Skip to main content

Table 3 The consequences of saying "no" or "yes" instead of "only in the context of an evaluation"

From: SUPPORT Tools for evidence-informed health Policymaking (STP) 17: Dealing with insufficient research evidence

All countries face resource constraints. For this reason, in the United Kingdom for example, the National Institute for Health and Clinical Excellence (NICE) officially recognises the principle of recommending that when important uncertainties exist about an intervention's effects, such interventions should only be used in the context of research [27]. Sixteen (approximately 4%) of NICE's technology appraisal recommendations published between 1999 and early 2007 advised the use of a technology only in the context of research. The consequences of getting decisions wrong by either saying "no" or "yes" to a technology without doing so, are summarised below (see Reference [27] for further details).

The consequence of saying "no" instead of "only in research"

• Patients are denied access to promising and potentially effective technologies

• There are delays in building the evidence base in key areas, with a resulting negative overall impact on health outcomes

The consequences of saying "yes" instead of "only in research"

• Access to unproven and potentially harmful or ineffective interventions is promoted

• Any ongoing or future research in the field is severely hindered. Important questions on effectiveness and cost-effectiveness may never be answered

• Limited resources are wasted

• Having to reverse a "yes" decision in the light of any future evidence compromises credibility and is difficult to implement