The term PB can refer to several types of document and many terms are used to qualify them: Technical Note, Policy Note, Evidence Brief, Evidence Summaries, Research Snapshot, etc. The definitions ascribed to them can vary just as much and could be placed on a continuum going from the most “neutral” to the most “interventionist”, but both definitions are always founded on scientific evidence. The “neutral” PB provides nuanced information to give an overall picture of the situation of a given problem.b The most “interventionist” PB puts forward solutions to a problem and seeks a quick change.3,4

The model proposed by the EVIPNetc group is a good example of PBs which it deems to be neutral. The network uses the term “Evidence Brief” (EB) instead, which it defines as a “context specific summary of what's known from a single study or a systematic review about a problem, three options to addressing it and the implementation considerations. […] the included products are much more commonly a systematic review than would be a single study”.5 Most of these EBs usually contain twenty or so densely written pages, but sometimes much mored and never contain recommendations for action. Yet, Avey and Desh6 have demonstrated that policy-makers do not read “any research papers that exceed 10-15 pages”. Furthermore, certain author urge caution and say that one should avoid bombarding decision-makers with convincing data.7

As part of our activities, PBs constitute one of the tools that serve to transfer the results of the studies we conduct. So, those we produce are considerably more interventionist. The definition we have adopted, based on our experiences and an examination of the numerous guides available on-line (Annex 1 shows links to these guides) is the following: “ (…) a short text, written in clear language and displayed in an attractive format. It summarizes the results of a study (or several studies) and expresses operational (actionable) recommendations intended for non-specialist audiences with the objective of their making use of them in their professional practices or for policy decision-making”. It is therefore a tool for knowledge transfer and is based on a set of criteria for content organization, writing and presentation. It is intended for decision-makers and practitioners to whom it provides solutions, which research has allowed to identify, with the objective of improving ongoing practices. It should provide a basis for entering into dialogue with the stakeholders on the relevance and the feasibility of implementing the recommendations.

There are still relatively few evidence on the effectiveness of PBs as a knowledge transfer tool. But studies have shown: 1) that decision-makers consider PBs to be a precious communication tool and that they use them in decision-making;8 2) senior officials have a preference for “pre-digested” results;9 and 3) concise documents.10 A recent systematic review identified three studies which show that PBs presenting the opinions of experts “might affect intended actions and intentions persisting to actions for public health policy”11 (p. 12). One of these studies, based on a randomized control trial, shows notably that the inclusion of expert opinions in PBs, for instance those coming from the people who carried out the study, helps to reinforce certain messages arising from the study.12 The mixed-method evaluations that we have conducted on the effectiveness of PBs during workshops to lead to knowledge utilization, also show that they are of little use if they are not sent out to participants in advance1,13 and that, when they are, they encourage the use of the results they present.14

It was already a well-known fact,6 but our practical experience since 2010 has shown that long documents has very little chance to be read by high level decision makers. During one of our training sessions with a group of researchers and decision-makers, when we asked participants to assess various formats of PBs, one of the decision-makers cried out: “this is four pages long, that's not very brief, is it?” And another responded: “(…) if it's four pages long, decision-makers won’t read it, they’ll get someone below them to do it”. During these assessment exercises which we took up over and over again during our training, participants systematically criticized certain elements in the PBs handed out to them; the length and overly dense contents being the most frequently cited criticisms. But participants who do not have basic research training mention, systematically, too frequent a use of scientific jargon or tables and figures that they find incomprehensible and so, useless and boring.

Based on our experiences and our examination of the literature available on the subject, we consider that, to be read and “make a splash”, a PB should demonstrate a number of qualities. Firstly, it must be succinct (two to four pages), be presented in a language which is both simple and clear, be restricted to information which is of real interest to the recipient and propose clear recommendations for action in a specific context. It must place in the forefront the highlights of the study or studies upon which it focuses and not focus on the research method, incomprehensible to those who do not have solid scientific training, but rather on the solutions to a problem. A reference or link to a source showing the methodological approach should, nevertheless, be provided. What is more, it must simplify the assimilation of data by using different ways of presenting them: text, pictures, graphs and tables. Lastly, it must put forward concrete, relevant measures to the targeted decision-makers. Table 1 presents the template that we suggest for preparing an effective PB.

It is evident that nobody holds the monopoly of the concept, term or contents of a policy brief. There are a multitude of definitions and practices that exist. There is certainly no point nor use in freezing the content and our goal is not to advocate a single format. The ones we propose target a different objective than EB promoted by the WHO and the EVIPNet network which, as the participant at one of our training sessions said, are “not really brief”. Ours are addressed directly to people in a position to take decisions, without asserting that these PBs will be able to do it alone, since the relationship between researchers and advisers requires specific knowledge transfer activities,15 which necessarily go beyond PBs. EBs, because of their length and absence of recommendations for action are intended instead, according to us, for political analysts entrusted with briefing policy-makers. They are therefore intended for advisers to policy-makers rather than directly to the latter. We have no doubt that this type of PB is of use when transmitting the best data available on the subject of a given problem. However, to our mind, they are not the best tool for reaching those who take decisions directly. The question that remains to be answered concerns the role of the researcher in writing a PB, but that will be for another editorial!

C. Dagenais wrote the first draft of the editorial and integrated V. Ridde comments. Both authors were comfortable with the final version of the manuscript submitted.

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