic apply evidence to individual patient care using decision aids endorsed by Agency for Healthcare Research and Quality. Public health authorities like Centers for Disease Control and Prevention and Public Health England translate evidence into vaccination policies exemplified by programs using Measles vaccine and pandemic responses to H1N1 influenza pandemic. Health systems such as Veterans Health Administration implement evidence-based pathways, while global health initiatives funded by Bill & Melinda Gates Foundation and coordinated by World Health Organization adapt evidence for low-resource settings like those studied by Doctors Without Borders.
Challenges include publication bias identified in journals like The Lancet and selective reporting scrutinized by bodies such as the European Medicines Agency; conflicts of interest involving stakeholders like pharmaceutical companies exemplified by cases reviewed by U.S. Department of Justice; and generalizability issues from trial populations at centers like Johns Hopkins Hospital to diverse settings such as those in Sub-Saharan Africa. Methodological limitations arise from residual confounding in observational studies from institutions including Harvard T.H. Chan School of Public Health, small-sample trials at single centers like Ben-Gurion University Medical School, and heterogeneity in meta-analyses synthesized by Cochrane Collaboration. Addressing these requires transparency promoted by registries like ClinicalTrials.gov, open data initiatives supported by organizations such as Wellcome Trust, and methodological advances pioneered at universities like University of Oxford.