The Common Rule and Continuous Improvement in Health Care: A Learning Health System Perspective – Institute of Medicine Discussion Paper – October 2011

Posted on November 1, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , |

The Common Rule and Continuous Improvement in Health Care: A Learning Health System Perspective – Institute of Medicine Discussion Paper – October 2011

Harry Selker, Claudia Grossmann, Alyce Adams, Donald Goldmann, Christopher Dezii, Gregg Meyer, Veronique Roger, Lucy Savitz and Richard Platt

Working Group participants drawn from the Clinical Effectiveness Research Innovation Collaborative of the IOM Roundtable on Value & Science-Driven Health Care

“Abstract

To generate needed improvements in healthcare, its delivery, and its outcomes, organized and sustained efforts at continuous improvement are needed. The Institute of Medicine’s Roundtable on Value & Science-Driven Health Care has developed the vision of a healthcare system that gets the right care to the right people when they need it, and captures the results for making improvements: a learning health system. The Roundtable sees the creation of generalizable new knowledge as a necessary, routine aspect of the delivery of healthcare. Activities that involve measurement, comparison, evaluation, systematic introduction of accepted therapies, sharing of experience and information, and coordination of these activities among organizations, either are, or should become, normal expected activities of such organizations.”  … continues on the site

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Comparative Effectiveness Review Methods: Clinical Heterogeneity – AHRQ – 27 September 2010

Posted on October 25, 2010. Filed under: Evidence Based Practice | Tags: , |

Comparative Effectiveness Review Methods: Clinical Heterogeneity – AHRQ – 27 September 2010
AHRQ = Agency for Healthcare Research and Quality [US]

AHRQ’s Effective Health Care Program released a new report, Comparative Effectiveness Review Methods: Clinical Heterogeneity prepared by AHRQ’s RTI International–University of North Carolina Evidence-based Practice Center.  The report explores best practices for addressing clinical heterogeneity in systematic reviews and comparative effectiveness reviews. Patients, clinicians, policymakers, and others assert that systematic reviews typically focus on broad populations and, as a result, often lack information relevant to individual patients or patient subgroups.  The report concluded that clear evidence-based guidance on addressing clinical heterogeneity in systematic reviews and comparative effectiveness reviews is not available currently but would be valuable to AHRQ’s Evidence-based Practice Centers and to others conducting systematic reviews internationally.

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Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine (US) – 30 June 2009

Posted on July 1, 2009. Filed under: Health Systems Improvement, Research | Tags: , , , , , |

Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine (US) – 30 June 2009

Full text of the report from National Academies Press

“Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. Consumers, patients, and caregivers also require this information to decide how to evaluate and treat their conditions. All too often, the information necessary to inform these medical decisions is incomplete or unavailable, resulting in more than half of the treatments delivered today lacking clear evidence of effectiveness.

Comparative effectiveness research (CER) identifies what works best for which patients under what circumstances. Congress, in the American Recovery and Reinvestment Act (ARRA) of 2009, tasked the Institute of Medicine (IOM) to recommend national priorities for research questions to be addressed by CER and supported by ARRA funds. In its 2009 report, Initial National Priorities for Comparative Effectiveness Research, the authoring committee establishes a working definition of CER, develops a priority list of research topics to be undertaken with ARRA funding using broad stakeholder input, and identifies the necessary requirements to support a robust and sustainable CER enterprise. The full list of priorities and recommendations can be found in the below report brief.”

2 articles on this from the NEJM – 30 June 2009

Prioritizing Comparative-Effectiveness Research — IOM Recommendations
J.K. Iglehart

Comparative-Effectiveness Research — Implications of the Federal Coordinating Council’s Report
P.H. Conway and C. Clancy

2 articles from the Annals of Internal Medicine

Comparative Effectiveness Research: A Report From the Institute of Medicine
Harold C. Sox, MD, Editor, and Sheldon Greenfield, MD
4 August 2009  Volume 151 Issue 3  Annals of Internal Medicine

Rethinking Randomized Clinical Trials for Comparative Effectiveness Research: The Need for Transformational Change
Bryan R. Luce, PhD, MBA; Judith M. Kramer, MD, MS; Steven N. Goodman, MD, MHS, PhD; Jason Connor, PhD; Sean Tunis, MD, MSc; Danielle Whicher, MHS; and J. Sanford Schwartz, MD
4 August 2009  Volume 151 Issue 3    Annals of Internal Medicine

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