Strengthening Evidence-support Systems in a Challenged World

Abstract

The COVID-19 pandemic stimulated new innovations in evidence support and exacerbated long-standing challenges confronting those providing evidence support. To build stronger and more sustainable evidence-support systems, two key issues are important: 1) matching a decision maker’s need to the right combination of forms of evidence; and 2) ensuring updated summaries of the evidence are available when decision-makers need it. This dissertation aims to address both issues by (1) creating a taxonomy of demand-driven types of question for which research could provide insight; (2) building lists of study designs that optimally address each type of question; and (3) producing a theoretical framework to better understand what constitutes a living evidence synthesis, when and how to update them, and their role in the decision-making process.

The first study is a cross-sectional survey targeting units providing evidence support to decision makers to create a demand-driven taxonomy of types of question. The second study is an online Delphi process asking methodological experts to create a list of study designs to answer these questions. Finally, study 3 is a critical interpretive synthesis to create a theoretical framework to understand living evidence syntheses and their role in decision-making processes.

In chapter 2, 29 participants responded the cross-sectional survey, and a taxonomy of 40 demand-driven types of questions structured in the four main decision-making stages was created. In chapter 3, 29 methodological experts participated in the online Delphi process, and consensus was reached for 28 out of the 40 types of questions. Finally, in chapter 4, 152 publications were included, and six thematic categories were found to produce a conceptual framework.

Together, the first two studies provide a way to facilitate the alignment between evidence demand and supply, while the third study helps to clarify the role of living evidence syntheses in decision-making processes.