Health Care Decision Makers’ Use of Comparative Effectiveness Research: Report from a Series of Focus Groups

Villa, L; Warholak, Terri; Hines, Lisa; Taylor, Ann M.; Brown, Mary Louise; Hurwitz, Jason T.; Brixner, Diana I.; Malone, Daniel C.

doi:10.18553/jmcp.2013.19.9.745

Cited by 10 publications

(8 citation statements)

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“…The main critiques of EPC reports in the formulary decisionmaker project that limited their effectiveness were: the reports lacked timeliness (they came out months after the new drug needed to be reviewed internally), and the results were perceived as largely inconclusive. 5 In our current project, KIs feel the timeframe from project initiation until publication of a systematic review is too long and they prefer guidelines because they have more definitive recommendations. Systematic reviews cannot be guidelines, even though quality guidelines are driven by rigorous systematic reviews.…”

Section: Discussion and Limitationsmentioning

confidence: 99%

“…In an assessment of formulary decisionmakers in health-systems published in 2013, 39 pharmacists and 18 physicians on health-systems pharmacy & therapeutics committees participated in 90-minute focus groups. 5 Overall, 51% of KIs said they had heard of the site to access EPC reports and 28% had used material from them. This is very similar to what we found in our current project with four of nine KIs being familiar with EPC reports and/or the journal publications that result from them.…”

Section: Discussion and Limitationsmentioning

confidence: 99%

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Understanding Health Systems' Use of and Need for Evidence To Inform Decisionmaking

Gd²,

Butler³

et al. 2017

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PrefaceThe Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public-and private-sector organizations in their efforts to improve the quality of health care in the United States.The reports and assessments provide organizations with comprehensive, evidence-based information on common medical conditions and new health care technologies and strategies. They also identify research gaps in the selected scientific area, identify methodological and scientific weaknesses, suggest research needs, and move the field forward through an unbiased, evidence-based assessment of the available literature. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments.To improve the scientific rigor of these evidence reports, AHRQ supports empiric research by the EPCs to help understand or improve complex methodologic issues in systematic reviews. These methods research projects are intended to contribute to the research base in and be used to improve the science of systematic reviews. They are not intended to be guidance to the EPC program, although they may be considered by EPCs along with other scientific research when determining EPC program methods guidance.AHRQ expects that the EPC evidence reports and technology assessments, when appropriate, will inform individual health plans, providers, and purchasers as well as the health care system as a whole by providing important information to help improve health care quality.If Background. According to the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine, in order for health care systems to improve health quality, outcomes, cost, and equity there needs to be a process for transmitting new knowledge into everyday care. Systematic reviews are one potential source of knowledge. However, little is known about the types of evidence used by health-systems and how evidence reports produced by the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program could be used by learning health-systems.Purpose. To better understand how health-systems identify and use evidence and how EPC reports could help them with their decisionmaking in the future.Methods. From February to September 2017, an AHRQ/EPC Methods Workgroup interviewed nine individuals with leadership roles in enhancing health-system quality, safety, and process improvement from academic, non-academic, and small community health-systems, as well as health-system collaborative organizations. Workgroup members reviewed interview notes and transcripts to identify key themes and exemplar quotations. The nine Key Informants (KI) reviewed the draft report for accuracy.Results. Health-systems have various internal processes for getting and using evidence in their decisionmaking. All of the ...

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Section: Discussion and Limitationsmentioning

confidence: 99%

Section: Discussion and Limitationsmentioning

confidence: 99%

Understanding Health Systems' Use of and Need for Evidence To Inform Decisionmaking

Gd²,

Butler³

et al. 2017

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“…A similarly designed study in a large academic health care system suggested the same. 18 Members of Pharmacy and Therapeutics committees (pharmacists and physicians from various health systems and organizations) participating in focus groups 34 were asked about their use of AHRQ EPC Program Comparative Effectiveness Reviews (CERs). Only 26% reported using the reviews in their organizations.…”

Section: Types Of Evidence Synthesis Sought By Health Systemsmentioning

confidence: 99%

“…In particular, they wanted training in evaluation of "evidence hierarchies," and wanted online course delivery. 34 In several studies, decisionmakers were interviewed or observed to identify preferences for presentation format. In general, they preferred summaries that were brief, presented in a "graded" format (key messages, executive summary) or presented verbally.…”

Section: Tools For Promoting Use Of Evidence In Health System Decisionsmentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

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PrefaceThe Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public-and private-sector organizations in their efforts to improve the quality of health care in the United States.The reports and assessments provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments.To improve the scientific rigor of these evidence reports, AHRQ supports empiric research by the EPCs to help understand or improve complex methodologic issues in systematic reviews. These methods research projects are intended to contribute to the research base in and be used to improve the science of systematic reviews. They are not intended to be guidance to the EPC program, although may be considered by EPCs along with other scientific research when determining EPC program methods guidance.AHRQ expects that the EPC evidence reports and technology assessments will inform individual health plans, providers, and purchasers as well as the health care system as a whole by providing important information to help improve health care quality. The reports undergo peer review prior to their release as a final report.If AcknowledgmentsThe authors gratefully acknowledge the input of the late Robert Lewis Kane, M.D., who was a member of our workgroup until his unexpected death on March 6, 2017. Dr. Kane stimulated the conversation of our workgroup with his ideas and challenges, and inspired creation of the initial framework for our efforts (See Appendix B).The authors also acknowledge two health system representatives, Lucy Savitz, Ph.D., and Charles P. Friedman, Ph.D. for their feedback on our initial framework and draft report. A Framework for Conceptualizing Evidence Needs of Health Systems Structured AbstractObjectives. To develop a framework for understanding the evidence needs of health systems to inform the AHRQ EPC Program future efforts.Data sources. Three data sources were used: (a) peer-reviewed literature from a systematic search of English-language publications in MEDLINE from January 2007-April 2017, (b) original data from four programs serving health system requests for evidence syntheses, and (c) input during a face-to-face meeting at AHRQ in June 2017 from health system stakeholders and EPC investigators.Methods. Data were synthesized narratively and thematically. We developed an initial framework to guide discussion and qualitative analysis. We built consensus around themes and refinement of the framework through weekly phone conferences, electronic communications, and a face-to-face meeting of workgroup members and health systems experts. Results.From the literature review, we found that health systems seek evidence to ...

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“…As a result, CER/PCOR evidence is rapidly accumulating in the literature. However, there remains a need to better integrate CER/PCOR evidence into decision making [5][6][7][8][9]. A major limitation may be that potential users of this evidence need to be educated on the strengths and weaknesses of CER and its place within the hierarchy of evidence levels.…”

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confidence: 99%

Comparative effectiveness and patient-centered outcomes research: enhancing uptake and use by patients, clinicians and payers

Schumock

Pickard

2018

J. Comp. Eff. Res.

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Evidence from comparative effectiveness research (CER) and patient-centered outcomes research (PCOR) studies are increasingly available in the literature. However, there remain opportunities to better integrate that evidence into decision-making. An invitation-only conference held in January 2017, titled “Comparative Effectiveness and Patient-Centered Outcomes Research: Enhancing Uptake and Use by Patients, Clinicians and Payers”, sought to identify and discuss both gaps in the uptake and use of CER/PCOR, and approaches to enhance the uptake and use of CER/PCOR evidence by patients, clinicians and payers. In this article, we summarize the conference proceedings, and highlight the themes and recommendations that resulted from the sessions. This paper also introduces other articles in this issue of CER from that conference.

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Health Care Decision Makers’ Use of Comparative Effectiveness Research: Report from a Series of Focus Groups

Abstract: BACKGROUND: Comparative effectiveness research (CER) is a helpful approach to improve health outcomes by developing and disseminating evidence-based information to patients, clinicians, and other decision makers about the most effective interventions.

Cited by 10 publications

References 10 publications

Understanding Health Systems' Use of and Need for Evidence To Inform Decisionmaking

Understanding Health Systems' Use of and Need for Evidence To Inform Decisionmaking

A Framework for Conceptualizing Evidence Needs of Health Systems

Comparative effectiveness and patient-centered outcomes research: enhancing uptake and use by patients, clinicians and payers

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