Matching study designs to disability-related comparative effectiveness research questions

2013 ◽  
Vol 2 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Jeffrey Ballou ◽  
Eugene Rich ◽  
Matthew Kehn
Keyword(s):  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Effectiveness Research ◽  
Research Questions ◽  
Study Designs

scholarly journals Comparative effectiveness research priorities: Identifying critical gaps in evidence for clinical and health policy decision making

2009 ◽  
Vol 25 (03) ◽  
pp. 241-248 ◽  
Author(s):  
Kalipso Chalkidou ◽  
Danielle Whicher ◽  
Weslie Kary ◽  
Sean Tunis
Keyword(s):  
Coronary Artery ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Group Process ◽  
Research Priorities ◽  
Decision Makers ◽  
Nominal Group ◽  
Effectiveness Research ◽  
Research Questions ◽  
Artery Disease

Background:In the debate on improving the quality and efficiency of the United States healthcare system, comparative effectiveness research is increasingly seen as a tool for reducing costs without compromising outcomes. Furthermore, the recent American Recovery and Reinvestment Act explicitly describes a prioritization function for establishing a comparative effectiveness research agenda. However, how such a function, in terms of methods and process, would go about identifying the most important priorities warranting further research has received little attention.Objectives:This study describes an Agency for Healthcare Research and Quality-funded pilot project to translate one current comparative effectiveness review into a prioritized list of evidence gaps and research questions reflecting the views of the healthcare decision makers involved in the pilot.Methods:To create a prioritized research agenda, we developed an interactive nominal group process that relied on a multistakeholder workgroup scoring a list of research questions on the management of coronary artery disease.Results:According to the group, the areas of greatest uncertainty regarding the management of coronary artery disease are the comparative effectiveness of medical therapy versus percutaneous coronary interventions versus coronary artery bypass grafting for different patient subgroups; the impact of diagnostic testing; and the most effective method of developing performance measures for providers.Conclusions:By applying our nominal group process, we were able to create a list of research priorities for healthcare decision makers. Future research should focus on refining this process because determining research priorities is essential to the success of developing an infrastructure for comparative effectiveness research.

scholarly journals Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Claudia M. Witt ◽  
Margaret Chesney ◽  
Richard Gliklich ◽  
Lawrence Green ◽  
George Lewith ◽  
...  
Keyword(s):  
Integrative Medicine ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Medical Community ◽  
Future Research ◽  
Effectiveness Research ◽  
Research Strategies ◽  
Complementary And Integrative Medicine ◽  
Study Designs ◽  
Shared Understandings

The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM) to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER): (1) CER studies should be made a priority in this field; (2) stakeholders should be engaged at every stage of the research; (3) CER study designs should highlight effectiveness over efficacy; (4) research questions should be well defined to enable the selection of an appropriate CER study design; (5) the CIM community should cultivate widely shared understandings, discourse, tools, and technologies to support the use and validity of CER methods; (6) Effectiveness Guidance Documents on methodological standards should be developed to shape future CER studies. CER is an emerging field and its development and impact must be reflected in future research strategies within CIM. This stakeholder symposium was a first step in providing systematic guidance for future CER in this field.

Comparative Effectiveness Research Paradigm: Implications for Systematic Reviews and Clinical Practice Guidelines

2012 ◽  
Vol 30 (34) ◽  
pp. 4202-4207 ◽  
Author(s):  
Melissa C. Brouwers ◽  
Lehana Thabane ◽  
David Moher ◽  
Sharon E. Straus
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Guideline Development ◽  
Routine Practice ◽  
Effectiveness Research ◽  
Study Designs

PurposeThe objectives of this article are (1) to examine the similarities and differences between comparative effectiveness research (CER) and evidence-based medicine (EBM); (2) to describe the implications of CER for systematic review methodologies in oncology; and (3) to address the transition from systematic reviews to guideline development and the implications of CER in this process.MethodAn analysis of the principles and methods of CER was undertaken in light of EBM, systematic reviews, and guidelines.Results and ConclusionThere is considerable overlap between the principles and methods of the two paradigms. The focus on best care options in the context of routine practice is a more central tenet of the CER paradigm. Thus, its value is not that it is the first paradigm to recognize the importance of a patient-focused approach in the research community, but rather, given the attention it has garnered, the CER paradigm may be precisely the reminder and push required to: one, influence how systematic questions are framed so that a more patient-relevant perspective is achieved; two, broaden the types of study designs that are valued and to include those, such as pragmatic trials and observational studies, that are better able to answer effectiveness questions; three, accelerate the development and application of statistical methods that enable indirect comparisons of cancer care options; and four, create clinical practice guidelines that are better positioned to improve quality of care and system performance. Over time, we will see if the CER paradigm lives up to its potential.

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