Although the importance of clinical evidence is accepted almost universally, the issue of evidence for public health policy has become increasingly visible only in recent years. The term 'evidence' has traditionally implied scientific evidence or research-based evidence, suggesting that scientific methods alone should be used to obtain the data. The WHO Regional Office for Europe believes that although this position may be acceptable within clinical practice, it is inadequate in the field of public health. The Regional Office feels that it is important to remember that other types of evidence may be valid. These include qualified information, surveys, public and expert opinion, consensus, case studies, etc.

The main aim of the Regional Office is to help assure that staff and programmes use the "best available evidence" in decision-making and in giving advice and recommendations to Member States. A related goal is to assure that the demonstrated links between a potential "intervention", and "improvements" in public health are the main bases for the advice. Realizing the need for a broader and more operational definition of evidence in the field of public health that would capture a broader scope than merely the results of scientific research, the office defines evidence as: ?findings from research and other knowledge that may serve as a useful basis for decision-making in public health and health care?.

The presentation will demonstrate the various ways in which the Regional Office plans to operationalize its evidence policy.

1. The approach of the evidence policy is based upon the fact that the steps to an evidence based approach begin with the policy makers' questions. The questions form the basis to start a dialogue with the policy maker. 2. The methodology and steps for evidence-based work - from defining the policy questions as "answerable" questions, searching, retrieving, interpreting and grading evidence, and developing policy options - all these steps concentrate on giving a focused and transparent response to policy makers' questions. 3. The process of developing policy options and communicating them to decision makers is done via a process of knowledge brokering in the form of country workshops, country focused case studies, evidence syntheses reports, etc.

The presentation will conclude with a summary of the yet-unanswered questions in the field of evidence-based health policy making: 1. How to capture the issue of "context" in developing policy options? 2. What is an appropriate "grading" scale for the grading of non-clinical evidence? 3. What are the best means of knowledge-brokerage to bridge the gap between research and policy making?