evidencetodecisions

Clinicians, patients, guideline developers, and policymakers sometimes neglect important criteria, give undue weight to criteria, and do not use the best available evidence to inform their judgments. Explicit and transparent systems for decision making can help to ensure that all important criteria are considered and that decisions are informed by the best available research evidence. The purpose of Evidence to Decision (EtD) frameworks is to help people use evidence in a structured and transparent way to inform decisions in the context of clinical decisions, coverage decisions, and health system or public health decisions [Alonso-Coello 2016]. They do this by:

• Informing judgements about the pros and cons of each intervention that is considered
• Ensuring that important factors that determine a decision (criteria) are considered
• Providing a concise summary of the best available research evidence to inform judgements about each criterion
• Helping structure thinking and discussion
• Making the basis for decisions transparent to guideline users or those affected by a policy decision

EtD frameworks have a common structure that includes formulation of the question, an assessment of the evidence, and drawing conclusions, though there are some differences between frameworks for each type of decision. EtD frameworks inform users of recommendations (and those affected by policy decisions) about the judgments that were made and the evidence supporting those judgments by making the basis for a recommendation (or policy) transparent. EtD frameworks also facilitate dissemination of recommendations and enable decision makers in other jurisdictions to adopt recommendations or policies, or adapt them to their context.

The interactive EtD (iEtD) tool facilitates use of EtD frameworks. It enables users to:

• Create tailored templates for making decisions or recommendations
• Create tailored templates for publishing elements of EtD frameworks in reports
• Create tailored, interactive summaries for targeted audiences (export versions for different end users)

The iEtD tool facilitates:

• Managing of templates for EtD frameworks
• Filling in of EtD frameworks
• Making judgements and decisions, when relevant voting, and inserting comments and notes
• Publishing of reports, frameworks and selected elements of EtD frameworks
• The use of recommendations by producing interactive presentations for target audiences with, for example, layered reports with links to more information, and hypertext links to explanations