1. Rapid reviews to support clinical priority setting decisions Dr Vivek Muthu Medical Director, Bazian Ltd King’s Fund, London 17 th July 2006

2. 1 May, 20152 Questions to answer today -Why do we need knowledge support for commissioning? -What does knowledge support really mean? -What effects does it have on commissioning? -What is the role of the librarian in all of this?

3. 1 May, 20153 The big picture ̶The end of affordable, equitable healthcare could be around the corner ̶Fortunately, there is a way out; thanks to knowledge support

4. 1 May, 20154 Why? FromTo It increases 5 year survival by 3.5%. Side effects are uncertain. It costs an extra £5,000. What is the best policy for all our patients, given these facts? No. They shouldn’t. Everyone should have it.

5. 1 May, 20155 True knowledge support: A transforming effect… FromTo Decisions made in ignorance of fundamental facts Adversarial contests Focus on entrenched positions Fragile policies Unsustainable, suboptimal healthcare Decisions that are properly informed Negotiated agreements Focus on shared interests Robust policies Affordable, optimal healthcare

6. 1 May, 20156 What is true knowledge support? Evidology n. [Latin: videre to discern, comprehend; evidere to appear plainly] A new medical specialty that enables scientific research to be incorporated systematically into healthcare decisions

7. 1 May, 20157 A new medical specialty…. Radiology   Outpatients Evidology  Occupational Health 

8. 1 May, 20158 Why is evidology a specialty? Not this…But this… A librarian working on his/her own Search and delivery of research papers A summary of papers’ conclusions Expectation that user will interpret An optional service that enquirers use at their discretion A helpful service A collaborative, multidisciplinary service Engagement and consultation Critical appraisal of methods Written interpretive reports An essential step in decision- making An accountable service

9. 1 May, 20159 Vs.

10. 1 May, 201510 Case study: brachytherapy Consultative question setting EB search (validated and reproducible) Critical appraisal Detailed analysis and interpretation User-friendly reporting

11. 1 May, 201511 The result… ̶A truly evidence-based, rigorous, transparent, duly diligent decision making process ̶One that saves time, saves money, emotional energy ̶A robust, defensible, well-accepted policy decision

12. 1 May, 201512 Summary ̶True knowledge support is a medical specialty: evidology ̶Evidology is here to stay ̶Librarianship is necessary but not sufficient (evidology is a multidisciplinary specialty)

13. 1 May, 201513 Thank you