Comparative Effectiveness Review Methods

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Comparative Effectiveness Review Methods

Author : U. S. Department of Health and Human Services
Publisher : Createspace Independent Pub
ISBN 13 : 9781484997062
Total Pages : 226 pages
Book Rating : 4.9/5 (97 download)

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Book Synopsis Comparative Effectiveness Review Methods by : U. S. Department of Health and Human Services

Download or read book Comparative Effectiveness Review Methods written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-17 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Agency for Healthcare Research and Quality (AHRQ) commissioned the RTI International–University of North Carolina at Chapel Hill (RTI-UNC) Evidence-based Practice Center (EPC) to explore how systematic review groups have dealt with clinical heterogeneity and to seek out best practices for addressing clinical heterogeneity in systematic reviews (SRs) and comparative effectiveness reviews (CERs). Such best practices, to the extent they exist, may enable AHRQ's EPCs to address critiques from patients, clinicians, policymakers, and other proponents of health care about the extent to which “average” estimates of the benefits and harms of health care interventions apply to individual patients or to small groups of patients sharing similar characteristics. Such users of reviews often assert that EPC reviews typically focus on broad populations and, as a result, often lack information relevant to patient subgroups that are of particular concern to them. More important, even when EPCs evaluate literature on homogeneous groups, there may be varying individual treatment for no apparent reason, indicating that average treatment effect does not point to the best treatment for any given individual. Thus, the health care community is looking for better ways to develop information that may foster better medical care at a “personal” or “individual” level. To address our charge for this methods project, the EPC set out to answer six key questions (KQ). Key questions for methods report on clinical heterogeneity include: 1. What is clinical heterogeneity? a. How has it been defined by various groups? b. How is it distinct from statistical heterogeneity? c. How does it fit with other issues that have been addressed by the AHRQ Methods Manual for CERs? 2. How have systematic reviews dealt with clinical heterogeneity in the key questions? a. What questions have been asked? b. How have they pre-identified population subgroups with common clinical characteristics that modify their intervention-outcome association? c. What are best practices in key questions and how these subgroups have been identified? 3. How have systematic reviews dealt with clinical heterogeneity in the review process? a. What do guidance documents of various systematic review groups recommend? b. How have EPCs handled clinical heterogeneity in their reviews? c. What are best practices in searching for and interpreting results for particular subgroups with common clinical characteristics that may modify their intervention-outcome association? 4. What are critiques in how systematic reviews handle clinical heterogeneity? a. What are critiques from specific reviews (peer and public) on how EPCs handled clinical heterogeneity? b. What general critiques (in the literature) have been made against how systematic reviews handle clinical heterogeneity? 5. What evidence is there to support how to best address clinical heterogeneity in a systematic review? 6. What questions should an EPC work group on clinical heterogeneity address? Heterogeneity (of any type) in EPC reviews is important because its appearance suggests that included studies differed on one or more dimensions such as patient demographics, study designs, coexisting conditions, or other factors. EPCs then need to clarify for clinical and other audiences, collectively referred to as stakeholders, what are the potential causes of the heterogeneity in their results. This will allow the stakeholders to understand whether and to what degree they can apply this information to their own patients or constituents. Of greatest importance for this project was clinical heterogeneity, which we define as the variation in study population characteristics, coexisting conditions, cointerventions, and outcomes evaluated across studies included in an SR or CER that may influence or modify the magnitude of the intervention measure of effect (e.g., odds ratio, risk ratio, risk difference).

Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide

Author : Agency for Health Care Research and Quality (U.S.)
Publisher : Government Printing Office
ISBN 13 : 1587634236
Total Pages : 236 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide by : Agency for Health Care Research and Quality (U.S.)

Download or read book Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

Finding What Works in Health Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309164257
Total Pages : 267 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Finding What Works in Health Care by : Institute of Medicine

Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Initial National Priorities for Comparative Effectiveness Research

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309138361
Total Pages : 252 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Initial National Priorities for Comparative Effectiveness Research by : Institute of Medicine

Download or read book Initial National Priorities for Comparative Effectiveness Research written by Institute of Medicine and published by National Academies Press. This book was released on 2009-11-14 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.

Methods in Comparative Effectiveness Research

Author : Constantine Gatsonis
Publisher : CRC Press
ISBN 13 : 1351659456
Total Pages : 547 pages
Book Rating : 4.3/5 (516 download)

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Book Synopsis Methods in Comparative Effectiveness Research by : Constantine Gatsonis

Download or read book Methods in Comparative Effectiveness Research written by Constantine Gatsonis and published by CRC Press. This book was released on 2017-02-24 with total page 547 pages. Available in PDF, EPUB and Kindle. Book excerpt: Comparative effectiveness research (CER) is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care (IOM 2009). CER is conducted to develop evidence that will aid patients, clinicians, purchasers, and health policy makers in making informed decisions at both the individual and population levels. CER encompasses a very broad range of types of studies—experimental, observational, prospective, retrospective, and research synthesis. This volume covers the main areas of quantitative methodology for the design and analysis of CER studies. The volume has four major sections—causal inference; clinical trials; research synthesis; and specialized topics. The audience includes CER methodologists, quantitative-trained researchers interested in CER, and graduate students in statistics, epidemiology, and health services and outcomes research. The book assumes a masters-level course in regression analysis and familiarity with clinical research.

Pharmacoepidemiology

Author : Brian L. Strom
Publisher : John Wiley & Sons
ISBN 13 : 1119413419
Total Pages : 1220 pages
Book Rating : 4.1/5 (194 download)

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Book Synopsis Pharmacoepidemiology by : Brian L. Strom

Download or read book Pharmacoepidemiology written by Brian L. Strom and published by John Wiley & Sons. This book was released on 2019-12-16 with total page 1220 pages. Available in PDF, EPUB and Kindle. Book excerpt: This classic, field-defining textbook, now in its sixth edition, provides the most comprehensive guidance available for anyone needing up-to-date information in pharmacoepidemiology. This edition has been fully revised and updated throughout and continues to provide a rounded view on all perspectives from academia, industry and regulatory bodies, addressing data sources, applications and methodologies with great clarity.

Comparative Effectiveness Review Methods

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (723 download)

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Book Synopsis Comparative Effectiveness Review Methods by :

Download or read book Comparative Effectiveness Review Methods written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVES: The Agency for Healthcare Research and Quality (AHRQ) funded the RTI International--University of North Carolina at Chapel Hill Evidence-based Practice Center to determine best practices for addressing clinical heterogeneity in systematic reviews (SRs) and comparative effectiveness reviews (CERs). These best practices address critiques from patients, clinicians, policymakers, and others who assert that SRs typically focus on broad populations and, as a result, often lack information relevant to individual patients or patient subgroups. DATA SOURCES AND METHODS: We used numerous data sources. We abstracted information from guidance documents prepared by U.S. and international organizations engaged in preparing reviews. We searched MEDLINE(r) to identify studies on how to handle clinical heterogeneity and subgroup analyses. We reviewed more than 120 SRs conducted by AHRQ's Evidence-based Practice Centers (EPCs), the Cochrane Collaboration, the Drug Effectiveness Review Project, the United Kingdom's National Institute for Health and Clinical Excellence and others that we identified from the Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects and Health Technology Assessment. We reviewed peer and public review comments from AHRQ's Scientific Review Center for three CERs, and we conducted key informant interviews with authors of six SRs prepared by AHRQ's EPCs or international organizations. RESULTS: Clinical heterogeneity has been defined as the variation in study population characteristics, coexisting conditions, cointerventions, and outcomes evaluated across studies included in an SR or CER that may influence or modify the magnitude of the intervention measure of effect (e.g., odds ratio, risk ratio, risk difference). Statistical heterogeneity is defined as variability in the observed treatment effects beyond what would be expected by random error. The review organizations we studied varied in their inclusion of factors, in terms of the key questions and analysis that may modify the treatment-outcome association. They tended to give more consideration to demographic factors than to disease factors (e.g., disease severity, risk factors, coexisting disease, or cointerventions). Individual systematic reviewers whom we interviewed preferred a priori identification of effect modifiers to post hoc determination because of the latter's data-dredging nature and the possibility of type 1 error when many subgroups are evaluated. Many publications that we identified through our literature searches did indicate that analysis of individual patient-level data in meta-analyses does allow better assessment of clinical heterogeneity, but the time, cost, and difficulty in obtaining these data are often prohibitive. CONCLUSIONS: Identifying factors that may influence the treatment-outcome association is important to clinicians and patients because it helps them understand which patients will benefit most, who is least likely to benefit, and who is at greatest risk of experiencing adverse outcomes. Clear evidence-based guidance on addressing clinical heterogeneity in SRs and CERs is not available currently but would be valuable to AHRQ's EPCs and to others conducting SRs internationally.

Applied Methods of Cost-effectiveness Analysis in Healthcare

Author : Alastair Gray
Publisher : Oxford University Press, USA
ISBN 13 : 0199227284
Total Pages : 326 pages
Book Rating : 4.1/5 (992 download)

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Book Synopsis Applied Methods of Cost-effectiveness Analysis in Healthcare by : Alastair Gray

Download or read book Applied Methods of Cost-effectiveness Analysis in Healthcare written by Alastair Gray and published by Oxford University Press, USA. This book was released on 2011 with total page 326 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides the reader with a comprehensive set of instructions and examples of how to perform an economic evaluation of a health intervention, focusing solely on cost-effectiveness analysis in healthcare.

Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (21 download)

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Book Synopsis Methods Guide for Effectiveness and Comparative Effectiveness Reviews by :

Download or read book Methods Guide for Effectiveness and Comparative Effectiveness Reviews written by and published by . This book was released on 2008 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Comparative Effectiveness Reviews are systematic reviews of existing research on the effectiveness, comparative effectiveness, and harms of different health care interventions. They provide syntheses of relevant evidence to inform real-world health care decisions for patients, providers, and policymakers. Strong methodologic approaches to systematic review improve the transparency, consistency, and scientific rigor of these reports. Through a collaborative effort of the Effective Health Care (EHC) Program, the Agency for Healthcare Research and Quality (AHRQ), the EHC Program Scientific Resource Center, and the AHRQ Evidence-based Practice Centers have developed a Methods Guide for Comparative Effectiveness Reviews. This Guide presents issues key to the development of Comparative Effectiveness Reviews and describes recommended approaches for addressing difficult, frequently encountered methodological issues. The Methods Guide for Comparative Effectiveness Reviews is a living document, and will be updated as further empiric evidence develops and our understanding of better methods improves. Comments and suggestions on the Methods Guide for Comparative Effectiveness Reviews and the Effective Health Care Program can be made at www.effectivehealthcare.ahrq.gov.

Cochrane Handbook for Systematic Reviews of Interventions

Author : Julian P. T. Higgins
Publisher : Wiley
ISBN 13 : 9780470699515
Total Pages : 672 pages
Book Rating : 4.6/5 (995 download)

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Book Synopsis Cochrane Handbook for Systematic Reviews of Interventions by : Julian P. T. Higgins

Download or read book Cochrane Handbook for Systematic Reviews of Interventions written by Julian P. T. Higgins and published by Wiley. This book was released on 2008-11-24 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.

Distributional Cost-Effectiveness Analysis

Author : Richard Cookson
Publisher : Handbooks in Health Economic Evaluation
ISBN 13 : 0198838190
Total Pages : 385 pages
Book Rating : 4.1/5 (988 download)

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Book Synopsis Distributional Cost-Effectiveness Analysis by : Richard Cookson

Download or read book Distributional Cost-Effectiveness Analysis written by Richard Cookson and published by Handbooks in Health Economic Evaluation. This book was released on 2020-09-30 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health inequalities blight lives, generate enormous costs, and exist everywhere. This book is the definitive all-in-one guide for anyone who wishes to learn about, commission, and use distributional cost-effectiveness analysis to promote both equity and efficiency in health and healthcare.

Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Author : Agency for Healthcare Research and Quality (US)
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (135 download)

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Book Synopsis Methods Guide for Effectiveness and Comparative Effectiveness Reviews by : Agency for Healthcare Research and Quality (US)

Download or read book Methods Guide for Effectiveness and Comparative Effectiveness Reviews written by Agency for Healthcare Research and Quality (US) and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Author : Agency for Healthcare Research and Quality
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (84 download)

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Book Synopsis Methods Guide for Effectiveness and Comparative Effectiveness Reviews by : Agency for Healthcare Research and Quality

Download or read book Methods Guide for Effectiveness and Comparative Effectiveness Reviews written by Agency for Healthcare Research and Quality and published by . This book was released on 2008 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Cost Effectiveness in Health and Medicine

Author : Peter J. Neumann
Publisher : Oxford University Press
ISBN 13 : 0190492937
Total Pages : 537 pages
Book Rating : 4.1/5 (94 download)

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Book Synopsis Cost Effectiveness in Health and Medicine by : Peter J. Neumann

Download or read book Cost Effectiveness in Health and Medicine written by Peter J. Neumann and published by Oxford University Press. This book was released on 2017 with total page 537 pages. Available in PDF, EPUB and Kindle. Book excerpt: CEAs (cost-effectiveness analyses) are used by decision makers in the health sector to make enlightened evaluations and this book provides an in depth look at how to evaluate the evaluator. The book is aimed specifically at Public health specialists.

Knowing What Works in Health Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309113563
Total Pages : 279 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Knowing What Works in Health Care by : Institute of Medicine

Download or read book Knowing What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2008-05-29 with total page 279 pages. Available in PDF, EPUB and Kindle. Book excerpt: There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States-setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines-and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions.

Learning What Works

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309120683
Total Pages : 610 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Learning What Works by : Institute of Medicine

Download or read book Learning What Works written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-09 with total page 610 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is essential for patients and clinicians to have the resources needed to make informed, collaborative care decisions. Despite this need, only a small fraction of health-related expenditures in the United States have been devoted to comparative effectiveness research (CER). To improve the effectiveness and value of the care delivered, the nation needs to build its capacity for ongoing study and monitoring of the relative effectiveness of clinical interventions and care processes through expanded trials and studies, systematic reviews, innovative research strategies, and clinical registries, as well as improving its ability to apply what is learned from such study through the translation and provision of information and decision support. As part of its Learning Health System series of workshops, the Institute of Medicine's (IOM's) Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss capacity priorities to build the evidence base necessary for care that is more effective and delivers higher value for patients. Learning What Works summarizes the proceedings of the seventh workshop in the Learning Health System series. This workshop focused on the infrastructure needs-including methods, coordination capacities, data resources and linkages, and workforce-for developing an expanded and efficient national capacity for CER. Learning What Works also assesses the current and needed capacity to expand and improve this work, and identifies priority next steps. Learning What Works is a valuable resource for health care professionals, as well as health care policy makers.

Cost-Effectiveness in Health and Medicine

Author : Marthe R. Gold
Publisher : Oxford University Press
ISBN 13 : 9780195108248
Total Pages : 462 pages
Book Rating : 4.1/5 (82 download)

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Book Synopsis Cost-Effectiveness in Health and Medicine by : Marthe R. Gold

Download or read book Cost-Effectiveness in Health and Medicine written by Marthe R. Gold and published by Oxford University Press. This book was released on 1996-07-18 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cost-effectiveness in health and medicine presents a consensus of experts on appropriate methods for standardizing the conduct of CEAs for use in policy arenas. Standardization is of particular importance for CEA, because it allows comparisons of the costs and health outcomes of alternative methods of improving health, such as public health programs and medical technologies. The book provides a detailed discussion of the theoretical background underlying areas of controversy, and uses theory to guide explicit recommendations for study conduct.