Perspectives on the production, and use, of rapid evidence in decision making during the COVID-19 pandemic: a qualitative study

Abstract

Objectives: To describe perceptions of providing, and using rapid evidence, to support decision making by two national bodies (one public health policy and one front-line clinical practice) during the COVID-19 pandemic.

Design: Descriptive qualitative study (March-August 2020): 25 semistructured interviews were conducted, transcribed verbatim and thematically analysed.

Setting: Data were obtained as part of an evaluation of two Irish national projects; the Irish COVID-19 Evidence for General Practitioners project (General Practice (GP) project) which provided relevant evidence to address clinical questions posed by GPs; and the COVID-19 Evidence Synthesis Team (Health Policy project) which produced rapid evidence products at the request of the National Public Health Emergency Team.

Participants: Purposive sample of 14 evidence providers (EPs: generated and disseminated rapid evidence) and 11 service ssers (SUs: GPs and policy-makers, who used the evidence).

Main outcome measures: Participant perceptions.

Results: The Policy Project comprised 27 EPs, producing 30 reports across 1432 person-work-days. The GP project comprised 10 members from 3 organisations, meeting 49 times and posting evidence-based answers to 126 questions. Four unique themes were generated. 'The Work' highlighted that a structured but flexible organisational approach to producing evidence was essential. Ensuring quality of evidence products was challenging, particularly in the context of absent or poor-quality evidence. 'The Use' highlighted that rapid evidence products were considered invaluable to decision making. Trust and credibility of EPs were key, however, communication difficulties were highlighted by SUs (eg, website functionality). 'The Team' emphasised that a highly skilled team, working collaboratively, is essential to meeting the substantial workload demands and tight turnaround time. 'The Future' highlighted that investing in resources, planning and embedding evidence synthesis support, is crucial to national emergency preparedness.

Conclusions: Rapid evidence products were considered invaluable to decision making. The credibility of EPs, a close relationship with SUs and having a highly skilled and adaptable team to meet the workload demands were identified as key strengths that optimised the utilisation of rapid evidence.

Ethics approval: Ethical approval was obtained from the National Research Ethics Committee for COVID-19-related Research, Ireland.

Keywords: COVID-19; Evidence-Based Practice; PRIMARY CARE; Public health; QUALITATIVE RESEARCH.

Figure 1

Overview of the project production processes. GP, General Practice; HIQA, Health Information and Quality Authority; HP, Health Policy; ICGP, Irish College of General Practitioners; NPHET, National Public Health Emergency Team; Q&A, questions and answer.

Figure 2

Overview of themes.