A new paper in the Journal of the Royal Society of Medicine, by three leading lights in evidence-informed policy and practice. Citation, extracts and a comment from me.
CITATION: Promoting informed health choices: the long and winding road
Andrew D Oxman, Iain Chalmers, Paul P Glasziou
J Roy Soc Med 2026; Volume 118, Issue 11
https://doi.org/10.1177/01410768251384317
https://journals.sagepub.com/doi/10.1177/01410768251384317
EXTRACTS
When health professionals intervene in the lives of others, their actions sometimes inadvertently do more harm than good...
In this commentary, we consider some of the challenges that confront those promoting the evaluation of the effects of health interventions to inform health choices. By ‘health choice’ we mean any action that individuals or groups can choose to take in the belief that it will protect or improve their health or the health of others. ‘Health interventions’ include everything from dietary, device, surgical or pharmaceutical interventions for individuals to policies for population health...
For informed health choices, reliable information about the probability of those effects is essential, but not sufficient...
The fundamental problem underlying poorly informed health choices is uncritical reliance on poorly informed opinions. Often, authorities (and others) express strong opinions about the effects of interventions without being explicit about the basis for their opinions, or cherry-picking evidence. Those opinions influence choices without people questioning their basis. In the current political environment, with increasing authoritarianism and massive amounts of misinformation, this is particularly important for all kinds of interventions, not just healthcare interventions...
The way forward
Addressing the multifaceted challenges in medicine, public health, research and science increasingly demands the pooling of diverse expertise, resources and perspectives. There has been increasing recognition of the power of focused collaborative endeavours, such as the Human Genome Project, the Cochrane and Campbell Collaborations, collaborations fostered by the Oxford Clinical Trials Service Unit, and other collaborations referred to in this commentary...
We have come a long way over the past four decades, but we still have a long way to go. Ongoing collaborative efforts are needed to ensure that the effects of interventions are evaluated when there are important uncertainties about their effects...
COMMENT (NPW): There is general consensus that more collaboration is needed to promote informed health choices, but this needs to go way beyond the Cochrane and Campbell Collaborations. The collaboration requires representation from every part of the global evidence ecosystem - those who generate, publish, synthesise, repackage, avail and apply evidence. https://www.hifa.org/about-hifa The current global evidence ecosystem isn't working, largely because of intrinsic weakenesses such as poor communication and cooperation among stakeholders, poor understanding of the drivers and barriers in the ecosystem itself, and an almost total absence of political and financial commitment to what is surely our common goal: universal access to reliable healthcare information - a world where every person will have access to the reliable healthcare information they need to protect their own health and the health of others. HIFA has been encouraging WHO to explicitly champion universal access to reliable healthcare information, and this came through as the #1 recommendation in our recent global consultation (https://www.hifa.org/sites/default/files/other_publications_uploads/HIFA...). On behalf of the WHO-HIFA Collaboration Group (https://www.hifa.org/projects/hifa-official-relations-who) I am delighted to report that we believe WHO is on the verge of explicitly championing universal access, and that would be a game-changer, not only for promoting informed health choices, but for global health.
HIFA is also calling on the global representative bodies of key stakeholders in the global evidence ecosystem to declare their political support for universal access. To date, the World Medical Association (representing the world's 10 million docotrs) and the International Federation of Library Associations (representing the world's library and information professionals) have done so. We recently invited the World Association of Medical Editors to do the same and we await their response.
https://www.wma.net/policies-post/wma-statement-on-healthcare-informatio...
https://www.ifla.org/news/health-information-is-a-right-new-ifla-statement/
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org