Figure 2 Examples from healthcare to illustrate the meta-decision framework application. These examples suggest variants of the meta-decision processes.

Notes: In possibility 1, all of the mentioned steps progress in sequence, including a design development option.

Possibility 2 is similar, but instead of designing custom-made ideas, a ready-made idea is used.

In possibility 3, no search takes place and ready-made ideas are sought directly.

In possibility 4, the decision maker skips the formulation of aims and the search; based on the identification, he/she moves directly to the evaluation phase.

In possibility 5, the decision maker moves from identification to selection where the development phase is omitted.

In possibility 6, all steps from the identification to the decision are skipped.

The evaluation step could be different in all of these case studies with regard to the population studied and their economic status, educational level, and age. Research using data collected locally is crucial for making informed decisions for all special populations in all settings as well as for validation of decisions.

Table 1 Relevance of meta-decision approach in decision making in healthcare. Practice and policy perspectives.