>> Health services research aims to explore the “last mile” of evidence. She deals with the translation between efficiency in experiments under controlled conditions and effectiveness in everyday life. She analyzes complex relationships and evaluates complex interventions to influence them.

This paradigmatic reference protects the research field of health services research from the arbitrariness of “research in health care”. Such a solution would give up its place in the urgently needed social discussion about the conclusiveness and effectiveness of medical and health science interventions and would get rid of its guarantor position, which consists in the fact that bridging the aforementioned “last mile” also requires methodological rigor, transparency and thus Verifiability or reproducibility is possible.

Society can expect that science and thus also health care research - in addition to its spontaneous scientific "search movement" - also proceeds in the evaluation of complex interventions to improve care according to standards that, especially when it comes to critical health policy decisions, are arbitrary, irrelevant or even incorrect Protect recommendations.

This is exactly what has been the focus of dealing with the Corona crisis over the past three years. There is agreement that an epidemic is not a purely biological event, but affects all levels of society - unchanged since time immemorial. Although “affects” is a gross understatement – one would rather use terms like “plowed through”.

An epidemic (and even more so a pan-
demie of global proportions) is therefore a classic field in which health services research is, or at least should be, in its “element”. It's not "just" about basic epidemiological terms, as you can read in the following, first article "On the Role of Clinical Infectiology" in the new series "Corona and Politics: On the Role of Science": In a large number of different comments it goes much further go into the field of complex interventions, which have always been the focus of outcomes research in their step-by-step planning, implementation and evaluation.

There are few social interventions more complex than those we have witnessed in recent years, such as: B. Vaccination campaigns. Above all, two important questions arise about the role of health services research:
1 Was health services research consulted during the planning?
Hardly, at least it wasn't visible to the outside world. There was probably no effort to do so, because health services research would inevitably have taken a warning stance on the question of the social gradient of the policy measures (in a house with a garden, a lockdown was hardly a problem...), especially because of its multidisciplinarity. Possibly serious mistakes such as school and daycare closures could also have been prevented. And perhaps a third example: health care researchers would certainly have expressed to politicians: “Be sure to implement…”

However, the reality is different: although this has happened to some extent, on the whole there has been hardly any take-up of the care.
research, just as little as from other “evidence producers”. The IQWiG was also bypassed despite several offers.

2 Has health services research itself actively spoken out by clearly and clearly demanding corrections to the “policy of measures” of the last few years?
Of course there were requests to speak, e.g. B. also in the “Monitor Health Care Research”. But overall it was very, very quiet.
Outcomes research in particular could and should have contributed much more to the outcome; namely in the sense of the definition: “What resonates with people.” The tools are available, for example, health services research now has the methodology for evaluating multi-level interventions available.

Given these key questions, what is the point of this series of comments? The clear answer: First and foremost, food for thought. But also a basis for a scientific dispute. It should be clear: we need to discuss things, including internally, into health services research.

Why? Because a research field that is not sure of itself can hardly have any impact.

That is why, with this series of opinion pieces, we want to call on the multidisciplinary field that has emerged in health services research to resume the discussion about the fundamentals and methodological standards. To take stock of the complex interventions in the corona pandemic and their effects and learn from them.

These lessons and the standards tested on them should ensure that health services research provides evidence that cannot be ignored and, with its unmistakable voice, leads to better decisions in health policy and the health system. Just as it should be in an applied science. <<