. "4 Strengthening the Evidence Base and Quality Improvement Infrastructure." Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington, DC: The National Academies Press, 2006.
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Improving the Quality of Health Care for Mental and Substance-Use Conditions
TABLE 4-1 Organizations and Initiatives Conducting Systematic Evidence Reviews in M/SU Health Care
The Cochrane Collaboration
The standard setter for evidence-based reviews, its Database of Systematic Reviews and other products are the output of over 50 international Collaborative Review Groups (CRGs), which follow detailed procedures contained in a 234-page handbook. CRGs review primarily randomized controlled trials (Alderson et al., 2004). The Cochrane Collaboration maintains four CRGs related to M/SU illnesses: the Depression, Anxiety and Neurosis Group; the Developmental, Psychosocial, and Learning Problems Group; the Drug and Alcohol Group; and the Schizophrenia Group, which together have produced over 100 evidence reports for these areas (The Cochrane Collaboration, 2004).
The U.S. Preventive Services Task Force
Congressionally mandated, it is the “gold standard” for reviewing preventive services in the United States (AHRQ, 2002–2003). Its standardized methodology has been adopted by others, including the Veterans Health Administration and Department of Defense. Because of its focus on prevention, its evidence reviews are limited to screening practices, counseling interventions, and other preventive interventions delivered in primary care settings (Harrison et al., 2001). To date, the task force’s recommendations pertaining to M/SU illnesses have addressed screening and/or counseling in primary care settings for alcohol misuse by adults, depression in adults, and suicide risk in the general population (Harris et al., 2001).
National Registry of Evidence-based Programs and Practices (NREPP)
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) rating and classification system for M/SU prevention and treatment interventions designates evidence-based programs and practices as “model,” “effective” or “promising.” As of June 2005, NREPP listed more than 50 model, 30 effective, and 50 promising programs. In contrast to the evaluation of generic practice interventions (e.g., screening, cognitive behavioral therapy), as is the focus of the Cochrane Collaboration and the U.S. Preventive Services Task Force, the majority of NREPP’s reviews to date have evaluated specific “brand-name” programs for prevention (e.g., the Keep A Clear Mind drug education program), but it also reviews generic practices such as multisystemic therapy and cognitive behavioral treatments. NREPP