Article type
Abstract
"Background:
KNOW ESSENTIALS is a validated tool [1] to facilitate evidence-informed, locally appropriate, healthcare decision-making, by diverse stakeholders (professionals, policy-makers, payers, or public).
Objective:
To describe the KNOW ESSENTIALS tool, its strengths for robust healthcare decision-making in diverse settings, and its limitations.
Methods and Results:
KNOW ESSENTIALS is an acronym for various facets needed for evidence-based decisions. The tool starts with an analysis of the problem, based on three cardinal criteria viz. (i) KN=Knowledge of need determined by examining the evidence on the problem (local epidemiology, consequences, public health significance vis-à-vis other needs, and robustness of local data); (ii) O=Outcome of interest from the perspective of the specific stakeholder(s) using the tool; and (iii) W=Who is the target of the proposed intervention.
The next four Major criteria include E=Evidence of effectiveness (or at least efficacy) of the intervention(s) in the same or similar population/setting); S=Safety data in terms of known and anticipated short and long term events; S=Social considerations in terms of inhibitory or faciliatory ethical, legal or social issues (ELSI) to the health-care recipient, provider and/or society; and (iv) E=Economic issues (determined through formal or informal cost considerations and/or cost-effectiveness analysis).
The other criteria are N=Novelty bias (that often tilts decisions in favour of novel interventions; T=Time to outcome of interest (especially relevant for public health and/or policy decisions); I=Integration (of the intervention and its delivery with/within the existing services); A=Alternate options (to address the problem, and their limitations); L=Likely impacts of deciding in favour or against the intervention; and S=Sustainability.
Decision-making steps: Explore if there is sufficient information on the cardinal criteria. If yes, proceed to the Major criteria. The Major and Other criteria are coded green, red, or yellow (indicating the level of confidence in the available evidence). Subjective and objective judgements can be added to facilitate decision-making.
Conclusion:
The KNOW ESSENTIALS tool can facilitate evidence-based decision-making starting from analysis of the problem (rather than solution/intervention). It can be used by diverse stakeholders even with limited prior expertise.
References
[1] Mathew JL. Int J Tech Assess Health Care 2011; 27: 139-150.
"
KNOW ESSENTIALS is a validated tool [1] to facilitate evidence-informed, locally appropriate, healthcare decision-making, by diverse stakeholders (professionals, policy-makers, payers, or public).
Objective:
To describe the KNOW ESSENTIALS tool, its strengths for robust healthcare decision-making in diverse settings, and its limitations.
Methods and Results:
KNOW ESSENTIALS is an acronym for various facets needed for evidence-based decisions. The tool starts with an analysis of the problem, based on three cardinal criteria viz. (i) KN=Knowledge of need determined by examining the evidence on the problem (local epidemiology, consequences, public health significance vis-à-vis other needs, and robustness of local data); (ii) O=Outcome of interest from the perspective of the specific stakeholder(s) using the tool; and (iii) W=Who is the target of the proposed intervention.
The next four Major criteria include E=Evidence of effectiveness (or at least efficacy) of the intervention(s) in the same or similar population/setting); S=Safety data in terms of known and anticipated short and long term events; S=Social considerations in terms of inhibitory or faciliatory ethical, legal or social issues (ELSI) to the health-care recipient, provider and/or society; and (iv) E=Economic issues (determined through formal or informal cost considerations and/or cost-effectiveness analysis).
The other criteria are N=Novelty bias (that often tilts decisions in favour of novel interventions; T=Time to outcome of interest (especially relevant for public health and/or policy decisions); I=Integration (of the intervention and its delivery with/within the existing services); A=Alternate options (to address the problem, and their limitations); L=Likely impacts of deciding in favour or against the intervention; and S=Sustainability.
Decision-making steps: Explore if there is sufficient information on the cardinal criteria. If yes, proceed to the Major criteria. The Major and Other criteria are coded green, red, or yellow (indicating the level of confidence in the available evidence). Subjective and objective judgements can be added to facilitate decision-making.
Conclusion:
The KNOW ESSENTIALS tool can facilitate evidence-based decision-making starting from analysis of the problem (rather than solution/intervention). It can be used by diverse stakeholders even with limited prior expertise.
References
[1] Mathew JL. Int J Tech Assess Health Care 2011; 27: 139-150.
"