This series of 18 articles describes processes for ensuring that relevant research is identified, appraised and used to inform decisions about health policies and programs. The tools were written for people responsible for health policy decision-making (e.g., health system managers and policy-makers) and for those who support them.

CHSRF worked in partnership with the SUPPORT Project to bring you the French version of this series. SUPPORT is an international collaboration network that provides training and support to encourage researchers and policy-makers in collaborative policy-relevant research.

A book version of SUPPORT Tools for evidence-informed health Policymaking (STP) is also available.

Support Tools

Dealing with insufficient research evidence

by Andrew D Oxman, John N Lavis, Atle Fretheim, Simon Lewin | Dec 16, 2009

Full text | PDF


In this article, we address the issue of decision making in situations in which there is insufficient evidence at hand. Policymakers often have insufficient evidence to know with certainty what the impacts of a health policy or programme option will be, but they must still make decisions.

We suggest four questions that can be considered when there may be insufficient evidence to be confident about the impacts of implementing an option. These are:

  1. Is there a systematic review of the impacts of the option?
  2. Has inconclusive evidence been misinterpreted as evidence of no effect?
  3. Is it possible to be confident about a decision despite a lack of evidence?
  4. Is the option potentially harmful, ineffective or not worth the cost?