Leading clinicians and health researchers from across Europe say much greater emphasis must be placed on the scientific evidence for the effectiveness of treatments and other healthcare interventions to ensure patients receive the best care available. The call is contained in a Science Policy Briefing published by the European Medical Research Councils, which also made ten key recommendations on how to improve the quality of research and healthcare in Europe.
The briefing, ‘Implementation of Medical Research in Clinical Practice’, says that there must be much greater awareness among health professionals of the benefits of health technology assessment (HTA). This is the systematic examination of the safety, effectiveness and cost-effectiveness of the application of a health technology – such as a drug, medical device or a clinical or surgical procedure. HTA must become a cornerstone of healthcare.
“It is imperative, morally, socially and economically, that healthcare received by patients in Europe is based on the best scientific evidence,” said Professor Liselotte Højgaard, chair of EMRC. “It is unacceptable for patients to be given treatments which have not been adequately assessed, or to not be offered treatments that have been shown to be the most effective.”
The report also argued that a much greater emphasis on systematic reviews of existing evidence for healthcare interventions is required. As such, the scientific evidence for a given treatment or technology must be thoroughly analysed andcomparative effectiveness studies must be carried out on new treatments. If a new drug comes on the market, for example, there must be good evidence that it is more effective and cost-effective than existing treatments before it can be approved for use in publicly funded healthcare services.
Where there are gaps or uncertainties in the current state of knowledge – whether a particular treatment is truly effective for example – then good quality research must be carried out to answer the question, and the results of such research must be made publicly available. All clinical studies must be rigorously and fully reported, regardless of whether they provide ‘positive’ or ‘negative’ results.
Professor Liselotte Højgaard commented:”Stakeholders must insist on implementing this recommendation as an ethical imperative. Over 50% of clinical studies are never published in full, and more than 30% of trial interventions are not sufficiently well described; there is too much biased under-reporting of studies that have disappointing results.”
To achieve these aims it is vital that patients and the public are closely involved in all stages, from making decisions about research priorities to the design of research programmes and clinical trials and the dissemination of the research results.
The briefing also recommends that a European Institute for Health Research be established to provide a forum where issues of common interest in Europe in healthcare research and policy can be debated and appropriate strategies formulated.
The Science Policy Briefing resulted from a series of workshops involving more than 20 experts, including medical practitioners, policy makers, healthcare researchers and patient representatives from countries across Europe.
European Science Foundation