Australia could be a world leader in living evidence synthesis

Australia is poised to be a world leader in the field of living evidence synthesis, prompting calls for a national research agenda.

In a perspective article published in the Medical Journal of Australia, researchers from the Australian Living Evidence Collaboration at Monash University have called for a national research agenda for translating living evidence into health policy.

Living evidence refers to research evidence that is frequently updated through continuous surveillance to provide decision makers with up-to-date information as the evidence emerges.

The value of living evidence was clearly demonstrated during the coronavirus (COVID-19) pandemic, where clinicians and policy makers needed a way to consolidate a deluge of constantly evolving research into national evidence-based guidelines.

The authors believe a national research agenda for living evidence could help cement Australia as leaders in this emerging field.

“We believe there is an opportunity to realise the substantial potential benefits of living evidence for health systems, and to lead this field internationally by co-creating mechanisms and strengthening knowledge translation architecture to encourage living evidence use in health policy,” the authors wrote.

“We believe realising this opportunity requires a national research agenda, because without one, we are likely to forego many potential benefits and positive health system impacts of living evidence.”

The benefits of a national research agenda

In their perspective article, the authors outlined four main benefits of establishing a national agenda for living evidence:

• strengthening policy decisions with an up-to-date body of evidence, which may help policy makers make more informed decisions and reduce duplication of evidence synthesis efforts across jurisdictions;
• strengthening evidence use across the Australian health system by collaborating with policy makers to translate real-time evidence into policy;
• strengthening a learning health system by integrating evidence from local data, clinical registries and trials through artificial intelligence and other technological solutions;
• continuing Australian leadership in this area with collaborative research that builds the infrastructure needed for the health system to adopt living evidence approaches.

“A national research agenda for incorporating living evidence into the policy process should involve sector-wide collaboration and meaningful consultation to develop priorities, leverage interdisciplinary expertise, establish transparent and standardised techniques and encourage collaboration,” the authors wrote.

Despite the many benefits, the authors acknowledge that living evidence can have risks when used in policy, such as causing confusion and scepticism due to rapidly changing evidence, or suboptimal translation of the evidence into policy.

“By understanding the potential benefits and risks of living evidence for health policy, and working with producers of living evidence, policy makers and communities, we can be more considered in working to enhance the benefits and avoid the risks,” the authors wrote.

Translating living evidence into health policy

The use of living evidence in developing health policy has been recommended for when a topic is high priority for decision making, when there is uncertainty in the existing evidence, and when new evidence is emerging.

However, the authors recognise that evidence is only one of many influences on policy, and the health systems will need to build the right infrastructure for the value of living evidence to be fully realised.

“Even when evidence answers a health policy question, it must be stewarded (often simultaneously) through multiple networks of organisations and settings within the health system that are each driven by their own priorities, capacity, culture and contexts,” the authors wrote.

“Research that explores how the health system could enable the uptake and application of living evidence products by policy makers — including retaining the fidelity of the emerging evidence in policy decisions; and whether these system changes are best driven through adaptive or transformational approaches — is crucial.”

“Theory-driven research that seeks to understand how living evidence influences policy, how this approach can be optimised for policy making, and how the policy ecosystem can be enabled to use living evidence, will advance evidence-informed policy research.”

Read the perspective in the Medical Journal of Australia.