The Foundation's Decision Support Synthesis program aims to contribute the best available evidence to decision-making in a particular policy or management context. Decision support syntheses are driven by the information needs of decision makers and produce recommendations for policy and management through a deliberative process that involves key stakeholders. These syntheses incorporate different types and sources of evidence, including research results and promising practices.

What is a decision support synthesis?

Decision support syntheses are distinct from knowledge support syntheses. Knowledge support syntheses summarize the research evidence and strive for greater general applicability and contribution to the knowledge pool. Cochrane-style systematic reviews are examples of high quality knowledge support syntheses. Decision support syntheses, on the other hand, include summarizing evidence as well as other tasks required to support decision-making in a particular context, such as determining recommendations for action and considering factors relevant to implementing change.

What is the Foundation's Decision Support Synthesis program?

The Decision Support Synthesis program:

  • answers system-driven needs by determining the question through decision-maker consultation;
  • recognizes multiple types of evidence;
  • includes implications and recommendations for management and/or policy; and
  • has linkage and exchange between researchers and decision makers throughout the process, particularly for determining recommendations.

What funds are available in the Decision Support Synthesis program?

Beginning in 2007, the Foundation allots up to $260,000 per year for the Decision Support Synthesis program. Required matching funds of at least 1:1 (cash and/or in-kind) from co-sponsor organizations enables up to four syntheses at $130,000 each to be funded each year. These funds are for a one year program of work that includes the synthesis of the scientific evidence by a research team and two roundtable meetings with key stakeholders.

Decision support syntheses are largely funded within the Foundation's priority research themes. However, there is some flexibility outside these theme areas to enable the Foundation to be responsive to other important system needs as they arise.

What is the process for producing a decision support synthesis?

A framework outlines the Foundation's process for producing a synthesis report targeted at health system managers and policy makers. The framework is made up of eight iterative key stages with several related activities and presents different options and considerations to take into account during the stages. It was developed primarily for Foundation staff, but it may also be used as a guide to others interested in doing or funding syntheses.

What are other Foundation-funded syntheses?

Between 1998 and 2006, the Foundation funded eight syntheses under its former Policy Synthesis program.

Going forward, the Foundation is committed to funding an increasing number of decision support syntheses. It is using this opportunity to experiment with different aspects of this synthesis framework, to test the validity and value of different approaches and, hence, to help establish best practices.

Background

The Decision Support Synthesis program was developed taking into account:

  • experience commissioning eight syntheses;
  • environmental and literature scans;
  • results of three research papers and four associated commentaries from decision makers on the methods of synthesis, commissioned by the Foundation through its Commissioned Research program, in partnership with the NHS Service Delivery and Organisation Research and Development Program, which were published in the Journal of Health Services Research & Policy;
  • the results of a systematic review considering the types of evidence and deliberative processes;
  • recent publications - empirical and conceptual - on the science of synthesis; and
  • outcomes of consultation activities with researchers and decision makers.

Some of these lessons include:

  • Flexibility: A synthesis framework should be flexible enough that it is possible to answer different types of questions, each of which might need different methods, have different audiences, different products and dissemination activities, etc.
  • Aim: When doing a synthesis, it is important to determine from the outset if it is a synthesis for knowledge support - summarizing the scientifically collected evidence - or decision support, which includes the analysis and processes required to contribute recommendations to decision-making in a particular policy or management context.
  • Decision-maker involvement: The more a synthesis aims to contribute to a particular decision, the more managers and policy makers will need to be closely involved in the process.
  • Evidence: Syntheses can combine different types of scientific evidence with colloquial evidence; however, the latter should be considered a complement to the former, not an equal.
  • Recommendations: The articulation of meaningful recommendations for managers and policy makers is an important element in a decision support synthesis.
  • Research use: Factors such as interactions between researchers and healthcare policy makers and timeliness appear to increase the prospects for research use among policy makers. On the other hand, other factors, such as an individual's negative attitudes towards research evidence and lack of skills and expertise, decrease the prospects for research use by policy makers.
  • Dissemination: Methods of communicating results of syntheses should be tailored to the various, specific audiences.
  • Experimentation: The time is ripe to experiment with different synthesis models, to test the validity and value of different approaches, and to establish best practices.