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The need for evidence-based decisions that take account of both effectiveness and economics is greater now than ever. Using case studies and illustrative examples throughout the authors describe how the activities and outputs of evidence synthesis, systematic review, economic analysis and decision-making interact within and across different spheres of health and social policy and practice. Expanding on the first edition the book now covers approaches to evidence synthesis that combine economics and systematic review methods in the applied fields of social welfare, education and criminal just

Public health interventions have unique characteristics compared to health technologies, which present additional challenges for economic evaluation (EE). High quality EEs that are able to address the particular methodological challenges are important for public health decision-makers. In England, they are even more pertinent given the transition of public health responsibilities in 2013 from the National Health Service to local government authorities where new agents are shaping policy decisions. Addressing alcohol misuse is a globally prioritised public health issue. This article provides a systematic review of EE and priority-setting studies for interventions to prevent and reduce alcohol misuse published internationally over the past decade (2006–2016). This review appraises the EE and priority-setting evidence to establish whether it is sufficient to meet the informational needs of public health decision-makers. 619 studies were identified via database searches. 7 additional studies were identified via hand searching journals, grey literature and reference lists. 27 met inclusion criteria. Methods identified included cost-utility analysis (18), cost-effectiveness analysis (6), cost-benefit analysis (CBA) (1), cost-consequence analysis (CCA) (1) and return-on-investment (1). The review identified a lack of consideration of methodological challenges associated with evaluating public health interventions and limited use of methods such as CBA and CCA which have been recommended as potentially useful for EE in public health. No studies using other specific priority-setting tools were identified.

Public health interventions have unique characteristics compared to health technologies, which present additional challenges for economic evaluation (EE). High quality EEs that are able to address the particular methodological challenges are important for public health decision-makers. In England, they are even more pertinent given the transition of public health responsibilities in 2013 from the National Health Service to local government authorities where new agents are shaping policy decisions. Addressing alcohol misuse is a globally prioritised public health issue. This article provides a systematic review of EE and priority-setting studies for interventions to prevent and reduce alcohol misuse published internationally over the past decade (2006–2016). This review appraises the EE and priority-setting evidence to establish whether it is sufficient to meet the informational needs of public health decision-makers. 619 studies were identified via database searches. 7 additional studies were identified via hand searching journals, grey literature and reference lists. 27 met inclusion criteria. Methods identified included cost-utility analysis (18), cost-effectiveness analysis (6), cost-benefit analysis (CBA) (1), cost-consequence analysis (CCA) (1) and return-on-investment (1). The review identified a lack of consideration of methodological challenges associated with evaluating public health interventions and limited use of methods such as CBA and CCA which have been recommended as potentially useful for EE in public health. No studies using other specific priority-setting tools were identified.

Funding: The project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA) Programme (project number 12/35/38). The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no role in considering the study design or in the collection, analysis, or interpretation of data; writing the report; or the decision to submit the article for publication. The views expressed herein are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Acknowledgments Sponsor representative: Pauline Hyman-Taylor (from February 2019), Natalie McGregor (March 2015 to February 2019), Audrey Athlan (from July 2014 to March 2015), Joanne Thornhill (from 2013 to July 2014). Patient and public involvement representative: Rick Walsh, Russel Young. CHaRT Trial Office: Mark Forrest (from 2015), Gladys McPherson (until 2015). CHaRT Trial Office data coordinator: Pauline Garden. Health economists: Eoin Maloney (until 2015), Mehdi Javanbakht (until June 2019).All participants in the trial, staff, and members of the TAGS Investigator Group responsible for recruitment in the clinical centres. ; Peer reviewed ; Publisher PDF

Funding: The project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA) Programme (project number 12/35/38). The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. ; Objective : To determine whether primary trabeculectomy or primary medical treatment produces better outcomes in term of quality of life, clinical effectiveness, and safety in patients presenting with advanced glaucoma. Design : Pragmatic multicentre randomised controlled trial. Setting : 27 secondary care glaucoma departments in the UK. Participants : 453 adults presenting with newly diagnosed advanced open angle glaucoma in at least one eye (Hodapp classification) between 3 June 2014 and 31 May 2017. Interventions : Mitomycin C augmented trabeculectomy (n=227) and escalating medical management with intraocular pressure reducing drops (n=226). Main outcome measures : Primary outcome: vision specific quality of life measured with Visual Function Questionnaire-25 (VFQ-25) at 24 months. Secondary outcomes: general health status, glaucoma related quality of life, clinical effectiveness (intraocular pressure, visual field, visual acuity), and safety. Results : At 24 months, the mean VFQ-25 scores in the trabeculectomy and medical arms were 85.4 (SD 13.8) and 84.5 (16.3), respectively (mean difference 1.06, 95% confidence interval −1.32 to 3.43; P=0.38). Mean intraocular pressure was 12.4 (SD 4.7) mm Hg for trabeculectomy and 15.1 (4.8) mm Hg for medical management (mean difference −2.8 (−3.8 to −1.7) mm Hg; P<0.001). Adverse events occurred in 88 (39%) patients in the trabeculectomy arm and 100 (44%) in the medical management arm (relative risk 0.88, 95% confidence interval 0.66 to 1.17; P=0.37). Serious side effects were rare. Conclusion : Primary trabeculectomy had similar quality of life and safety outcomes and achieved a lower intraocular pressure compared with primary medication. ; Publisher PDF ; Peer reviewed

Acknowledgements This research was supported by the Health Foundation Improvement Science Award (grant number: GIFTS ID 7223 awarded to SP). JMG holds a Canada Research Chair in Health Knowledge Transfer and Uptake. DK's work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund; grant number POIR.04.04.00-00-5CF3/18-00; HOMING 5/2018. We would also like to thank Lauren Basey for optimising the design of our included figure. ; Peer reviewed ; Publisher PDF

Funding Information: This research was supported by the Health Foundation Improvement Science Award (grant number: GIFTS ID 7223 awarded to Sebastian Potthoff). Tracy Finch, Tim Rapley, Sebastian Potthoff, Tom Saunders and Luke Vale are members of the NIHR Applied Research Collaboration North East and North Cumbria ( NIHR200173 ). Luke Vale is also a member of the NIHR Newcastle In Vitro Diagnostics Co-operative, NIHR School for Public Health Research, and Fuse, the Centre for Translational Research in Public Health . The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care . Jeremy M. Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Dominika Kwasnicka's work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund ; grant number POIR.04.04.00-00-5CF3/18-00 ; HOMING 5/2018. We would also like to thank Lauren Basey for optimising the design of our included figure. Funding Information: This research was supported by the Health Foundation Improvement Science Award (grant number: GIFTS ID 7223 awarded to Sebastian Potthoff). Tracy Finch, Tim Rapley, Sebastian Potthoff, Tom Saunders and Luke Vale are members of the NIHR Applied Research Collaboration North East and North Cumbria (NIHR200173). Luke Vale is also a member of the NIHR Newcastle In Vitro Diagnostics Co-operative, NIHR School for Public Health Research, and Fuse, the Centre for Translational Research in Public Health. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Jeremy M. Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Dominika Kwasnicka's work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund; grant number POIR.04.04.00-00-5CF3/18-00; ...

Funder: UK National Institute for Health Research. Open Access funded by Department of Health UK Acknowledgments We thank all the participants for their commitment to the study, Sheila Wallace for updating the systematic review, members of the Trial Steering Committee and members of the Data Monitoring Committee for their valuable guidance. We thank the National Health Service organisations, principal investigators and local research staff who hosted and ran the study at site. We thank the Health Technology Assessment Programme of the UK NIHR for funding the study (no. 11/72/01). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Government Department of Health. A full report of the study30 has been published by the NIHR Library. ; Peer reviewed ; Publisher PDF

Funding: Funding for this work was received from the MRC-NIHR UK Methodology Research Programme in response to an open commissioned call for an effect size methodology state-of-the-art workshop. The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no involvement in study design, collection, analysis, and interpretation of data; reporting; or the decision to publish. ; Peer reviewed ; Publisher PDF

An alliance of researchers lays out a framework for taking decisions based on thinking critically about claims and comparisons. Everyone makes claims about what works. Politicians claim that stop and search will reduce violent crime; friends claim that vaccines cause autism; advertisers claim that natural food is healthy. One group of scientists claims that "deworming" programmes (giving deworming pills to all school children in affected areas) improve school performance and health, calling deworming one of the most potent anti-poverty interventions of our time. Another that deworming does not improve either school performance or health. Unfortunately, people often fail to think critically about the trustworthiness of claims, including policy makers weighing claims made by scientists. Schools do not do enough to prepare young people to think critically 1. So many people struggle to assess the trustworthiness of evidence. As a consequence, they may not make informed choices. To address this deficit, we present here a general tool: Key Concepts for Making Informed Choices (Table 1, with examples in Box 2). We hope scientists and professionals in all fields will use, evolve and evaluate it. The tool was adapted, drawing on the expertise of two dozen researchers, from a framework developed for healthcare 2 (Box 1). Ideally, the Key Concepts for Making Informed Choices should be embedded in education for citizens of all ages. This should be done using learning resources and teaching strategies that have been evaluated and shown to be effective. Trustworthy evidence People are flooded with information. Simply giving them more is unlikely to be helpful unless its value is understood. A recent survey in the UK showed that only about a third of the public trust evidence from medical research; about two-thirds trust the experiences of friends and family 3. Not all evidence is created equal. Yet people often don't appreciate which claims are more trustworthy than others; what sort of comparisons are needed to evaluate ...