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QUERI Investigators Develop and Refine Evidence Assessment Checklist to Help VA Comply with Evidence Act Requirements


BACKGROUND:
In January 2021, the White House released the Memorandum on Restoring Trust in Government Through Scientific Integrity and Evidence-Based Policymaking, which directed federal cabinet-level agencies to establish scientific integrity policies and procedures – and provided guidance for supporting policy decisions with evidence, as required by the Foundations for Evidence-based Policymaking Act of 2018 (Evidence Act). Implementation of the Evidence Act reinforced requests from the Office of Management and Budget (OMB) that budget requests be tied more closely to evidence. QUERI was tasked with assisting VHA leadership with implementing the Evidence Act – and focused on the processing and approval of legislative and budget proposals. Through this, QUERI investigators learned that no systematic process existed to evaluate the supporting evidence base for proposals. To address this gap, investigators created a checklist to assess the strength of evidence included in VHA legislative and budget proposals. This article describes the development, refinement, and use of the checklist to assess the strength of evidence included in VHA legislative and budget proposals.

FINDINGS:

  • A checklist approach can be used to systematize review of evidence to support the need for a new or changed approach, its feasibility, effectiveness and cost, as well as the choice of the proposed policy or policy change over potential alternatives.
  • Lessons learned from the initial use of an evidence checklist included the clarification of definitions. For example, investigators clarified that program offices needed to specify what “success” meant to them and provide a metric to gauge success.
  • Further refinements to the checklist included grading proposals out of 100 points for ease of grading and comparison; if policymakers choose, they can rank proposals by strength of supporting evidence as they make approval decisions.

IMPLICATIONS:

  • The evidence assessment checklist is now part of the regular review process for VHA legislative and budget proposals. It is also being adapted for use elsewhere within VA.
  • Including evidence reviews in the legislative and budget proposal prioritization process may be an effective institutional arrangement to promote the use of evidence to inform high-level health policy decisions and to build a “culture of evidence” within the government.

AUTHOR/FUNDING INFORMATION:
This study was funded by QUERI. All authors are part of HSR&D/QUERI’s Partnered Evidence-based Policy Resource Center (PEPReC), Boston, MA.


Garrido M, Pearson E, Avila CJ, and Pizer S. Grading Evidence to Support Legislative and Budget Proposals – VHA’s Key to Implementing the Evidence Act. Value in Health. Published online ahead of print. November 1, 2022.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.


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