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Making policy when the evidence is in dispute
David Atkins1, Joanna Siegel, Jean Slutsky
1Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland, USA. datkins@ahrq.gov
Health Affairs (Project Hope)
|January 14, 2005
Summary
Navigating medical policy debates requires distinguishing scientific evidence from differing values. This study offers a framework and questions to clarify disagreements in complex health policy issues.
Area of Science:
- Health policy analysis
- Medical decision-making
- Scientific communication
Background:
- Policymakers face challenges with medical issues marked by intense scientific debate.
- Many debates stem from conflicting values and perspectives, not just evidence disagreements.
Purpose of the Study:
- To summarize factors underlying recent medical policy debates.
- To outline questions that help separate evidence from values in policy discussions.
- To illustrate a framework for clarifying agreement and disagreement in policy debates.
Main Methods:
- Analysis of common factors in scientific policy debates.
- Development of a question-based framework to distinguish evidence from values.
- Application of the framework to four case studies: prostate-specific antigen (PSA) screening, high-dose chemotherapy for breast cancer, antibiotic therapy for otitis media, and newborn hearing screening.
Main Results:
- Identified common underlying factors in scientific policy debates.
- Proposed a structured approach to differentiate evidence-based questions from value-based considerations.
- Demonstrated the utility of the framework in clarifying complex medical policy disputes.
Conclusions:
- A systematic approach can disentangle evidence and values in medical policy debates.
- Clarifying these distinctions aids in understanding areas of agreement and disagreement.
- This framework supports more informed and productive policy discussions on contentious medical issues.