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. ...
This article focuses on a fundamental question: which types of health care studies are most trustworthy? That is, which study designs are most immune to the many biases and alternative explanations that may produce unreliable results". The article is available to read in free full text at: http://dx.doi.org/10.5888/pcd12.150187. Soumerai SB, Starr D, Majumdar SR. (2015). How Do You Know Which Health Care Effectiveness Research You Can Trust? A Guide to Study Design for the Perplexed. Preventing Chronic Disease, 12:150187.. ...
This article focuses on a fundamental question: which types of health care studies are most trustworthy? That is, which study designs are most immune to the many biases and alternative explanations that may produce unreliable results". The article is available to read in free full text at: http://dx.doi.org/10.5888/pcd12.150187. Soumerai SB, Starr D, Majumdar SR. (2015). How Do You Know Which Health Care Effectiveness Research You Can Trust? A Guide to Study Design for the Perplexed. Preventing Chronic Disease, 12:150187.. ...
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 ...