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The evidence basis of recommendations for decisions in public health (report for WHO)

European health systems face the common challenge of delivering effective and cost-effective measures of public health. However, many public health measures and interventions thought to be beneficial do not yield benefits, and even sometimes produce more harm than good. Decisions to cease, to initiate or to continue the allocation of resources to a public health intervention can therefore have substantial influence on the performance of health systems. Evidence-based recommendations may be useful for decision-makers when they are designed as relevant and practical tools for decision-making.
The document by TUB’s Department of Health Care Management is a part of a series of WHO-EURO commissioned papers to review evidence-based recommendations in their utility as tools for decision-making in public health. It serves as a background for discussion during WHO-EURO’s Fourth Futures Forum on “Tools for decision-making in Public Health”, on 16 and 17 June 2003 in Brussels.
This document reviews the evidence base, availability and nature of recommendations from systematic research for decisions. It focuses on systematic reviews and reports, i.e. those that are published on the basis of collected and analysed evidence. It first introduces the concept of evidence-based recommendations for decision-making in public health. It secondly reviews the evidence base of the conclusions and recommendations from reports and systematic reviews exemplary on two public health interventions: screening for prostate cancer and nicotine replacement therapy.

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