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Art.  The science of science advice  The European context: European Science Advisory Network for Health  Improving Science Advice project (EuSANH.

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Presentation on theme: "Art.  The science of science advice  The European context: European Science Advisory Network for Health  Improving Science Advice project (EuSANH."— Presentation transcript:

1 Art


3  The science of science advice  The European context: European Science Advisory Network for Health  Improving Science Advice project (EuSANH – ISA)  Future perspectives

4  Progress  average life expectancy in developed countries: by about 25 years in 20th century  (health related) quality of life >>  Remaining and new issues  social gradients, ageing, mental health, food and nutrition, lifestyle, environment, quality of care  infectious diseases  opportunities/risks new technologies  ethical implications

5  Increasing knowledge implies new opportunities, but also higher responsibility  International dimension of problems and knowledge  Culture of justification, accountability, and transparency  Increased expectations/demands from the public: predictable effect, no-risk  Public interest groups  Media pressure  Time pressure  Longterm impact  shortterm policies


7 Thomas Stearns Eliot (1888 – 1965): Where is the life we have lost in living, Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? (Chorus from the rock)


9 Science advice: recommendations for policy based on knowledge, considering also expert judgment, ethical and societal aspects,and ‘experience expertise’

10 Important study subject per se  Priority, relevance, impact, evaluation  Quality and reproducibility (ceteris paribus, mutatis mutandis)  International standard development  Common methodological basis (compare EBM, Cochrane, HTA)

11  Origin  External (government agency, parliament, researchers, professionals, public/patients)  Internal  Motive  Uncertainty over best policy  Public credibility  Conflict resolution

12 As science itself, science advice can (should) only be convincing when based on solid methodology


14 - A clear question - An appropriate working method - expertise (quality and composition committee) - evidence base (literature - quantitative, qualitative), investigations, - analysis: SR/MA & appraisal, HTA, expert judgment, ethical analysis, context - experience expertise, stakeholder involvement/consultation - reaching conclusions/recommendations/options

15  Committee: the best experts in the field of interest  Multidisciplinarity, balance  Authority committee chair  Volunteer participation; no honorarium  Independence and integrity, disclosure of interests  Skill and experience of the Staff  Independent peer review (internal, external)


17  Adequacy of funding  Timeliness (product differentiation)  Relation to policy makers and politics (content and progress)  Communication/dissemination  Implementability  implementation  Evaluation  Transparency


19 (IOM)

20 It is easy to lie with statistics. It is even easier to lie without them. Frederick Mosteller

21 It is easy to make bad policy with science. It is even easier to make bad policy without science. Harvey Fineberg

22  Policy makers  Health professionals  Public  Business and civic leaders  Patient interest groups  Educators and researchers  Others



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26  Science has longterm scope  Good science has shown to be effective in history  Science advice  not to reproduce straightforward research results (e.g., RCTs on singular treatment effects)  should focus on more complex issues, uncertainties, disagreement

27  Science is international by definition  Many public health problems are border crossing  In EU, with ever intensifying interactions in addition to national approaches, increasing international dimensions

28  Complexity of problems  Cumulation of knowledge  Scarcity of expertise  Limited resources  Quality optimisation  international exchange, sharing, & collaboration easier when methods have commons basis

29 ‘ The commission in general and DG Sanco in particular attach high importance to the use of sound science to underpin its work, and strive therefore to ensure that its scientific advice is of the highest quality.’ ‘… make the best use of external experts and benefit from the enormous reservoir in the Community and beyond.’ (Sanco DG Robert Madelin, 2004)

30  Combining (scarce) expertise, efforts and resources in the field of science advice: quality, effectiveness/efficiency, coverage  To promote evidence informed policy making at the national and European level  With the objective to improve the health of the population  Target groups: policy makers, professionals, other stakeholders, the public

31 Statutory Advisory bodies Permanent Advising to government/parliament Independent Broad scope 13 MS currently involved


33  e.g., ageing, lifestyle issues diabetes, obesity, population screening, cost- effectiveness/benefit questions

34  Pan/epi-demics  air quality  food safety  healthcare infrequent disorders/treatments extensive infrastructure for treatment (e.g., heart transplantation in young children)  comparative analysis health system performance health disparities

35  Cultural and ethical diversity  Socio-economic health differences  Antibiotic resistence  Organ donation  Primary care orientation

36 Life expectancy women, at birth EU-25 France Hungary Poland UK EU-15 Italy Netherlands Portugal Sweden

37  Exchanging/sharing scientific knowledge and expertise  Complementarity of working programmes  Sharing expertise in collaborative advisory committees  Joint advisory reports  National governments  European bodies Level of co- opera- tion

38 The Directorate General Research -launched an e-Network to make scientific advice more available at the EU and national level: SINAPSE (Scientific Information for Policy Support in Europe). - keen to support initiatives to strenghten science-based policy making

39  Variety of topics but also overlap  Many reports not available in English  Method:  Variety of methods: not always explicit justification  Evidence, expert judgment and experience  Existing evidence and/or additional surveys  Stakeholders and peer review not always mentioned  Recommendations for implementation need more attention  Procedures to safeguard independence not always mentioned

40 Improving Science Advice for Health in Europe To improve quality, effectiveness and efficiency of science advice for health across Europe  Current status in EuSANH member countries; thematic analysis of reports from each participant country.  Common ‘best practice’ methodology for science advice  Communication and co-operation structure for the expanding network, using the SINAPSE e-communication tool.  Test the common methodology and the network by developing in a case study for a European report.  Internal and external diss emination of results


42  Globalize the evidence localize the decision (John M Eisenberg, Agency for healthcare research and quality US) Health Aff (Millwood) 2002; 21: 166-8)  Proportionality and subsidiarity: what advice on national level, between individual states, or EU level ?

43  Cross-border scientific advice to bridge gaps  in the field of science and health  between science and policy  to guide policy makers to anticipate rather than be reluctant  EuSANH to be a generally recognised source for independent science advice for health in the European policy arena  Complementarity/collaboration other actors  Compare USA: CDC,FDA IOM ECDC, EFSA, EMEA EuSANH

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