Methodological issues on evidence review for public health intervention in Republic of Korea

Article type
Year
Authors
Choi M1, Kim J2, Lee N3, Lyu DH3, Lee SJ3, Kim SY4
1National Evidence-based Healthcare Collaborating Agency (NECA), South Korea
2National Evidence-based Healthcare Collaborating Agency (NECA), South Korea
3National Evidence-based Healthcare Collaborating Agency (NECA), South Korea
4Department of Family Medicine, Hallym University, South Korea
Abstract
Background: Healthcare policy makers need more concrete evidence due to variations of values in public health recommendation. But public health evidence has different characteristics compared to medical or clinical area. There are need to develop a methodology for public health evidence review in Republic of Korea.
Objectives: To establish standard evidence review process for public health recommendation in Korea.
Methods: Firstly, we reviewed previous manuals and methodologies published about evidence-based public health recommendations and guidelines. A committee consists of experts of methodology, health policy consulted to construct contents and process establishing. External review also will be performed for quality of contents. Secondly, we compared 2 quality of evidence methodologies based on our systematic review results on public health intervention.
Results: We have selected common tasks for evidence review, but there were some methodological issues on review process. Population-level intervention has more complexity and heterogeneity than individual level intervention. Also, we have reviewed two grading methodologies (Community Guide and GRADE approach) for evaluating quality of evidence. In case of observation studies, the quality of evidence can be ‘low’ or ‘very low’ to make recommendation by GRADE approach but it can be ‘strong’ according to Community guide. Mainly, this result was related to study design and quality assessment methodology. Lack of local evidence is also another issue on making recommendations.
Conclusion: We found there are some methodological issues to establishing standard evidence review process on public health area. Further research would be needed to compensate the methodological weakness in evidence review process for public health recommendation.