Institutionalizing the use of evidence-based approach during the COVID-19 pandemic response in Chile
2Ministry of Health (Undersecretary), Chile
Background: The COVID-19 pandemic required novel methods to support the stakeholders and government authorities’ decision-making. In March 2022, the newly elected Chilean government implemented a novel COVID-19 governance, which included the National Pandemic Response Commission (CNRP Spanish: Comisión Nacional de Respuesta Pandémica). The CNRP aimed to monitor the country’s COVID-19 situation, assess health related measures, and recommend potential changes in public health interventions for the pandemic response. The CNRP incorporated a high-level external advisory committee and a technical board, with six permanent working groups: vaccines, diagnosis and surveillance, COVID-19 therapies, health services, non-pharmacological preventive measures, social and economic measures, and intersectoral response.
Objectives: Stablish evidence-based in all decision-making processes.
Methods: The Evidence Informed Health Policy (EIHP) Unit, from the Health Technology Assessment and Evidence-Based Healthcare (HTA-EBH) Department, Ministry of Health Chile, incorporated evidence-based methods in the CNRP working groups deliberation process by including representatives of the HTA-EBH Department in each working group’s weekly session. They oversaw the scientific evidence requested. First, all the research queries were collected, then the research questions raised were attuned by the HTA-EBH professionals according to the PICO structure. Secondly, the research questions were prioritized each week by the Ministry of Health authorities, according to urgency, main concerns, and necessities. Then, the HTA-EBH team developed rapid systematic reviews or GRADE evidence to decision framework (EtD). The working groups made recommendations based on the rapid systematic reviews applying the GRADE EtD.
Results: Some of the topics covered in the rapid systematic reviews were the use of HEPA/MERV filters and the effectiveness of mask use in school children. The topics of EtD recommendations were the use of self-testing antigens versus PCR for COVID-19 diagnosis in a) patients and b) in healthy populations.
Conclusions: The institutionalization of evidence-based in all decision-making processes is crucial for a better allocation of the limited resources and to be able to implement evidence-based methods in a rapid moving situation like the COVID-19 pandemic. The novelty of this approach was the incorporation of civil society representatives in the working groups. This process involved a successful evidence literacy approach to the decision-making processes.