과학적인 의사결정을 위한 근거문헌 활용지침: 제7판 개정하면서

Abstract

The significance and quality of evidence-based healthcare systems are crucial to the effectiveness of healthcare delivery. In 2005, the Health Insurance Review & Assessment Service (HIRA) developed the Evidence Based Review Manual (EBRM) to provide scientifically grounded information that supports efficient benefit reviews, rational decision-making, and the evaluation of reimbursement systems. This article presents the latest insights from the 2024 7th edition of the EBRM. For this revision, we consulted systematic review methodologies employed internationally as well as policy data related to decision-making processes and pertinent academic journals. In the 7th edition, we updated the tools for assessing the risk of bias in clinical research and revisited the criteria for the decision-making process. The EBRM emphasizes the inclusion of textbooks, clinical practice guidelines, and clinical research literature as sources of scientific evidence. To facilitate this, the manual introduces a standardized, highly practical method for presenting evidence. Currently, various HIRA committees base reimbursement policy decisions on the EBRM, including rapid systematic reviews. We also reviewed the RAND/UCLA Appropriateness Method (RAM), a modified Delphi survey method used in the United States. Implementing the structured RAM would enhance the scientific rigor and transparency of HIRA’s decision-making processes. As evidence-based decision-making systems expand within healthcare, it is essential that knowledge remains current and is continuously updated and disseminated. Accordingly, the 7th edition of the EBRM will be revised to improve both its internal and external application and to support the ongoing dissemination of scientific knowledge.