Comparative Effectiveness Research is an international, peer reviewed, open access journal that strives to cover this emerging field. Comparative effectiveness research (CER) is a PICOT (Population, Intervention, Comparison, Outcome, Time) question-driven, systematic process of investigation; it utilizes the well-characterized design of research synthesis, validated methodology for assessing the evidence and data analysis, which includes acceptable sampling and meta-analysis. CER assembles the best available evidence for ensuring effectiveness-focused, patient-centered and evidence-based medicine, dentistry, nursing and allied disciplines. CER is the critical and timely process of translational healthcare; it evinces the most reliable evidence to compare the advantages, disadvantages and expenditure for an intervention with other available options for the prevention, diagnosis, treatment and monitoring of a clinical condition. CER amalgamates patients, clinicians, caregivers and other stakeholders to

Abstract (from Health Affairs): Medicines current evidence base is insufficient for many of the decisions made daily by clinicians, patients, purchasers, and policy makers. The Patient-Centered Outcomes Research Institute (PCORI) represents an effort by the US government to address this shortcoming by funding comparative effectiveness research (CER). Prioritizing that research will be a critical first step. To better understand components of an optimal process, NPC reviewed the literature and conducted interviews regarding the prioritization efforts of leading public and private health organizations in the United States and abroad. From this review, NPC proposes a framework for prioritization, poses and answers key questions, and makes recommendations regarding application of that framework. NPC also recommends that during the priority-setting process, there should be transparent conversations among those who make decisions about the priorities and the public.. ...

NIH Funding Opportunities and Notices in the NIH Guide for Grants and Contracts: Recovery Act 2009 Limited Competition OS ARRA: Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient (R21) RFA-HS-10-009. AHRQ

The prevalence of obesity and diabetes in older adults is increasing. Because older adults are often portrayed as less likely to change long-standing health behaviors, health promotion in this age group has lagged behind others. In fact, little attention has been given to the importance of diabetes prevention in community-dwelling older adults through the implementation of programs that promote healthy nutrition, increase physical activity and improve self-management. The Diabetes Prevention Program (DPP), which demonstrated the benefit of modest weight loss on the reduction of diabetes risk (58% overall reduction with a 71% reduction in the older population), has yet to be translated into widespread public health practice.. The overall objective of this protocol is to implement evidence-informed, innovative interventions to increase adoption of findings from comparative effectiveness research (CER) for diabetes management and prevention in South Florida older veterans. Specifically, the ...

The main thrust of this con article is to state that the area of portable monitoring and home-based treatment of sleep apnea direly needs comparative effectiveness research (CER) with cost-efficacy and tangible patient outcomes measurements before widespread institution into real-world practice. In the absence of such CER, currently, there are few modeling studies that are not favorable toward portable monitoring and home-based treatment initiation, and that requires careful attention.16-18. Pietzche and colleagues recently published their Markov model-based study which used a hypothetical model applied to 50-year-old men with a 50% chance of having moderate-severe sleep apnea.17 They performed 10-year and lifetime incremental cost-effectiveness ratio projections for laboratory based studies and portable monitoring.17 They factored rates and cost of cardiovascular events and motor vehicle accidents, health-related quality of life, CPAP adherence, and failure of portable monitoring or therapy. ...

Agencies in Australia, France, Germany, and the U.K. have comparative effectiveness research agencies that offer lessons for the United States.

Dr. Steven Pearson, president of Institute for Clinical and Economic Review, explains how private and public payers might use comparative effectiveness research, particularly with the expected influx of new information from federal sources. NPC spoke with Dr. Pearson at the Drug Information Association Annual Meeting in June 2011.. ...

In the aftermath of the Supreme Courts landmark Affordable Care Act ruling, leading health care researchers will discuss strategies for analyzing large population databases to conduct comparative effectiveness research (CER) July 13 at Rice Universitys Baker Institute for Public Policy.

For all its costs, flaws, and inequities, American health care is fundamentally rooted in a belief that treatment should be based on solid scientific research. To this end, between 2003 and 2010, three different federal laws were enacted, the most recent being the Affordable Care Act of 2010, that mandated new federal investments in a type of clinical research called comparative effectiveness research (CER) - research into what works best in medical care.

But the truth is: this trial never would have seen the light of day if it werent for industry. Note that St. Jude Medical paid $20 million and Biosense Webster paid $18 million toward the trial, while the government could only foot 35% ($18 million) of the costs for the trial. Some will consider this an "efficient" use of government funds. Others will point to the governments new paradigm for requiring significant industry sponsorship to fund their comparative effectiveness research (CER) trials as opening the potential for the development of "pay to play" relationships to develop between government and industry. One only has to look to the FDAs recent challenges at separating themselves from industry influence to see the potential for conflict ...

But the truth is: this trial never would have seen the light of day if it werent for industry. Note that St. Jude Medical paid $20 million and Biosense Webster paid $18 million toward the trial, while the government could only foot 35% ($18 million) of the costs for the trial. Some will consider this an "efficient" use of government funds. Others will point to the governments new paradigm for requiring significant industry sponsorship to fund their comparative effectiveness research (CER) trials as opening the potential for the development of "pay to play" relationships to develop between government and industry. One only has to look to the FDAs recent challenges at separating themselves from industry influence to see the potential for conflict ...

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Meystre S, Gouripeddi R, Tieder J, Simmons J, Srivastava R, Shah S. Enhancing Comparative Effectiveness Research With Automated Pediatric Pneumonia Detection in a Multi-Institutional Clinical Repository: A PHIS+ Pilot Study. J Med Internet Res. 2017 May 15;19(5):e162.. ...

Mood stabilizers, medications that prevent future mood episodes, are the foundation for treatment of bipolar disorder. While all published bipolar disorder treatment guidelines recommend that pharmacotherapy should include mood stabilizers for long-term maintenance treatment, no randomized comparative effectiveness studies have examined the real-world advantages and disadvantages of the newer second generation antipsychotic (SGA) mood stabilizers compared to the classic mood stabilizers, such as lithium (Li). No studies have looked at the effectiveness of SGAs compared to mood stabilizers when used in the context of other medications required to manage bipolar patients, since bipolar disorder patients take a median of 3 medications for optimal outcomes. Quetiapine (QTP) is the most extensively studied, broadly efficacious and the most widely prescribed SGA for bipolar disorder. The classic mood stabilizer Li has the largest evidence base for treating bipolar disorder, but has been largely ...

1) Comparative effectiveness research and 2) ACGME proposals for work duty hours. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Michael Benatar interviews Dr. Jacqueline French about her paper on comparative effectiveness research. In the next segment, Dr. Ryan Overman is reading our e-Pearl of the week about Guillain-Barré-like syndrome with thallium poisoning. In the next part of the podcast Dr. Ted Burns interviews Dr. Lori Schuh about ACGME recommendations for work duty hours for Read More 1) Comparative effectiveness research and 2) ACGME proposals for work duty hours. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Michael Benatar interviews Dr. Jacqueline French about her paper on ...

TY - JOUR. T1 - Comparative effectiveness review of treatment options for pituitary microadenomas in acromegaly. T2 - Clinical article. AU - Marko, Nicholas F.. AU - Lasota, Emily. AU - Hamrahian, Amir. AU - Weil, Robert J.. PY - 2012/9/1. Y1 - 2012/9/1. N2 - Object. Acromegaly, a syndrome of excess growth hormone (GH) secretion typically caused by a GH-secreting pituitary adenoma, reduces life expectancy by approximately 10 years when left untreated. Treatment of acromegaly involves combinations of one or more discrete therapeutic modalities to achieve biochemical control. Unfortunately, data capable of informing decisions among alternate management strategies are presently lacking. Methods. The authors performed a comparative effectiveness research (CER) review integrating efficacy, cost, and quality of life (QOL) analysis for treatment strategies comprising various combinations of surgery, radiotherapy, stereotactic radiosurgery, and pharmacotherapy in patients with acromegaly caused by a ...

Group Health has been approved for two research awards from the Patient-Centered Outcomes Research Institute (PCORI) to study ways to improve care for back pain and to connect patients with community resources. The projects are part of a portfolio of patient-centered comparative clinical effectiveness research that addresses PCORIs National Priorities for Research and Research Agenda.. ...

Under some all-powerful government CER panel would Clinton have received the stents? What does CER tell us about the best treatment for ACS? We have comparative effectiveness studies out the wazoo on this issue alone and they would be too numerous to mention here. For the most part these studies are compiled and evaluated in the latest ACC/AHA guidelines for unstable angina/NSTEMI, which is what Clinton most likely had. Under these guidelines either an initial conservative or invasive strategy is allowed, and if the patient stabilizes clinically a stress test is recommended before cardiac catheterization. Positive cardiac markers and ST segment or T wave changes suggest, but do not mandate, an initial invasive strategy under the guidelines. My summary is a gross oversimplification. Be assured the government will oversimplify even more. The Fox piece is distorted and non-informative but suffice it to say that in an era where government panels wrest EBM from the hands of physicians Clinton (or ...

Comparative Effectiveness Review Number 134 Pharmacotherapy for Adults With Alcohol- Use Disorders in Outpatient Settings Comparative Effectiveness Review Number 134 Pharmacotherapy for Adults With Alcohol-Use

The Patient-Centered Outcomes Research Institute (PCORI) is a United States-based non-governmental institute created as part of a modification to the Social Security Act by clauses in the Patient Protection and Affordable Care Act. It is a government-sponsored organization charged with investigating the relative effectiveness of various medical treatments. Medicare may consider the Institutes research in the determining what sorts of therapies it will cover. PCORI was established by the 2010 Patient Protection and Affordable Care Act. It is a 501(c)(1) organization. PCORI is charged with examining the "relative health outcomes, clinical effectiveness, and appropriateness" of different medical treatments by evaluating existing studies and conducting its own. Its nineteen-member board includes patients, physicians, nurses, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts. It will not have the power to mandate or even endorse coverage rules or ...

Current Membership of the Patient-Centered Outcomes Research Institute (PCORI) Governing Board. Following are brief biographies of the current members of the PCORI Board of Governors.. Debra Barksdale, PhD, RN, is Professor and Associate Dean of Academic Programs at the Virginia Commonwealth University in Richmond, VA. She is a researcher, certified nurse practitioner, and educator. Her research program focuses on psychological and physical stress, coping, and cardiovascular responses in African-Americans. She is a Fellow of the American Academy of Nurse Practitioners and the American Academy of Nursing. She received a BS in nursing from the University of Virginia, a masters in nursing from Howard University, a post-masters in teaching from the University of Pennsylvania, and a PhD in Nursing Research from the University of Michigan. Dr. Barksdale was appointed in September 2010 for a 2-year term and reappointed in September 2012 for a 6-year term.. Kerry Barnett, JD, (Vice Chair) is President ...

These are not new concepts to anesthesiologists. However, much like the practice of medicine as a whole, many of our clinical decisions are not rooted in large comparative effectiveness trials. Efficacy trials are typically small, early-stage randomized controlled trials of a treatment. They often enroll a specific, high-risk patient population to maximize statistical power and require detailed protocols mandating specific care patterns and ideal use of the studied intervention. An example would be the van den Berghe et al. 6 trial of intensive insulin therapy in surgical intensive care unit patients, which demonstrated a profound mortality and morbidity benefit to targeting blood glucose levels less than 110 mg/dl. This "proof-of-concept" study was then rapidly extrapolated to become a mainstay of critical care protocols. A multicenter study enrolling more than 6,000 heterogeneous patients under typical care settings demonstrated lower mortality using conventional blood glucose targets.7 These ...

This query was raised by provincial health plan decision-makers earlier in 2012. Thiazide diuretics (i.e. hydrochlorothiazide) have been shown to be at least as effective as calcium channel blockers (CCBs) (e.g. amlodipine), angiotensin converting enzyme (ACE) inhibitors (e.g. lisinopril) and angiotensin receptor blockers (ARBs) (e.g. losartan). In response to this query, we will evaluate the comparative effectiveness of antihypertensive treatments among older adults without diabetes, focusing on thiazides monotherapy compared with other monotherapy.. Q2. What is the comparative effectiveness and safety of sitagliptan and NPH insulin for the management of type 2 DM not controlled by metformin plus sulfonylurea ...

Dr. Testa and colleagues are developing quantitative and health information technology methods and processes relating to the measurement and analysis of expanded patient outcomes (quality of life, cost-effectiveness and risk-benefit) for clinical, pharmacoeconomic, pharmacoepidemiologic, quality of care and comparative effectiveness research studies with particular application to primary care, cardiovascular disease, HIV, and diabetes.. Quality of Life, Patient Satisfaction, Clinical Decision Making and Comparative Effectiveness Research Dr. Testa is working on analytical, statistical and health information methods for conducting health outcomes and comparative effectivness research for pharmaceutical drug development, disease management, quality of care programs and primary care and physician subspecialty practice management. As part of this methodologic work, she is analyzing a comprehensive database of patients who have participated in large-scale clinical trials of antihypertensive and ...

Purpose - Little is known about the comparative effects of common oral antidiabetic drugs ([OADs] metformin, sulfonylureas, or thiazolidinediones [THZs]) on chronic kidney disease (CKD) outcomes in patients newly diagnosed with type 2 diabetes (T2DM) and followed in community primary care practices. Electronic health records (EHRs) were used to evaluate the relationships

case-control studies [mh] OR cohort studies [mh] OR cross-over studies [mh] OR epidemiologic studies [mh:noexp] OR cross-sectional studies [mh] OR evaluation studies as topic [mh] OR meta-analysis as topic [mh] OR practice guidelines as topic [mh] OR case control [tw] OR case controlled [tw] OR case controls [tw] OR cohort [tw]OR cohorts [tw] OR follow-up [tw] OR followup [tw] OR longitudinal [tw] OR matched-pair analysis [mh] OR observational studies [tw] OR observational study [tw] OR multicenter study [pt]) AND ((comparative study [pt] OR compare [tw] OR compares [tw] OR compared [tw] OR comparing [tw] OR comparison [tw] OR comparative [tw] OR effective [tw] OR effectiveness [tw] OR versus [ti] OR vs [ti]) AND (activities of daily living [mh] OR benefit [tw] OR benefits [tw] OR budgets [mh] OR chronic disease [mh] OR clinical trials data monitoring committees [mh] OR cognitive function [tw] OR ec [sh] OR death [mh] OR diffusion of innovation [mh] OR discharge [tw] OR economics, pharmaceutical ...

The mission of the MDEpiNet Public Private Partnerships is to develop and implement innovative methods and national/international infrastructure for robust studies and surveillance to improve our understanding of medical device safety and effectiveness throughout device life-cycle. Our main objectives are to improve how medical device information is utilized throughout the life cycle of a device and to synthesize evidence on how medical devices are used throughout their life cycle. To accomplish our mission and objectives we have brought together an array of diverse stakeholders, including other government agencies, academia, health care industry organizations, and patient and consumer groups. These stakeholders bring to the table strategic resources, skills, and expertise from a variety of domains and requires participation from all . Read More... ...

Seven studies with a total number of 9618 patients (mainly composed of non-ST elevated myocardial infarction/NSTEMI) were included. This analysis showed mortality to be similarly observed between enoxaparin and fondaparinux with OR: 1.05, 95% CI: 0.67-1.63; P = 0.84. Myocardial infarction (MI) and stroke were also not significantly different throughout different follow up periods. However, minor, major and total bleeding were significantly lower with fondaparinux (OR: 0.40, 95% CI: 0.27-0.58; P = 0.00001), (OR: 0.46, 95% CI: 0.32-0.66; P = 0.0001) and (OR: 0.47, 95% CI: 0.37-0.60; P = 0.00001) respectively during the 10-day follow up period. Even during a follow up period of 30 days or a midterm follow up, major and minor bleeding still significantly favored fondaparinux in comparison to enoxaparin. ...

The idea of CER is that researchers and scientists gather evidence and compare surgeries, medical devices, drugs, tests, or health care services, and weigh the

BACKGROUND: Adverse outcomes and resource use rates are high after hip fracture surgery. Peripheral nerve blocks could improve outcomes through enhanced

This trial is comparing the efficacy of immediate treatment with fosfomycin tromethamine [Monuril; Pierre Favre]versus symptomatic relief with ibuprofen

In just a few days a new Obamacare tax-that will double the following year-will kick in to fund "comparative effectiveness research" thats supposed to help the government save money by finding ways to ration healthcare.. This is crazy; a semi-secret tax so the feds have cash to pay bureaucrats to examine everyones health records and, in turn, the government can save money by cutting back on care. The official plan, as noted by a national news wire this week, is to conduct research to find out which drugs, medical procedures, tests and treatments work best. Its part of a "little-known provision" of the presidents socialist takeover of the nations healthcare system.. Who will conduct this valuable research? A new quasi-governmental agency (Patient-Centered Outcomes Research Institute or PCORI) created by Obamacare to provide information about the "best available evidence to help patients and their health care providers make more informed decisions." PCORI claims its research is intended to ...

OBJECTIVES: The purpose of this study was to compare self-reported pain and "improvement" of patients with symptomatic, magnetic resonance imaging-confirmed, lumbar disk herniations treated with either high-velocity, low-amplitude spinal manipulative therapy (SMT) or nerve root injections (NRI). METHODS: This prospective cohort comparative effectiveness study included 102 age- and sex-matched patients treated with either NRI or SMT. Numerical rating scale (NRS) pain data were collected before treatment. One month after treatment, current NRS pain levels and overall improvement assessed using the Patient Global Impression of Change scale were recorded. The proportion of patients, "improved" or "worse," was calculated for each treatment. Comparison of pretreatment and 1-month NRS scores used the paired t test. Numerical rating scale and NRS change scores for the 2 groups were compared using the unpaired t test. The groups were also compared for "improvement" using the χ(2) test. Odds ratios with ...

Due to their condition, dialysis patients have limited access to inpatient and outpatient mental health (MH) treatment. The primary goal of this project is to establish a patient-caregiver-clinician-researcher partnership to develop a patient-centered comparative effectiveness research study that will identify potentially effective mechanisms for increasing access to and utilization of MH treatment for dialysis patients.

Drugs commonly used to treat high blood pressure, and prevent heart attacks and strokes, are associated with significantly worse cardiovascular outcomes in hypertensive African Americans compared to whites, according to a new comparative effectiveness research study led by researchers in the Department of Population Health at NYU Langone Medical Center and published in the Journal of the American College of Cardiology.

Our collective experience suggests that successful implementation of a patient- and stakeholder- engaged research paradigm involves: (1) defining the roles and process for the incorporation of input; (2) identifying the particular patients and stakeholders to build a foundation of key stakeholders who appropriately represent the target treatment population and its caregivers; (3) engaging patients and stakeholders so they appreciate the value of their own participation and have personal investment in the research process; and (4) overcoming barriers and challenges that arise and threaten the productivity of the collaboration. Engaging patients may include educating them so they understand the research process and how it is connected to changes in clinical practice, and are therefore equipped to make meaningful contributions (31). Foundations of trust and mutual respect are key elements to being able to successfully navigate all of the foreseeable and unforeseeable challenges that present ...

Section 6301(f)(2) of the Patient Protection and Affordable Care Act (PPACA) requires the Comptroller General "to consider and disclose any conflicts of interest" in appointing the Board of Governors on GAOs Web site.. Section 6301(a)(3) of PPACA defines "conflict of interest" as: "[A]n association, including a financial or personal association, that have the potential to bias or have the appearance of biasing an individuals decision in matters related to the Institute or the conduct of activities under this section." Below are the associations of the Board of Governors that upon appointment by the Comptroller General, fit within PPACAs definition of a "conflict of interest".. Notes: ...

CONTACT:. Lorie Slass (215) 801-4057. [email protected] FOR IMMEDIATE RELEASE August 30, 2017 Society to Improve Diagnosis in Medicine Approved for a $250,000 Engagement Award from the Patient-Centered Outcomes Research Institute Award Will Address Gap in Patient Representation in Development of Research Around Diagnostic Error and Establish a New Academy of Patient Partners. (August 30, 2017) The Society to Improve Diagnosis in Medicine (SIDM) has received a Eugene Washington PCORI Engagement Award from the Patient-Centered Outcomes Research Institute (PCORI). The 18-month project, Patients Improving Research in Diagnosis, will develop and evaluate an innovative curriculum to train Patient Partners to participate in the design, execution and dissemination of research to improve diagnosis. SIDM and its partners from Project Patient Care (PPC) and the MedStar Institute for Quality and Safety will also work together to develop a new Academy for Patient Partners. The 2015 National ...

Added participation by patients, clinicians and others in the health care community while developing comparative clinical effectiveness research studies will make such studies far more constructive.

Effectiveness and implementation trials additionally provide key records. The aim of those trials is to determine effective techniques for handing over demonstrated effective interventions in habitual medical settings. An instance of this kind of NHLBI backed studies encompass the Home Blood Pressure Telemonitoring and Case Management to Control Hypertension observe which promotes network efforts to obtain blood pressure control via in-domestic blood strain tracking with the collaboration of pharmacists and number one care physicians. This takes a look at plans to assess the long-time feasibility and critical factors for translating this intervention into exercise.. NINDS and NHLBI are partnering with the Patient-Centered Outcomes Research Institute to improve hypertension control amongst excessive hazard racial and ethnic minority populations by sponsoring two comparative effectiveness trials to evaluate high blood pressure manage strategies at the health machine and/or community stage. Several ...

Congratulations to Consortium members University of Pittsburgh, Boston University, and Johns Hopkins for receiving a Patient-Centered Outcomes Research Institute (PCORI) award for a five-year, $14 million, large pragmatic comparative effectiveness trial entitled, "Targeted Interventions to Prevent Chronic Low Back Pain in High Risk Patients: A Multi-site Pragmatic RCT" (The TARGET Study).. Anthony Delitto, PT, PhD, Professor and Chair of the Department of Physical Therapy at the University of Pittsburgh, and Rob Saper, MD, MPH, of Boston Medical Center are the Co-Principal Investigators.. Using a two-arm cluster randomized controlled trial, the question being asked is:. Can chronic low back pain be prevented when patients with acute low back pain are promptly referred to physical therapy augmented with cognitive behavioral principles?. The project will be based at the University of Pittsburgh with subawards to Boston Medical Center, Johns Hopkins Hospital and Health System, Intermountain ...

By Ruth Faden and Jonathan D. Moreno, Its a name only a policy wonk could love: comparative effectiveness research. But get ready to hear a lot about it; it could save your rights as a patient - and maybe even your life.. If opponents have their way, it could be the bogeyman that brings down health care reform. Using false and misleading scare tactics, Conservatives for Patients Rights, a group opposed to comprehensive health care reform, announced last week a $1 million ad attacking comparative effectiveness. ...

Authors of a comparative effectiveness review released by the Agency for Healthcare Research and Quality report that the "body of evidence is not informative" regarding effectiveness or comparative effectiveness of multidisciplinary postacute rehabilitation for adults with moderate to severe traumatic brain injury (TBI). Multidisciplinary Postacute Rehabilitation for Moderate to Severe Traumatic Brain Injury in Adults examines 5 key questions related to characterizing the interventions, effectiveness and comparative effectiveness, minimal clinically important differences, sustainability of intervention effectiveness, and adverse events. The authors state that, "Although we found stronger evidence on the comparative effectiveness of different approaches to multidisciplinary postacute rehabilitation for participation outcomes, we found a limited number of eligible studies and no clear demonstration that one approach was superior to another.". The authors call for further research to "address ...

The Patient-Centered Outcomes Research Institute (PCORI) yesterday approved 25 awards, totaling $40.7 million over 3 years, to fund patient-centered comparative clinical effectiveness research (CER) projects under the first 4 areas of its National Priorities for Research and Research Agenda.. The projects approved for funding include those that will study rehabilitation services for survivors of acute ischemic stroke, nonsurgical treatment methods for patients with lumbar spinal stenosis, and a patient-centered risk stratification method for improving primary care for back pain. Other projects seek ways to improve patient-clinician communication, reduce selected health disparities, and improve the way health care systems operate.. The projects were approved by PCORIs Board of Governors through a competitive, multi-stage review process that incorporated patients, caregivers, and other stakeholders in the evaluation of proposals. Applications were evaluated on scientific merit, engagement of ...

This guide summarizes evidence comparing the effectiveness and safety of disease-modifying antirheumatic drugs (DMARDs) and corticosteroids used for rheumatoid arthritis (RA). It does not address other drugs that are no longer commonly used as first-line treatment for RA, such as azathioprine, chloroquine, cyclosporine, gold, and penicillamine. It also does not discuss analgesics, such as acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids.

The primary and secondary abstractors/evaluators will independently review each study included in the review. Study quality for the individual RCTs included in the systematic review will be evaluated by using criteria based on the domains recommended by the Cochrane Collaboration. These criteria include an assessment of the risk of bias within each study by specifically evaluating: 1) adequacy of allocation concealment, based on the approach developed by Schulz and Grimes;30 2) blinding methods (participant, investigator, and/or outcome assessor); 3) data completeness (inclusion of all randomized participants in outcomes analyses, i.e., intention-to-treat); and 4) whether reasons for dropouts/attrition were reported (to judge whether those reasons could possibly be related to outcomes and were balanced between treatment groups).31 Studies will be assigned individual ratings of good, fair, or poor. A rating of good generally indicates that the trial reported adequate allocation concealment, ...

The standard of care of care for metastatic CRC confined to the liver is surgical resection; however, most patients are not surgical candidates due to patient and tumor characteristics. Liver-directed therapy is an option for many of these patients whose liver metastases are unresectable. There is uncertainty surrounding the optimal use of the various local therapies in these settings. This topic is clinically relevant and one of importance to health care providers, patients, and policymakers.. Patients with unresectable liver metastasis are a heterogeneous group, in which careful patient selection may offer opportunities for successful treatment. Patient-selection criteria are a key issue, in particular the definition of medically or technically inoperable patients.24 All patients in our review will have been classified as having unresectable disease, either due to the extent of the tumor or patient characteristics (poor surgical candidate). Our review will include two distinct patient ...

Unique interdisciplinary fellowship training opportunities in Health Services Research and Geriatrics/Gerontology are available at Brown University for MDs, PhDs and those seeking doctoral training in health services research. The position requirements for a post-doctoral fellowship are: MD and continuation of basic clinical training, or PhD in health services research, sociology, epidemiology, economics or related field. Qualified candidates for doctoral training in health services research are also eligible. Physicians seeking a post-doctoral appointment may opt to pursue a Masters degree in Epidemiology, Translational Research or an MPH. Pre- and post-doctoral fellows are integrated into on-going externally funded research in one or more substantive areas, including chronic disease management, long-term care, community-based systems of care, health care organizations and methodological approaches to comparative effectiveness research.. Term of appointment is for two years, renewable ...

New members of the IOM are elected by current active members through a selective process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care, and public health. At least one-quarter of the members are drawn from fields outside the health professions, such as engineering, social sciences, law, and the humanities.. Dr. Simpson is nationally recognized for her contributions to health services research and health policy, particularly in the areas of childrens health, disparities, health care quality and comparative effectiveness research. Through her role as the leader of AcademyHealth, in her research and academic appointments, and as a former deputy director of the Agency for Healthcare Research and Quality, Dr. Simpson has long stood at the forefront of the field of health services research, actively working to improve the relevance, rigor and reputation of the field and advocate for its use to inform health policy and ...

Government-sponsored comparative effectiveness research is the first step toward allowing Uncle Sam to push a restrictive formulary.

Dr. Duh is a pharmacoepidemiologist specializing in the safety, health economics, and outcomes of pharmaceuticals and medical devices. She has published more than 110 articles in peer-reviewed journals in the areas of drug safety, health economics, outcomes research, patient reported outcomes, comparative effectiveness research, direct and indirect costs, and cost-effectiveness analysis, and has utilized data from clinical trials, literature, large health insurance claims databases, medical records review, patient surveys, and Medwatch spontaneous reports data. She has led research and publications for numerous pharmaceutical companies in the areas of health economics and outcomes research, the U.S. Food and Drug Administrations post-marketing commitment and post-marketing requirement studies, and the European Medicines Agencys post-authorization safety studies. Her work also includes pharmaceutical liability litigation and securities fraud litigation associated with adverse drug events that lead to

Research Australia today lodged its submission in response to the National Mental Health Commissions Review of Mental Health Services and Programmes. The focus of the review is on measures to improve the effectiveness and efficiency of the sector, and the terms of reference specifically include mental health research.. Research Australias submission has focused on the better integration of research into the design, delivery and evaluation of mental health programmes and services, and the benefits this can bring through improved effectiveness and efficiency. Specific measures include the more effective collection and use of data across mental health services and an investment in infrastructure to facilitate clinical trials and comparative effectiveness research.. The submission was developed with the assistance of an expert working group drawn from Research Australias membership, and their contribution is gratefully acknowledged.. ...

Dr. Emily B. Levitan earned masters and doctoral degrees in epidemiology from the Harvard School of Public Health. She then completed a research fellowship in cardiovascular epidemiology and epidemiologic methods at Beth Israel Deaconess Medical Center and Harvard Medical School. She joined the faculty at UAB in 2009 and is currently an Agency for Healthcare Research and Quality-funded Scholar in Comparative Effectiveness Research. Her primary research interests are cardiovascular diseases and the application of epidemiologic and statistical methods to address public health questions. ...

Note: This study was performed as part of a multicenter cancer screening comparative effectiveness research project, SEARCH (Screening Effectiveness and Research in Community-based Healthcare), which was supported by grant UC2CA148576 from the National Cancer Institute of the National Institutes of Health.. Disclaimer: The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the National Cancer Institute.. Acknowledgment: The authors thank the SEARCH coordinators (Debra Bonollo, Shawn Gagne, Gabrielle Gundersen, Denise Schwarzkopf, and Cyndee Yonehara) for coordinating data collection on this project, the medical records auditors (Amy Stone Murai, RN, MS, APRN-C, CHRC, at Kaiser Permanente Hawaii; Janet Guilbert and Doris Hoyer at Reliant Medical Group; Elie Castro and Melanie Currier at the Group Health Research Institute; and Kim Olsen at Kaiser Permanente Northwest), and Hirut Fassil ...

It has been suggested that comparative effectiveness research (CER) could improve the management and use of treatments, leading to more effective health care and decreased spending. But most research involving CER has neglected the viewpoint of commercial payers. A new study in the American Journal of Managed Care seeks to change that.. Anthony Wang, MPH, and others at PriceSpective, a consultancy, determined how commercial payers use different types of CER study designs to make coverage decisions in different disease states. They recruited 20 payers involved in pharmaceutical and therapeutic decision making, stratified by health plan scope (national vs. regional) and respondents role (medical director vs. pharmacy director). The researchers probed respondents about their views of CER studies of pharmaceutical treatments in five common scenarios.. Overall, insurers preferred randomized controlled clinical trials (RCTs) when comparing drug effectiveness for diseases in which coverage decisions ...

H.R. 451, Healthcare Truth and Transparency Act: Healthcare Provider Transparency, Healthcare Provider Misrepresentation National All Schedules Prescription Electronic Reporting Reauthorization Act S. 296, Preserving Access to Life-saving Medications Act, drug shortages H.R. 1540, National Defense Authorization Act for Fiscal Year 2012, H.Amdt. 141, To expand Department of Defense state licensure exception PPACA Nondiscrimination language regarding paraprofessionals - repeal DEA Scheduling Propofol Comparative Effectiveness Research Hospital Acquired Infections HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Risk Evaluation and Mitigation Strategies Medical Liability Reform; H.R. 5, HEALTH Act of 2011 FDA Safe Use Initiative Pain Management Individual Mandate- PPACA Proposed Federal CME requirements by ONDCP FDA Operating Room Fires FDA ACTION Initiative FDA Propofol Shortage FDA Sentinel ...

Joshua Cohen, PhD, and colleagues reviewed eight high-profile drugs and their companion diagnostic tests to determine which tests could be used to guide a prescriber in selecting a drug or in determining dosing tailored to a persons genetic makeup. This field, pharmacogenomics, is more commonly known as personalized medicine. It explores the ways in which genetic variation in an individual can determine whether a patient will benefit from a drug, will have an adverse reaction to the drug, or will have no reaction at all.. Cohen, a senior research fellow at the center, says that there are clinical, economic, and regulatory obstacles associated with personalized medicine but that the biggest is "a lack of clinically useful diagnostics . . . which leads to an evidence gap in terms of knowledge of drug and diagnostic clinical effectiveness.". But the future is promising, according to Cohen: He points to "an increase in comparative effectiveness research that may help to close the evidence ...

Younger surgeons comprise a large percentage of the SVS membership as well as VAM attendees, said Dr. Grace Wang, chair of the Young Surgeons Committee. "We wanted sessions that are of interest to both private practice and academic surgeons.". C4: Connections and Conversations. This session is cosponsored by the SVS Research Council, SVS Research and Education Committee, SVS Young Surgeons Committee, and the SVS Clinical and Comparative Effectiveness Research Committee.. "Research" now includes several disparate arenas, each with its own sets of challenges, said Dr. Wang. Accordingly, planners divided the session to include four main research areas. Experts in those fields will provide brief overviews and then facilitate small-group discussions with time allowed for both general and specific questions.. Speakers include Dr. Alan Dardik, "Basic Science and Translational Research;" Dr. Michael S. Conte, "Clinical Research" (including clinical trials); Dr. Philip P. Goodney, "Patient-Centered ...

Dr. Gregory Daniel left Brookings in January 2016 to join the Duke-Robert J. Margolis, MD, Center for Health Policy at Duke University. While at Brookings, Daniel lead the Center for Health Policys pharmaceutical and medical device policy portfolio that included developing strategies for better post-market safety surveillance and comparative effectiveness research, improving regulatory science, fostering practical steps for implementing expedited drug development and review tools, improving biomedical innovation, and supporting payment reform.. ...

Dr. Gregory Daniel left Brookings in January 2016 to join the Duke-Robert J. Margolis, MD, Center for Health Policy at Duke University. While at Brookings, Daniel lead the Center for Health Policys pharmaceutical and medical device policy portfolio that included developing strategies for better post-market safety surveillance and comparative effectiveness research, improving regulatory science, fostering practical steps for implementing expedited drug development and review tools, improving biomedical innovation, and supporting payment reform.. ...

Timeline Photos The Foundation of the ASNR is currently accepting applications for the following 2018 Foundation Awards: Comparative Effectiveness Research Award, Research Scientist Award, and Scholar Award ... ...

Timeline Photos The Foundation of the ASNR is currently accepting applications for the following 2018 Foundation Awards: Comparative Effectiveness Research Award, Research Scientist Award, and Scholar Award ... ...

What data standards will payers - Medicaid and private health insurance plans, in particular - want to see from comparative effectiveness research? When will they want to see the data? How big of a clinical difference between one drug and a competitors drug will be needed to get payers to cover all or a portion of its use? And how big of an impact will such studies have on the bottom line ...

Our previous studies indicated that the MnP preprotein from I. lacteus F17 is composed of 359 amino acid residues, including a 26-amino acid signal peptide and four disulfide bridges essential for the native conformation of the enzyme [22]. A cDNA encoding the mature 333-amino acid MnP protein without the signal sequence was subcloned into pET28a and expressed in E. coli Rosetta (DE3) cells. As expected, this protein formed inclusion bodies and required in vitro refolding to convert it into an active enzyme, as is true for recombinant MnP from P. chrysosporium [12] and Phlebia radiata [27].. One of the purposes of the present study was to enhance the MnP yield by optimizing the in vitro refolding conditions. Orthogonal design is a good mathematical method used for planning multivariate tests [28]. Its greatest applications have been in healthcare evaluations or comparative effectiveness research [29]. Using an orthogonal design in the present study, the optimal refolding conditions were ...

Sponsors of self-insured health plans and health insurers must pay the Patient-Centered Outcomes Research Fee by July 31, 2013 for plan years ending on or after October 1, 2012. The Affordable Care Act established the Patient-Centered Outcomes Research Institute (the PCORI) to evaluate the effectiveness of medical treatments and procedures. The PCORI is funded by the

Click here to view ISCHEMIA-CKD study results. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease trial (ISCHEMIA-CKD) is an international comparative effectiveness study to determine the best way to manage stable ischemic heart disease (SIHD) in patients with advanced chronic kidney disease (eGFR ,30 or on dialysis). Prior trials of strategy trials of revascularization versus medical therapy alone for SIHD have routinely excluded patients with CKD or enrolled a small proportion of such patients. As such, the evidence from randomized trials to drive decision making in this cohort is weak at best.. This is a multicenter clinical trial which has randomized 777 participants with advanced CKD with moderate to severe ischemia on stress testing. Participants were randomly assigned to a routine invasive strategy (INV) with cardiac catheterization (cath) followed by revascularization (if feasible) plus optimal medical therapy (OMT) or ...

This randomised controlled study is the first RCT to evaluate the effects of G-CSF on the prevention of FN in patients with ovarian cancer. Treatment with G-CSF per physician discretion showed inferior outcomes for FN and myelosuppression. However, prophylactic treatment with short-acting G-CSF according to a stringent protocol would probably not result in such inferior outcomes. In a systematic review and meta-analysis, the weight of evidence from RCTs indicates little difference in efficacy between the short-acting and long-acting G-CSFs if dosed according to recommended guidelines. It was suggested long-acting G-CSFs in non-RCTs had greater efficacy, which may be a result of the underdosing of short-acting G-CSF in general practice in real-world usage.10 However, based on the findings of a systematic review of real-world comparative effectiveness studies, the risks of FN and FN-related complications are generally lower for prophylaxis with pegfilgrastim versus prophylaxis with short-acting ...

High Risk of Preventable and Mitigable Adverse Events in Cancer Care. Researchers have identified a significant burden of adverse events across the cancer care continuum, including preventable or mitigable events.. Read More. Breast Cancer Survival Outcomes After Mastectomy vs Breast-Conserving Surgery. A recent comparative effectiveness study examined long-term survival outcomes for patients with multiple stages of breast cancer after undergoing either mastectomy or breast-conserving surgery.. Read More. Genetic Testing Underutilized in Women With History of Ovarian Cancer. Less than 20% of patients with a history of ovarian cancer meeting NCCN guidelines have undergone genetic testing or have discussed testing with their health care providers. Read More. Aggressive Local Therapy Improves Outcomes in Patients With Head, Neck Cancer. A recent study uncovered the benefits of adding high-intensity local treatment to systemic therapy for head and neck squamous cell carcinoma.. Read More. Resistance ...

The Problem: Comparative Effectiveness studies burst on to the health policy scene, providing new hope theyd help make health care more affordable and help clinicians deliver care of higher quality. Our Engagement: We were engaged to patient groups understand the territory so they could engage in the variety of policy-setting meetings underway in both theRead More. ...

Rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis who failed to respond to a single previous TNF inhibitor: SWITCH-RA, a global, observational, comparative effectiveness study ...

Clinical Trials - clinicaltrials.gov This is a comparative effectiveness study of two pragmatic models aiming to introduce palliative care in care for end stage...

A new comparative effectiveness study found older adults with stable coronary heart disease (CHD) who underwent bypass surgery had better long-term survival rates than those who underwent a non-surgical procedure to improve ...

In an observational comparative effectiveness study of targeted vs non-targeted therapy for metastatic renal cell carcinoma (mRCC), older patients saw modest survival advantages when treated with targeted therapies. The retrospective study showed that a broader range of patients than previously thought were potentially candidates for the less...

Three groups of post-menopausal women each took different AlgaeCal formulations with all groups increasing bone density at one year. The smallest average increase among the 3 groups was 1.3% - an extraordinary result since traditional calcium supplements do not increase bone density.. This comparative effectiveness study measured bone density via DEXA scan at baseline and then again at 6 months and one year. AlgaeCals results were compared to published data on traditional calcium supplements BMD scores. Post menopausal women are expected to lose approximately 1% of bone density per year with traditional calcium supplements only slowing that rate of loss slightly.. ...

We first qualitatively summarised included trials, describing the types of direct and indirect comparisons. For each direct comparison between two treatments we conducted pairwise meta-analyses using the DerSimonian-Laird (random effects) method,23 and statisticaly inspected heterogeneity using the I2 measure. We used rough I2 thresholds of 25%, 50%, and 75% to define low (,25%), moderate (25-49%), high (50-75%), and very high (,75%) heterogeneity. To determine the comparative effectiveness of exercise and drug interventions, we then conducted network meta-analysis, which is a generalisation of indirect comparisons across pairwise meta-analyses.24 This type of analysis allows for comparing interventions in the absence of head to head trials comparing all the interventions of interest.25 In cases where both direct (from trials that include a specific pairwise comparison) and indirect (from a network of trials that do not include that comparison) sources of evidence exist, network meta-analysis is ...

BMS-Pfizer Alliance to Unveil Real-World Data Analyses - Cost, Safety and Comparative Effectiveness Findings Associated with Oral Anticoagulants in Non-Valvular Atrial Fibrillation | Nachricht | finanzen.net

The aim of this study is to assess the real world comparative effectiveness of Rivaroxaban prescribed in non-valvular atrial fibrillation (NVAF) routine care

Schousboe JT, Gourlay ML. Comparative Effectiveness and Cost-Effectiveness of Strategies to Screen for Osteoporosis in Postmenopausal Women. Ann Intern Med. 2011;155:788-789. doi: 10.7326/0003-4819-155-11-201112060-00012. Download citation file:. ...

Comparative Effectiveness of Dynamic Patterns of Glucose Lowering Therapies. In type 2 diabetes, the maintenance of intensive glucose control over time typicall...

Long-term comparative effectiveness of the Lap Band Surgery for morbid obesity has grown exponentially and is now the 2nd most common abdominal operation in the...

On January 20, 2016, partners from across the state convened for the OneFlorida Clinical Research Consortiums second Annual Stakeholder Meeting in Lake Nona, where attendees celebrated the consortiums accomplishments and strategized future collaborations.. At the meeting, Bill Hogan, M.D., co-director of the OneFlorida CDRN and director of biomedical informatics at the University of Florida Clinical and Translational Science Institute, presented one of the consortiums most notable successes of 2015 - the further development of the OneFlorida Clinical Data Research Network, which received a $7.6 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) in August.. "OneFlorida has successfully brought together leading researchers throughout our state and nation to improve health outcomes not only in Florida, but also across the U.S.," said Betsy Shenkman, Ph.D., co-director of the OneFlorida Clinical Data Research Network and co-director of the University of Florida ...

Last week, OCHIN, Inc. was awarded nearly $7 million by the Patient-Centered Outcomes Research Institute to establish itself as part of PCORIs new Patient-Centered National Clinical Research Network. Jennifer DeVoe, M.D., DPhil, OCHINs research director and an associate professor in OHSUs Department of Family Medicine, is principal investigator on the project.. "By collaborating across the nation we hope to provide results that will inform policy and improve patient and population health outcomes," Dr. DeVoe said. "This opportunity with PCORI comes at a time when our nation is working to transform healthcare and needs the best evidence possible to ensure that care is more patient-centered. Im so proud to be serving on this team.". Read more.. ...

SAN FRANCISCO - The patient-centered studys premise was straightforward: Since there is a definite link between parents psychosocial stress levels and asthma suffered by inner city kids, if you provide stressed-out parents effective coping skills, would kids take their medicines more regularly and would their health improve?. A $2.2 million, first-of-its kind randomized study found no differences between kids with asthma who received standard care based on National Institutes of Health (NIH) guidelines compared with kids whose parents received stress-mitigation techniques in addition to evidence-based asthma care. The stress-mitigation techniques were designed by a team at Childrens National Health System funded by the Patient-Centered Outcomes Research Institute.. "While it is somewhat disappointing that we did not demonstrate a treatment effect from the parental stress-mitigation techniques, the good news for children suffering from asthma is that all study participants experienced ...

The Patient-Centered Outcomes Research Institute (PCORI), a non-profit organization established by Congress through the Patient Protection and Affordable Care A

CHERYL BUSHNELL: Im going to start out by just mentioning that this study Im going to tell you about was funded by the Patient-Centered Outcomes Research Institute. And if those of you who are not familiar with PCORI, it was actually a part of the Affordable Care Act. And so without getting too political, we do know that the Affordable Care Act is probably not going to be around much longer. I think the question is whether the funding for important research like if pragmatic trials and effectiveness will still continue. So on that note, were only going to get more positive from there. So my objective today is to help you understand what population health is this is a relatively new concept. Honestly, four or five years ago, I had no idea what this was but. Its now really a buzzword in all health systems. And just talk about how population health and stroke care and across the continuum is a really important facet of value based care. And then Ill also talk about the gaps and challenges with ...

MILWAUKEE _ Alice Yan has been funded through a Patient-Centered Outcomes Research Institute (PCORI) Pipeline-to-Proposal Award to support a project focused on eliminating disparities in survival rates among young African-American women. The yearlong project, "Lets Talk: Engaging Community Stakeholders for… Read More. ...

Black women are among those most likely to have insomnia, according to Lynn Rosenberg, ScD, associate director of Boston Universitys Slone Epidemiology Center and a principal investigator of the Black Womens Health Study (BWHS). Rosenberg has been awarded a three year $2,225,495 grant from the Patient-Centered Outcomes Research Institute (PCORI) to study this. The study will be using a self-administered internet program called SHUTi (Sleep Healthy Using the Internet), a web-tool based on cognitive behavioral therapy (CBT).

Joshua Fenton, a leader in research to improve the quality of primary health-care services, has been selected to receive nearly $700,000 from the Patient-Centered Outcomes Research Institute (PCORI) to identify ways to reduce unneeded medical care.

PCORI issues draft methodology report. // AHA News;6/11/2012, Vol. 48 Issue 12, p8 The article reports on the release of draft research standards by the Patient-Centered Outcomes Research Institute (PCORI) that will serve as a resource for initial applicants for PCORI funding, noting that applicants will not be scored based on their adherence to the draft recommendations. ...

By John Weeks, Integrator Blog The Patient-Centered Outcomes Research Institute (PCORI) has called for comment on the new agencys draft plan. The comment

April 11, 2013: Doriane Miller, MD, has been appointed to serve a one-year term on the Patient-Centered Outcomes Research Institute (PCORI) Advisory Panel on Addressing Disparities.

Posted on: November 7, 2017. The Patient-Centered Outcomes Research Institute (PCORI) recently awarded an $8.6 million grant to Joel M. Gelfand, MD MSCE, professor of Dermatology and Epidemiology at the Perelman School of Medicine, the University of Pennsylvania. The purpose of the grant is to … Read More. ...

Chest pain concerning for a coronary syndrome leads to millions of hospital admissions each year that is often evaluated with diagnostic testing. As a noninvasive diagnostic study, coronary computed tomography angiography (CCTA) has been shown to have excellent diagnostic capabilities. However, concerns over CCTA remain, including radiation exposure, false-positives, and trials of the diagnostic modality that were mostly limited to low-risk patients with underrepresentation of minorities and women. In this single-center randomized, controlled comparative effectiveness trial, 400 intermediate-risk patients (63% women, 54% Hispanic, 37% African-American) admitted to a telemetry floor were randomized to either CCTA or myocardial perfusion imaging (MPI) and followed for 40 months. Patients with baseline renal dysfunction were excluded. At 1 year, there were no significant differences in the primary outcome of coronary angiography that did not lead to revascularization (hazard ratio [HR], 0.77; 95% ...

... serves as the definitive guide to successful investigation of health care outcomes and the key resource for ensuring quality care. As consumer, insurer and government demands for quality health care increase, the field of research required to measure such quality stands to grow exponentially. Conducting Health Outcomes Research brings together the practical, actionable information needed to conduct research on health outcomes, with the goal of measuring the quality of the care being delivered. The book details the methodology for performing successful research in this growing field: from formulating models, choosing study design, measuring and gathering data to assessing and presenting results. The text dually covers risk adjustment and the interplay of demographic, psychological and social factors. Conducting Health Outcomes Research answers the growing call for evidence-based practice, comparative effectiveness reviews and overall quality assurance in health ...

SCANNER (SCAlable National Network for Effectiveness Research) will provide a distributed network infrastructure to enable near real-time comparative effectiveness and prospective analysis of data collected from clinical databases. Through collaborations between UC San Diego and multiple institutions, SCANNER represents a unique collection of academic, government, technology, and healthcare ecosystem participants that together include the ingredients necessary to deploy, validate, and grow a network that streamlines and improves research and clinical practice on a national scale.

The Pituitary Network Association is an international non-profit organization for patients with pituitary tumors and disorders, their families, loved ones, and the physicians and health care providers who treat them.

The topic for this report was nominated in a public process. With input from technical experts, the Scientific Resource Center (SRC) for the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program drafted the initial key questions and, after approval from AHRQ, posted them to a public Web site. The public was invited to comment on these questions. After reviewing the public commentary, the SRC drafted final key questions and submitted them to AHRQ for approval.

Cost data can also be incorporated in comparisons. Many so-called "cost-effectiveness" studies use hospital charges as a surrogate for costs. This is misleading, as it represents costs only for uninsured patients, and probably very few of them. First, we must decide the perspective to take; in other words, cost to whom? Most commonly, cost-effectiveness studies use a societal perspective.13 This is certainly the appropriate perspective for policy makers to take when evaluating new technology. Increasingly, hospitals are quantifying costs for procedures and inpatient and outpatient services, making it possible for investigators to use a hospital perspective. For certain uses, the perspective of the insurer, the equipment supplier, or the patient is appropriate. Considering the recent trend toward more uninsured patients and higher deductibles and copays,5 a patient perspective may be preferable for some costs. For some analyses we also consider "indirect" costs, such as lost wages associated with ...

Hypertension is one of the most important modifiable risk factors for adverse health outcomes: premature death, renal failure, stroke, and myocardial infarction are each reduced when blood pressure is controlled [1-8]. Hypertension is increasingly diagnosed in children, and effective treatment will be particularly important to reduce the ultimate years of healthy life lost to these problems.. Unfortunately, only sparse data from clinical trials inform the use of different antihypertensive agents in children [9]. As a result, the best first-line therapy for children has not been defined for national guidelines [10], and clinical practice is highly variable [11-13]. In a survey of North American pediatric nephrologists, 47 % chose angiotensin-converting enzyme (ACE) inhibitors; 37 %, calcium channel blockers, and 15 % diuretics as initial therapy in children with primary hypertension [14].. Large parallel-group randomized clinical trials (RCTs) are generally required to determine which therapy is ...

Rheumatoid arthritis (RA) is a chronic, systemic, often disabling autoimmune disease affecting 1% of adults and 2-3% of older adults. A companion inflammatory arthritis, spondyloarthritis (SpA), has a similar prevalence and includes such subtypes as psoriatic arthritis, inflammatory bowel-related arthritis, and ankylosing spondylitis. These debilitating types of arthritis typically strike younger people (median age 30s and 40s)-in the prime of work and family productivity-and are usually lifelong.

Official website for the American Nurses Association, part of the ANA Enterprise, featuring nursing news, professional development and continuing education for nurses.

Summary: IHPC, others convene stakeholders for policy action plan on integrative practices in reform law … Goertz named to influential Board of Governors of PCORI, significant new, national comparative effectiveness research institute … AANP urges members to weigh in on endocrine disruption bill … Australian study reports cost savings from acupuncture and 3 natural products … Disturbing national data on incomes of licensed AOM practitioners stimulates soul-searching … Two-thirds of massage therapists note downturn in practices in lagging economy … Supplement sales hold steady … Managed CAM and wellness firm American Specialty Health hits $147-million in revenues … Penny George Institute/Allina publish 2010 outcomes report … Donna Karans Urban Zen expands nationally with Kent State partnership in program for nurses … Georgetown and Bastyr initiate novel agreement between naturopathic and conventional academic programs … Marino Center links with Mass Medical Society for ...

The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of Phototherapy medical devices for treatment of chronic plaque psoriasis. Scientific information is being solicited to inform our Comparative Effectiveness Review of Biologic...

Patients with active rheumatoid arthritis (RA) despite anti-tumor necrosis factor(anti-TNF)agent treatment can switch to either a subsequent anti-TNF agent or a biologic with an alternative mechanism of action, such as rituximab; however, there are limited data available to help physicians decide between these 2 strategies. The objective of this analysis was to examine the effectiveness and safety of rituximab versus a subsequent anti-TNF agent in anti-TNF-experienced patients with RA using clinical practice data from the Corrona registry. Rituximab-naive patients from the Corrona registry with prior exposure to ≥1 anti-TNF agent who initiated rituximab or anti-TNF agents (2/28/2006-10/31/2012) were included. Two cohorts were analyzed: the trimmed population (excluding patients who fell outside the propensity score distribution overlap) and the stratified-matched population (stratified by 1 vs ≥2 anti-TNF agents, then matched based on propensity score). The primary effectiveness outcome was

PURPOSE: To evaluate effectiveness and safety of rivaroxaban versus warfarin or dabigatran etexilate in a prospective cohort of routine care non-valvular atrial fibrillation (AF) patients during February 2012 to August 2014.. METHODS: We identified in nationwide health registries a cohort of AF patients who were new-users of rivaroxaban 15 mg (R15) or 20 mg (R20); dabigatran 110 mg (D110) or 150 mg (D150); or warfarin. Propensity-adjusted Cox regression was used to compare outcome rates in four settings: R15 vs. warfarin; R15 vs. D110; R20 vs. warfarin; and R20 vs. D150.. RESULTS: Rivaroxaban users (R15: n = 776; R20: n = 1629) were older and with more comorbidities than warfarin (n = 11 045) and dabigatran users (D110: n = 3588; D150: n = 5320). Rivaroxaban 15-mg users had the overall highest crude mortality rate. After propensity adjustment, rivaroxaban had lower stroke rates vs. warfarin (R15: hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.26-0.82; R20 HR: 0.72, 95%CI: ...

Neuromuscular transmission recovery was assessed by the recovery of T1 and TOF ratio (ratio of the twitch response of the fourth to the first stimulus of each TOF stimulation). To evaluate their effectiveness, the reversal agents were administered every 10 min until recovery of the TOF ratio to 0.9. To evaluate rocuronium reversal, we administered an initial bolus of sugammadex or calabadion 2, each 5 mg, followed by repetitive doses of 0.4 mg. For cisatracurium reversal, an initial dose of 8 mg calabadion 2 was added to the tissue bath, followed by repetitive doses of 1.5 mg. To address the impact of the Hoffmann degradation on the concentration of cisatracurium when cisatracurium was used as NMBA, 10 additional hemidiaphragm preparations were incubated in 6 µM cisatracurium bath (EC90) to evaluate spontaneous recovery. In these preparations, the twitch response was measured every 10 min, and the expected spontaneous sigmoidal recovery course was observed. Linearization by logit transformation ...

Valid, reliable measures of patient experience and their health outcomes are critical to promoting public health and improving the quality, safety, and efficiency of health care. This includes the development and evaluation of tools that inform health care providers, federal agencies, and foundations on a wide range of outcomes and experiences, such as patient reports of care quality and health outcomes, patient-centered outcomes research, health insurance literacy, and patient-centered clinical quality indicators. View our latest work in Patient-Reported Outcomes Measurement Learn about our client services in Patient-Reported Outcomes Measurement

TY - JOUR. T1 - Cluster randomized trials of prescription medicines or prescribing policy. T2 - British Journal of Clinical Pharmacology. AU - MacKenzie,Isla S.. AU - Wei,Li. AU - Paterson,Kenneth R.. AU - MacDonald,Thomas M.. N1 - Copyright 2012 Elsevier B.V., All rights reserved.. PY - 2012. Y1 - 2012. N2 - AIMS To understand public and general practitioner (GP) opinion on the acceptability of randomized policy design (RPD) studies (cluster randomized trials) of prescription medicines in Scotland. METHODS We surveyed public opinion on the concept of RPD studies in a sample of 1040 adults to determine acceptability and understand how people feel when changes are made to their medicines. We also surveyed GPs (n=1034) about the concept of RPD studies as a tool for improving understanding of comparative effectiveness and safety of medicines in the usual care setting. RESULTS Thirty per cent of people would be happy to receive a letter about randomized policy changes to their therapy, 31% would ...

St. Jude Childrens Research Hospital, an institution focused on pediatric cancer and other catastrophic diseases, treats nearly 8,000 patients annually and has used AHRQs "Hospital Survey on Patient Safety Culture" since 2009 to understand and improve the hospitals culture, identify areas ripe for quality improvement, and collect data on its own research projects.. "The Hospital Survey on Patient Safety Culture Survey is a trusted tool that is used by over 1,000 hospitals and has been validated in many contexts and cultures," says James M. Hoffman, PharmD, the Medication Outcomes and Safety Officer at St. Jude. "We believe the entire process of promoting the survey-participating, discussing, and sharing the results of the survey and then using the results to prioritize improvement efforts-helps us improve patient care.". AHRQs tool helps hospitals assess their patient safety culture, track changes, and evaluate the impact of patient safety interventions. "Because we have used the survey ...