ArticleImplementation science : IS2010
Rationality versus reality: the challenges of evidence-based decision making for health policy makers.
Article in Implementation science : IS, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How contexts and issues influence the use of policy-relevant research syntheses: a critical interpretive synthesis.The Milbank quarterly · 2013Pooled it
- Evaluating the Impact of the Grading and Assessment of Predictive Tools Framework on Clinicians and Health Care Professionals' Decisions in Selecting Clinical Predictive Tools: Randomized Controlled Trial.Journal of medical Internet research · 2020Trial
- Modeling Health Effects of Alternative Treatment Options during Surgical Delay to Inform Prioritization of Surgical Care.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Exploring perspectives of knowledge users about reporting on health equity in observational studies: a qualitative study informing the development of the STROBE-Equity reporting guideline.International journal for equity in health · 2026Article
- How to design decision-support tools for primary healthcare using a human-centred design approach: the processes and experience of PHISICC in three Sub-Saharan countries.BMJ global health · 2026Article
- Deploying projected utility to predict health behaviour in health economics: a quantitative study.Scientific reports · 2025Article
- The what, the when and the how: A qualitative study of allied health decision-maker perspectives on factors influencing the development and implementation of advanced and extended scopes of practice in Australia.The International journal of health planning and management · 2025Article
- Experiences of Indigenous peoples living with pelvic health conditions: A scoping review.PloS one · 2025Article
- Article
- Evidence-based practice models and frameworks in the healthcare setting: a scoping review.BMJ open · 2023Article
- Framing access to essential medicines in the context of Universal Health Coverage: a critical analysis of health sector strategic plans from eight countries in the WHO African region.BMC health services research · 2022Article
- What public health interventions do people in Canada prefer to fund? A discrete choice experiment.BMC public health · 2022Article
- Public Compliance Matters in Evidence-Based Public Health Policy: Evidence from Evaluating Social Distancing in the First Wave of COVID-19.International journal of environmental research and public health · 2022Article
- Persuasive Effects of Message Framing and Narrative Format on Promoting COVID-19 Vaccination: A Study on Chinese College Students.International journal of environmental research and public health · 2021Article
- Evaluation of dialysis centres: values and criteria of the stakeholders.BMC health services research · 2020Article
- Improving recommendations for genomic medicine: building an evolutionary process from clinical practice advisory documents to guidelines.Genetics in medicine : official journal of the American College of Medical Genetics · 2019Review
- An interactive application for malaria elimination transmission and costing in the Asia-Pacific.Wellcome open research · 2019Article
- Simulation Modeling for Psychiatric Service Planning: Protocol for a Mixed-Methods Study.JMIR research protocols · 2018Article
- Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis.International journal of health policy and management · 2018Review
- Standardizing an approach to the evaluation of implementation science proposals.Implementation science : IS · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. DISCUSSION: We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. SUMMARY: In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be improved.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.