知證衛生決策工具之四——使用證據明確問題*_《中國循證醫學雜志》

作者：

John N Lavis ¹ , Michael G Wilson ² , Andrew D Oxman ³ , Simon Lewin ⁴ , Atle Fretheim ⁵

關鍵詞：

DOI：

10.7507/1672-2531.20100396

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政策制定者及其決策支持者常發現他們會面臨一些促使他們想找到定義一個問題的最佳方法的情況，包括如在議會上被問及一個棘手或有挑戰性的問題或成為頭條新聞的問題。政策制定者想找準問題的動機多種多樣. 從想確定是否該對他人認為重要的問題給予重視, 到如何說服他人認同某一問題的重要性。圍繞如何定義一個問題的爭論和努力是政策制定過程中至關重要的部分。這些爭論和努力的結果將影響決策者決定是否采取行動來解決問題及對其決定如何采取措施也有部分影響。這些并行事件與政策和項目方案（如發表一份展示特定方案效果的報告），或政治事件（如對某一問題感興趣的人被任命為衛生部長）有關。我們在本文中提出以下問題來指導那些需要定義問題并描述問題特點的人：① 問題是什么？② 問題是如何引起關注的？該過程是否會影響解決這一問題的前景？③ 應使用或收集什么指標來確定問題的重要程度和評估問題解決的進展程度？④ 應采用何種對照來確定問題的重要程度并評估問題解決的進展程度？⑤ 應如何擬訂（或描述）問題來動員不同群體？

引用本文： John N Lavis,Michael G Wilson,Andrew D Oxman,Simon Lewin,Atle Fretheim. 知證衛生決策工具之四——使用證據明確問題*. 中國循證醫學雜志, 2010, 10(3): 262-268. doi: 10.7507/1672-2531.20100396 復制

1.	Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2.	Lavis JN, Wilson MG, Oxman AD, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 5. Using research evidence to frame options to address a problem. Health Res Policy Syst, 2009, 7(Suppl 1): S5.
3.	Fretheim A, Munabi-Babigumira S, Oxman AD, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 6. Using research evidence to address how an option will be implemented. Health Res Policy Syst, 2009, 7(Suppl 1): S6.
4.	Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 3. Setting priorities for supporting evidence-informed policymaking. Health Res Policy Syst, 2009, 7(Suppl 1): S3.
5.	Rochefort DA, Cobb RW. Problem definition, agenda access, and policy choice. Policy Studies Journal, 1993, 21: 56-71.
6.	Stone D. Policy paradox: The art of political decision making. W. W. Norton and Company; 1997.
7.	Kingdon JW. Agendas, alternatives, and public policies. 2nd edition. Longman; 2003.
8.	Lavis JN, Oxman AD, Grimshaw J, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 7. Finding systematic reviews. Health Res Policy Syst, 2009, 7(Suppl 1): S7.
9.	Lewin S, Oxman AD, Lavis JN, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 11. Finding and using research evidence about local conditions. Health Res Policy Syst, 2009, 7(Suppl 1): S11.
10.	Oxman AD, Lavis JN, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 10. Taking equity into consideration when assessing the findings of a systematic review. Health Res Policy Syst, 2009, 7(Suppl 1): S10-11.
11.	World Health Organization (WHO): Guidelines for the treatment of Malaria. World Health Organization; 2006.
12.	Wilczynski NL, Haynes RB, Lavis JN, et al. Optimal search strategies for detecting health services research studies in MEDLINE. CMAJ, 2004, 171: 1179-1185.

1. Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2. Lavis JN, Wilson MG, Oxman AD, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 5. Using research evidence to frame options to address a problem. Health Res Policy Syst, 2009, 7(Suppl 1): S5.
3. Fretheim A, Munabi-Babigumira S, Oxman AD, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 6. Using research evidence to address how an option will be implemented. Health Res Policy Syst, 2009, 7(Suppl 1): S6.
4. Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 3. Setting priorities for supporting evidence-informed policymaking. Health Res Policy Syst, 2009, 7(Suppl 1): S3.
5. Rochefort DA, Cobb RW. Problem definition, agenda access, and policy choice. Policy Studies Journal, 1993, 21: 56-71.
6. Stone D. Policy paradox: The art of political decision making. W. W. Norton and Company; 1997.
7. Kingdon JW. Agendas, alternatives, and public policies. 2nd edition. Longman; 2003.
8. Lavis JN, Oxman AD, Grimshaw J, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 7. Finding systematic reviews. Health Res Policy Syst, 2009, 7(Suppl 1): S7.
9. Lewin S, Oxman AD, Lavis JN, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 11. Finding and using research evidence about local conditions. Health Res Policy Syst, 2009, 7(Suppl 1): S11.
10. Oxman AD, Lavis JN, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 10. Taking equity into consideration when assessing the findings of a systematic review. Health Res Policy Syst, 2009, 7(Suppl 1): S10-11.
11. World Health Organization (WHO): Guidelines for the treatment of Malaria. World Health Organization; 2006.
12. Wilczynski NL, Haynes RB, Lavis JN, et al. Optimal search strategies for detecting health services research studies in MEDLINE. CMAJ, 2004, 171: 1179-1185.

《中國循證醫學雜志》

知證衛生決策工具之四——使用證據明確問題*

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《中國循證醫學雜志》

知證衛生決策工具之四——使用證據明確問題*

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