Implications for decision makers

Where the study warrants it, authors are encouraged to identify implications for practice or local service delivery from the findings of their research. Research is most influential when authors clearly set out implications for decision makers in the context of the evidence. Research that makes clear what actions are needed is more likely to encourage uptake.

If you wish to go beyond implications and make recommendations for policy or practice, make sure that you do so in a way that is supported and justified by the research evidence.

Implications and recommendations must be supported and justified by the evidence. For example:

• 'The evidence suggests that a national programme for X may meet the National Screening Committee’s criteria . . .'
• 'The accepted criteria for an X screening programme are not currently met'
• 'Findings from this research indicate that substitution of care by x (staff) for y (staff) may provide equivalent quality of care, but there was no evidence of cost reductions in the study groups'
• 'Research suggested a strong positive association between a particular form of incentive scheme and improved clinical processes'
• 'This report has shown the association between organisations with designated board level responsibility for support workers and impact on staff engagement'

The paper should make recommendations about future research. These should be listed in order of priority.

In addition, papers must indicate how rapidly the ‘knowledge base’ in an area is developing, to help inform a decision about when it might be appropriate to update a review in the area.

Recommendations arising from research will undergo careful consideration by the advisors of research commissioning bodies.

Divergent results

It will be important for authors to reflect carefully on the results of technology assessments which indicate that the findings of effectiveness and cost-effectiveness analyses do not agree. That is, where effectiveness assessment concludes that a technology is not effective, or there is not significant evidence to support a conclusion of effectiveness, but the economic analysis reports that the technology is likely to be considered cost effective.

Such situations are not rare and can make the overall assessment of a technology challenging. Authors should consider contextual and analytic factors which may contribute to apparently divergent findings between elements of their health technology assessment and make these transparent to readers.