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Rajit D, Johnson A, Callander E, Teede H, Enticott J. Learning health systems and evidence ecosystems: a perspective on the future of evidence-based medicine and evidence-based guideline development. Health Res Policy Syst 2024; 22:4. [PMID: 38178086 PMCID: PMC10768258 DOI: 10.1186/s12961-023-01095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024] Open
Abstract
Despite forming the cornerstone of modern clinical practice for decades, implementation of evidence-based medicine at scale remains a crucial challenge for health systems. As a result, there has been a growing need for conceptual models to better contextualise and pragmatize the use of evidence-based medicine, particularly in tandem with patient-centred care. In this commentary, we highlight the emergence of the learning health system as one such model and analyse its potential role in pragmatizing both evidence-based medicine and patient-centred care. We apply the learning health system lens to contextualise the key activity of evidence-based guideline development and implementation, and highlight how current inefficiencies and bottlenecks in the evidence synthesis phase of evidence-based guideline development threaten downstream adherence. Lastly, we introduce the evidence ecosystem as a complementary model to learning health systems, and propose how innovative developments from the evidence ecosystem may be integrated with learning health systems to better enable health impact at speed and scale.
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Affiliation(s)
- D Rajit
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
| | - A Johnson
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
| | - E Callander
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia
- Monash Health Endocrinology and Diabetes Departments, Melbourne, Australia
| | - J Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Level 1, 43-51 Kanooka Grove, Melbourne, VIC, 3168, Australia.
- Monash Partners Academic Health Sciences Centre, Melbourne, VIC, Australia.
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