Evidence produced in evidence based medicine needs to be relevant

Editor—It was encouraging to see all the research papers on patient involvement in healthcare decision making in the issue of the BMJ on 18 September devoted to patient partnership. Research findings in this area go some way to filling the enormous gap in evidence that has existed for too long. There are publications that offer guidance on how to involve patients and the public, but these give practical advice and do not detail the evidence of these approaches.¹

This emergence of evidence is particularly timely given that the importance of patient and public involvement has been emphasised throughout government policies. Evidence relevant to patient/public involvement in clinical governance, health improvement plans, the development of primary care groups, and more recently the public health white paper Saving Lives: Our Healthier Nation is much needed.² As the momentum of research in this area is beginning to build up we would suggest that there may be some lessons to be learnt from clinical effectiveness evidence.

Simply having evidence available will not necessarily mean that it will be used. Like many clinicians in the case of evidence based medicine, those who need the evidence on involvement of patients may not have the motivation to access it via scientific journals or the skills to appraise it. Accessibility through appropriate presentation and dissemination is therefore an important consideration. Additionally, as found with clinical effectiveness evidence, to be of real value and to get used the evidence produced must be relevant to those working in the field.³,⁴ This means that research should try to answer questions that such people want answers to and not simply cover topics that are interesting or can be researched using the methods deemed “fundable.”⁵

From the Office for Public Management's perspective (the office is an organisation that supports NHS bodies involving patients and the public in decisions), an increase in the evidence base of approaches is greatly welcomed. An important consideration for those who will produce the evidence, however, is that its impact will depend on how relevant it is to the NHS agenda and how accessible it is to those in the field.