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Uso de la evidencia en las recomendaciones de la OMS
Andrew D Oxman1, John N Lavis2, Atle Fretheim1
1Norwegian Knowledge Centre for the Health Services, PO Box 7004, St Olavs plass, N-0130 Oslo, Norway.
Lancet (London, England)
|May 12, 2007
Resumen
Las recomendaciones de la Organización Mundial de la Salud (OMS) rara vez utilizan revisiones sistemáticas, confiando en su lugar en la opinión de expertos. Mejorar el desarrollo de recomendaciones requiere liderazgo, recursos y atención a la literatura de investigación.
Área de la Ciencia:
- Salud Pública La salud pública.
- Política de salud Política de salud
- Práctica basada en la evidencia.
Sus antecedentes:
- Los reglamentos históricos de la OMS (1951) priorizaron la opinión de expertos para las recomendaciones.
- Las directrices actuales de la OMS (2003) hacen hincapié en las revisiones sistemáticas y las estrategias basadas en la evidencia.
- Existe una brecha entre las directrices establecidas y la práctica real en el desarrollo de recomendaciones de la OMS.
Objetivo del estudio:
- Examinar la utilización de la evidencia, específicamente la evidencia de efectos, en las recomendaciones departamentales de la OMS.
- Evaluar la alineación entre las directrices establecidas por la OMS y sus procesos de desarrollo de recomendaciones.
Principales métodos:
- Entrevistas con directores de departamentos de la OMS en la sede de Ginebra.
- Revisión de los informes de recomendación y la documentación de apoyo discutidos durante las entrevistas.
- Análisis independiente de los datos de las entrevistas y la documentación por dos individuos.
Principales resultados:
- Las revisiones sistemáticas y los hallazgos resumidos rara vez se emplean en el desarrollo de recomendaciones de la OMS.
- El desarrollo de recomendaciones se basa principalmente en expertos especializados, no en usuarios finales o expertos metodológicos.
- Las prácticas actuales se desvían significativamente del enfoque basado en la evidencia descrito en las directrices de la OMS.
Conclusiones:
- Avanzar en el desarrollo, adaptación e implementación de las recomendaciones de la OMS requiere un fuerte liderazgo.
- Los recursos adecuados son cruciales para los procesos de recomendación transparentes y defendibles.
- El compromiso continuo con la literatura de investigación actual y emergente es vital para mejorar las estrategias de recomendación de la OMS.
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