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).

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 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 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 Chronic Illness Care written by Timothy P. Daaleman and published by Springer. This book was released on 2018-02-24 with total page 561 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers a comprehensive overview to chronic illness care, which is the coordinated, comprehensive, and sustained response to chronic diseases and conditions by a range of health care providers, formal and informal caregivers, healthcare systems, and community-based resources. Using an ecological framework, which looks at the interdependent influences between individuals and their larger environment, this unique text examines chronic illness care at multiple levels and includes sections on the individual influences on chronic illness, the role of family and social networks, and how chronic care is provided across the spectrum of health care settings; from home to clinic to the emergency department to hospital and residential care facilities. The book describes the organizational frameworks and strategies that are needed to provide quality care for chronically ill patients, including behavioral health, care management, transitions of care, and health information technology. The book also addresses the changing workforce needs in health care, and the fiscal models and policies that will be required to meet the needs of this population, with a focus on sustaining the ongoing transformation in health care. This book acts as a major reference for practitioners and students in medicine, nursing, social work, allied health, and behavioral medicine, as well as stakeholders in public health, health policy, and population health.

Download or read book Comparative Effectiveness and Efficacy Research and Analysis for Practice CEERAP written by Francesco Chiappelli and published by Springer Science & Business Media. This book was released on 2012-02-22 with total page 199 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent trends in health care across the United States and internationally have emphasized a novel approach that consists in comparing the effectiveness and efficacy of treatment interventions with a patient-centered emphasis (i.e., evidence-based health care), while ensuring cost constraints, maximizing benefits, and minimizing risks. In this book, experts in comparative effectiveness and efficacy research and analysis for practice (CEERAP) in health care in general address a range of topical issues. The emphasis is on implications for endodontics and nursing, both of which are considered in a series of detailed chapters. Commonalities and differences among CEERAP, utility-based and logic-based analysis and decision-making, and evidence-based and patient-centered practice are defined and discussed. The book concludes by examining applications for CEERAP in developing patient-centered optimal treatment interventions for the next decade.

Download or read book Encyclopedia of Human Services and Diversity written by Linwood H. Cousins and published by SAGE Publications. This book was released on 2014-09-05 with total page 1603 pages. Available in PDF, EPUB and Kindle. Book excerpt: Encyclopedia of Human Services and Diversity is the first encyclopedia to reflect the changes in the mission of human services professionals as they face today’s increasingly diverse service population. Diversity encompasses a broad range of human differences, including differences in ability and disability, age, education level, ethnicity, gender, geographic origin, religion, sexual orientation, socioeconomic class, and values. Understanding the needs and problems of Asian Americans, Hispanic Americans, the deaf, the blind, the LGBT community, and many other groups demands an up-to-date and cutting-edge reference. This three-volume encyclopedia provides human services students, professors, librarians, and practitioners the reference information they need to meet the needs of an increasingly diverse population. Features: 600 signed entries are organized A-to-Z across three volumes. Entries, authored by key figures in the field, conclude with cross references and further readings. A Reader’s Guide groups related articles within broad, thematic areas, such as aging, community mental health, family and child services, substance abuse, etc. A detailed index, the Reader’s Guide, and cross references combine for search-and-browse in the electronic version. A helpful Resource Guide guides students to classic books, journals, and web sites, and a glossary assists them with the terminology of the field. Available in both print and electronic formats, Encyclopedia of Human Services and Diversity is an ideal reference for students, practitioners, faculty and librarians.

Download or read book Essentials of Epidemiology in Public Health written by Ann Aschengrau and published by Jones & Bartlett Publishers. This book was released on 2013-06-03 with total page 547 pages. Available in PDF, EPUB and Kindle. Book excerpt: Successfully tested in the authors' courses at Boston University and Harvard University, this text combines theory and practice in presenting traditional and new epidemiologic concepts. Broad in scope, the text opens with five chapters covering the basic epidemiologic concepts and data sources. A major emphasis is placed on study design, with separate chapters devoted to each of the three main analytic designs: experimental, cohort, and case-control studies. Full chapters on bias, confounding, and random error, including the role of statistics in epidemiology, ensure that students are well-equipped with the necessary information to interpret the results of epidemiologic studies. An entire chapter is also devoted to the concept of effect measure modification, an often-neglected topic in introductory textbooks. Up-to-date examples from the epidemiologic literature on diseases of public health importance are provided throughout the book. The Third Edition is a thorough update that offers: • New examples, the latest references, and public health statistics. • Nearly 50 new review questions. • Updated discussion of certain epidemiologic methods. • New figures depicting epidemiologic concepts.

Download or read book Federal Register written by and published by . This book was released on 2013-04 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Veteran Psychiatry in the US written by Elspeth Cameron Ritchie and published by Springer. This book was released on 2019-03-29 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume explores the unique psychiatric needs of active and former military personnel and offers clinical pearls for the optimal delivery of care for these individuals. Written by experts in military and veteran psychiatry, this book addresses the most common issues in military and veteran patients, including depression, traumatic brain injury, posttraumatic stress disorder, substance use disorder, homelessness, and suicidality. Chapters highlight the characteristics of veterans suffering from each disorder that requires special treatment, making it a valuable resource for both military and civilian clinicians. Veteran Psychiatry in the US is a valuable resource for all mental health clinicians working with or seeking to work with veterans, including psychiatrists, neurologists, primary care physicians, psychologists, counselors, social workers, nurses, residents, and all others.

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.

Download or read book Evidence synthesis for health policy and systems written by World Health Organization and published by World Health Organization. This book was released on 2018-08-14 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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.

Download or read book Making Choices in Health written by World Health Organization and published by World Health Organization. This book was released on 2003 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Guide, in Part I, begins with a brief description of generalized CEA and how it relates to the two questions raised above. It then considers issues relating to study design, estimating costs, assessing health effects, discounting, uncertainty and sensitivity analysis, and reporting results. Detailed discussions of selected technical issues and applications are provided in a series of background papers, originally published in journals, but included in this book for easy reference in Part II." (from the back cover).

Download or read book AI and education written by Miao, Fengchun and published by UNESCO Publishing. This book was released on 2021-04-08 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: Artificial Intelligence (AI) has the potential to address some of the biggest challenges in education today, innovate teaching and learning practices, and ultimately accelerate the progress towards SDG 4. However, these rapid technological developments inevitably bring multiple risks and challenges, which have so far outpaced policy debates and regulatory frameworks. This publication offers guidance for policy-makers on how best to leverage the opportunities and address the risks, presented by the growing connection between AI and education. It starts with the essentials of AI: definitions, techniques and technologies. It continues with a detailed analysis of the emerging trends and implications of AI for teaching and learning, including how we can ensure the ethical, inclusive and equitable use of AI in education, how education can prepare humans to live and work with AI, and how AI can be applied to enhance education. It finally introduces the challenges of harnessing AI to achieve SDG 4 and offers concrete actionable recommendations for policy-makers to plan policies and programmes for local contexts. [Publisher summary, ed]

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.

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: