Evidence-based decision-making: practical issues in the appraisal of evidence to inform policy and practice

Objective. To highlight the differences between a systematic review of the literature and a systematic review of the best available evidence; to discuss practical issues in the appraisal of evidence to inform public health policy and practice; and to make recommendations for next steps in the development of evidence-based decision making in public health. Data sources and selection. Literature and other sources were reviewed including the subject reading list, recommended texts and websites for the La Trobe University postgraduate subject Evidence Based Public Health Practice 2007 and other relevant sources identified. Data extraction and synthesis. Relevant opinions were extracted to summarise debate in relation to definitions of evidence, usefulness of systematic reviews, tools for critical appraisal and other practical issues in the translation of evidence into practice. Conclusions. Evidence relevant to decisions regarding public health policy and practice may include evidence from the literature including experimental and observational studies as well as other sources, including policies and opinions of stakeholders. Further development of skills and approaches to the critical appraisal of evidence are required. Recommendations include: mapping of Australian competencies to public health education; development of national guidelines to inform the appraisal of evidence for public health decision making; and promotion of leadership and education in evidence-based approaches, discussion and debate in relation to definitions of evidence, and public health research that generates the best possible evidence.