Download or read book The Prevention and Treatment of Missing Data in Clinical Trials written by National Research Council and published by National Academies Press. This book was released on 2010-12-21 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.
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.
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)
Download or read book Clinical Effectiveness and Clinical Governance Made Easy written by Ruth Chambers and published by Radcliffe Publishing. This book was released on 2007 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text presents a guide to clinical effectiveness and governance. It aims to increase awareness of, and skills in, an evidence-based approach to health care, and there is advice on collecting, evaluating, interpreting and applying evidence.
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.
Download or read book Evidence based Medicine to Inform Practice Assessing Clinical Effectiveness and Economic Burden of Medicine written by Kevin Lu and published by Frontiers Media SA. This book was released on 2022-03-08 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Download or read book Hearing on Strategies to Increase Information on Comparative Clinical Effectiveness written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2009 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medical Effectiveness Research Data Methods written by Mary L. Grady and published by . This book was released on 1992 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Beyond the HIPAA Privacy Rule written by Institute of Medicine and published by National Academies Press. This book was released on 2009-03-24 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. 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.
Download or read book Identifying Health Technologies That Work written by DIANE Publishing Company and published by DIANE Publishing. This book was released on 1996-09 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Federal government is the main sponsor of research to evaluate health technologies currently in use. The purpose of this report is to examine two crucial questions: what are we getting out of this investment?, & how can we improve it? Contents: behind the search for evidence; tools for effectiveness research; issues in improving effectiveness research; the state of cost-effectiveness analysis; the Federal role in health technology assessment; the development of clinical practice guidelines; & the impact of clinical practice guidelines. Glossary.
Download or read book Congressional Record written by Congress and published by St. Martin's Press. This book was released on 2014-04-21 with total page 1414 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Congressional Record contains the proceedings and debates of each Congressional session in the House of Representatives and the Senate. Arranged in calendar order, each volume includes the exact text of everything that was said and includes members' remarks.
Download or read book Small Clinical Trials written by Institute of Medicine and published by National Academies Press. This book was released on 2001-01-01 with total page 221 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
Download or read book Clinical Effectiveness in Psychotherapy and Mental Health written by Penny Leroux and published by Routledge. This book was released on 2018-05-30 with total page 125 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this volume, the editors examine the state of clinical governance in the Mental Health sector. Despite the often confusing wealth of literature on the subject, little, if any, refers specifically to psychological treatment services. Clinical Effectiveness in Psychotherapy and Mental Health provides a guide to learning about the different guidelines and evaluation methods. It focuses on three important contributions to clinically effective practice: clinical audit, outcome monitoring and evidence-based practice.
Download or read book Effective Dissemination of Clinical and Health Information written by and published by . This book was released on 1994 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Cost Effectiveness Modelling for Health Technology Assessment written by Richard Edlin and published by Springer. This book was released on 2015-08-11 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides an introduction to decision analytic cost-effectiveness modelling, giving the theoretical and practical knowledge required to design and implement analyses that meet the methodological standards of health technology assessment organisations. The book guides you through building a decision tree and Markov model and, importantly, shows how the results of cost-effectiveness analyses are interpreted. Given the complex nature of cost-effectiveness modelling and the often unfamiliar language that runs alongside it, we wanted to make this book as accessible as possible whilst still providing a comprehensive, in-depth, practical guide that reflects the state of the art – that includes the most recent developments in cost-effectiveness modelling. Although the nature of cost effectiveness modelling means that some parts are inevitably quite technical, across the 13 chapters we have broken down explanations of theory and methods into bite-sized pieces that you can work through at your own pace; we have provided explanations of terms and methods as we use them. Importantly, the exercises and online workbooks allow you to test your skills and understanding as you go along.
