Evidence Reviews

Whether commissioning healthcare or public health services, or treating individual patients, it is paramount that decisions made by commissioners or healthcare professionals about future services or interventions are based on recent relevant evidence. It is also vital that the evidence used is robust and trustworthy.

Health Evidence Matters is skilled and experienced in the provision of rapid evidence reviews to help guide decisions and practice across a wide variety of settings including NHS secondary care and primary care CCGs; public health teams; local authorities and third sector organisations .

There are several types of reviews that Health Evidence Matters can provide and in all cases, the company will work with you to ensure that your precise information need is clarified and met. This includes:

  • Working with you to frame and scope an appropriate question(s) to be addressed; drilling down perhaps a broad information need to precisely identify your specific populations/problems, interventions and outcomes about which you need information
  • Comprehensively searching a wide-range of evidence sources to identify the most relevant evidence for your information need
  • Critically appraising and synthesising the evidence including appraising the methodology and methods, the clinical and statistical significance and limitations of the evidence, and summarising the degree of certainty we can have in its findings

Exceptional/Individual Funding Requests (EFR/IFR)

Christina has over 9 years experience of writing evidence reviews to help EFR panels make decisions about funding. She also has over 6 years experience of being an EFR panel public health member. She fully understands the EFR process, what exceptionality to a given policy means and what "potential to benefit" means.

A rapid evidence review can be provided in response to an EFR from a clinician which not only appraises the evidence of effectiveness of the proposed intervention for the condition but also addresses issues such as:

  • summary of condition
  • summary of proposed intervention
  • the standard treatment pathway for this condition
  • where this patient is on that pathway – whether it has been completed and whether standard treatment is unavailable/inaccessible for this patient for some reason
  • the size of the cohort of patients who could also benefit from the proposed intervention
  • where this patient sits within the cohort in terms of severity
  • identification of issues in the clinical detail that indicates that this patient may have a greater potential to benefit than other cohort members
  • if there is a policy, identification of issues that may indicate exceptionality to that policy
  • how do the costs of this compare with costs of what will happen if not funded
  • safety/adverse events

An EFR evidence review does not attempt to definitively advise on exceptionality, but does provide comprehensive information for panel members to make a fully-informed, robust, rational decision about the case which is defensible in case of challenge.

 

Drug Formulary Requests

Christina has worked with Medicines Management teams for over 7 years, writing rapid evidence reviews which provide an ethical framework for decision-making that not only appraise the evidence of the clinical and cost-effectiveness of the proposed intervention for a particular condition but also address issues such as:

  • summary of proposed intervention
  • health needs of patients and condition including a definition of the specific patient group; anticipated outcomes; standard care/ available alternatives; health impacts and prognosis for this condition in this group; number of people affected
  • relevant evidence-derived and consensus-derived professional guidance; other local policies and drug formulary decisions
  • the needs of the community, including, where relevant, potential impact on population health, reduction of health inequalities, equitable healthcare and patient choice

Each review also contains a summary of any remaining questions, unresolved issues or areas of uncertainty the decision-makers may need to consider

 

Clinical policy development; Service development support

Christina has worked with commissioners of services for 9 years. She has provided rapid evidence reviews to inform and support for example commissioning policies for INNF, decisions about service developments or decisions about disinvestment.

Each setting, scenario or case is different. Health Evidence Matters will work with you to ensure that a tailored, customised review is conducted, which meets your precise information needs. This will help to ensure that all decisions about future practice and investment are based on robust evidence.