SEaRCH™ expert panel process: streamlining the link between evidence and practice

Abstract

BackgroundWith rising health care costs and the diversity of scientific and clinical information available to health care providers it is essential to have methodologies that synthesize and distill the quality of information and make it practical to clinicians, patients and policy makers. Too often research synthesis results in the statement that “more and better research is needed” or the conclusions are slanted toward the biases of one type of stakeholder. Such conclusions are discouraging to clinicians and patients who need better guidance on the decisions they make every day.MethodExpert panels are one method for offering valuable insight into the scientific evidence and what experts believe about its application to a given clinical situation. However, with improper management their conclusions can end up being biased or even wrong. There are several types of expert panels, but two that have been extensively involved in bringing evidence to bear on clinical practice are consensus panels, and appropriateness panels. These types of panels are utilized by organizations such as the National Institutes of Health, the Institute of Medicine, RAND, and other organizations to provide clinical guidance. However, there is a need for a more cost effective and efficient approach in conducting these panels. In this paper we describe both types of expert panels and ways to adapt those models to form part of Samueli Institute’s Scientific Evaluation and Research of Claims in Health Care (SEaRCH™) program.DiscussionExpert Panels provide evidence-based information to guide research, practice and health care decision making. The panel process used in SEaRCH seeks to customize, synthesize and streamline these methods. By making the process transparent the panel process informs decisions about clinical appropriateness and research agenda decisions.

Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining “What Works” in Healthcare

“…6 The final method involves the structured management of EPs for making value judgments about the use of current evidence. 7 There are several types of EPs, depending on the purpose and need. A Clinical Expert Panel focuses expert opinion on the appropriateness of a given clinical practice or product for clinical use.…”

“…8 In addition, the Institute has begun to incorporate EP methodology, adapted from RAND's “Appropriateness” process to complete the SEaRCH design described here. 7,20 …”

“…The second method is the Rapid Evidence Assessment of the Literature (REAL © ), which uses streamlined systematic review methods to determine the current state of the evidence. 6 The third method involves the structured use of expert panels (EPs) 7 in order to deliver evidence-informed decisions to the end user in a transparent fashion.…”

“…6,7,9–15 This validation testing has been done on existing practices in areas of behavioral medicine, self-care, nutrition, life-style programs, and CIM. However, the principles of this framework are drawn from general scientific evaluation methods, and are applicable to any healthcare claim, whether about a program, practice, or product already in use.…”

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part I

“…Although there is general agreement that all patients should receive health care that is appropriate to their health problem and that inappropriate care is costly, 1 the challenge comes in determining what is appropriate care. 2 In general, appropriateness comprises the right therapy, for the right problem, and for the right patient.…”