Index

A

Aetna, 67, 69-70, 220

Agency for Health Care Policy and Research (AHCPR), 26, 27, 123, 125-126, 138, 139

Agency for Healthcare Research and Quality (AHRQ), 20, 42, 48, 49, 155, 159.

See also National Guideline Clearinghouse

Center for Medical Effectiveness Research, 27

comparative effectiveness methods, 87 n.6, 104

Effective Health Care Program, 28, 43, 60, 61, 72, 76, 83, 104, 164, 189

Evidence-based Practice Centers (EPCs), 20, 27, 44, 46-47, 59, 60, 61, 64, 65, 66-67, 68, 83, 84, 91, 133, 186, 189, 190

funding for, 157

identifying potential topics, 61, 62, 64, 66-67, 72, 76, 164, 186

research grants, 109

statutory limitations on, 61

template for submission of topics, 193-198

updating guidelines, 111, 138

Alzheimer’s disease, 20, 88, 92, 181, 182, 183

Ambulatory Care Quality Alliance, 48

America’s Health Insurance Plans, 27, 28, 48

American Academy of Audiology, 65

American Academy of Family Physicians, 48, 65

American Academy of Neurology, 85, 103, 136

American Academy of Orthopedic Surgeons, 65

American Academy of Pediatrics (AAP), 65, 122-123

American Association of Clinical Chemistry, 65

American Association of Health Plans, 27

American Board of Medical Specialties, 187

American College of Cardiology (ACC), 20, 46, 65, 85, 103, 134-135, 136, 139, 186

American College of Chest Physicians (ACCP), 65, 85, 103, 135, 136

American College of Obstetricians and Gynecologists, 65

American College of Physicians (ACP), 65, 85, 123, 135

Clinical Efficacy Assessment Project, 26, 46

performance measurement, 48

Physicians’ Information and Education Resource, 47



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Index A America’s Health Insurance Plans, 27, 28, 48 Aetna, 67, 69-70, 220 American Academy of Audiology, 65 Agency for Health Care Policy and American Academy of Family Physicians, Research (AHCPR), 26, 27, 123, 48, 65 125-126, 138, 139 American Academy of Neurology, 85, 103, Agency for Healthcare Research and 136 Quality (AHRQ), 20, 42, 48, American Academy of Orthopedic 49, 155, 159. See also National Surgeons, 65 Guideline Clearinghouse American Academy of Pediatrics (AAP), Center for Medical Effectiveness 65, 122-123 Research, 27 American Association of Clinical comparative effectiveness methods, 87 Chemistry, 65 n.6, 104 American Association of Health Plans, 27 Effective Health Care Program, 28, 43, American Board of Medical Specialties, 60, 61, 72, 76, 83, 104, 164, 189 187 Evidence-based Practice Centers (EPCs), American College of Cardiology (ACC), 20, 27, 44, 46-47, 59, 60, 61, 64, 20, 46, 65, 85, 103, 134-135, 136, 65, 66-67, 68, 83, 84, 91, 133, 186, 139, 186 189, 190 American College of Chest Physicians funding for, 157 (ACCP), 65, 85, 103, 135, 136 identifying potential topics, 61, 62, 64, American College of Obstetricians and 66-67, 72, 76, 164, 186 Gynecologists, 65 research grants, 109 American College of Physicians (ACP), 65, statutory limitations on, 61 85, 123, 135 template for submission of topics, Clinical Efficacy Assessment Project, 26, 193-198 46 updating guidelines, 111, 138 performance measurement, 48 Alzheimer’s disease, 20, 88, 92, 181, 182, 183 Physicians’ Information and Education Ambulatory Care Quality Alliance, 48 Resource, 47 7

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 KNOWING WHAT WORKS IN HEALTH CARE American Dental Association, 65 Breast cancer, 64-65, 68, 69, 72, 77, 92, American Diabetes Association, 46, 135 95, 96, 137 American Dietetic Association (ADA), 46, Burden-of-disease criterion, 6, 11, 13, 71- 65 72, 73, 74, 76, 172-173, 197 American Heart Association (AHA), 20, 46, 83, 85, 103, 135, 136, 139, 186 C American Medical Association (AMA), 20, 27, 187 Canada, national program, 28, 71, 102, American Organization of Nurse 123, 124, 160, 161, 162, 163, 215 Executives, 65 Canadian Agency for Drugs and American Society for Therapeutic Technologies in Health (CADTH), Radiology and Oncology, 134 71, 162, 215 American Society of Clinical Oncology Canadian Task Force on the Periodic (ASCO), 46, 65, 85, 134 Health Examination, 28, 123 American Urological Association, 134 Cardiovascular care, 46, 51, 68, 82, 95, Appraisal of Guidelines Research and 96, 103, 135, 186 Evaluation (AGREE) Instrument, Case-control studies, 4, 23, 24, 91, 92, 223 136-137, 155, 231-232 Case series, 4, 23, 24, 91, 92, 102, 103 AQA Alliance, 48 Center for Biologics Evaluation and Australia, national programs, 124, 160, Research, 42 161, 162, 163 Center for Devices and Radiological Autologous bone marrow transplant, 64- Health, 42 65, 68 Center for Drug Evaluation and Research (CDER), 42 Center for Medical Effectiveness Research, B 27 Back pain, 68, 69, 70, 95, 96, 139, 157 Centers for Disease Control and Benchmarks of appropriate care, 39, 40, 43 Prevention, 42, 65, 83-84, 206, 217 Bevacizumab (Avastin®) for age-related Centers for Medicare & Medicaid Services macular degeneration, 20, 92, 183 (CMS), 64, 65, 188, 219 Bias. See also Conflicts of interest coverage determinations, 51, 59-61, 93, attrition, 98 94, 95 defined, 8, 97, 154 n.1 database, 216-217 detection/ascertainment, 98 expenditures on health services, 37, 38, information, 98 39, 50-51, 163 intellectual, 75, 129-130, 143, 144, Medicare Coverage Advisory 145, 158 Committee (MCAC), 27, 45 minimizing, 91, 97-98, 129-132, 139, Medicare Evidence Development and 142-146, 157, 159 Coverage Advisory Committee performance, 98 (MedCAC), 27, 45, 59-60, 62, 71, publication, 97, 101, 159 75, 83, 84 reporting, 97, 98, 158 regional differences in spending, 38, 39 selection, 98 utilization of evidence assessments, 26, statistical, 8 27, 28, 44, 45, 83, 84 Blue Cross and Blue Shield Association Cervical cancer, 70, 94, 96, 205-217 (BCBSA), 28 Chalmers, Iain, 81, 86 Technology Evaluation Center (TEC), Cholesterol reduction, 50, 68 20, 26, 43, 44, 59, 60, 62, 67, 69- Chronic obstructive pulmonary disease, 63, 70, 71, 84, 85, 189 66, 95

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9 INDEX CINHAL (Cumulative Index to Nursing & continuum, 3, 4, 22, 23 Allied Health Literature), 99 current landscape, 8-9, 121, 125-138 Clinical effectiveness defined, 125 defined, 22-24 developers, 8, 26, 43, 45-47, 61, 124- evidence of, see Evidence of 125, 132-133 effectiveness efficiency and timeliness, 121, 122, Clinical Effectiveness Advisory Board, 10- 140-141 11, 13, 153, 171, 172-173 expert opinion vs. empirical evidence, Clinical effectiveness research. See also 41, 124, 125, 127 Systematic reviews external review, 141, 147 challenges, 47, 49-52 gaps and overlaps, 8, 134, 140-141, conflicts of interest in, 25, 97 156 context for, 34-36 grading strength of recommendations, current landscape, 5-6, 41-52 49, 90, 123, 128, 129, 132-133, duplication of effort, 5, 6, 51-52, 66- 135-136, 140, 141-142, 146, 234 68, 69-70, 73, 156 historical context for, 24-25, 26-28, estimate of effect, 101 122-123 evidence base, 35-36, 92-94, 127 improving current guidelines, 134-137, external validity, 101 139 grading systems for strength of information quality, 8-9, 36, 126-132 evidence, 7, 9, 49, 108, 123, 134 language standardization, 126, 141- health policy challenges and, 36-41 142, 146-147, 167 individual studies and, 82-83 limitations of, 8-9, 121, 138, 165-166 information needs, 47, 49 methodological rigor, 15, 127-129, 130, key players, 42-47 139, 165 performance measurement, 40, 43, 47, multiple conflicting guidelines, 126, 48, 122, 137, 147 133-134, 138, 140-141 political pressures, 157 objectivity, 50-51, 121, 122, 127, 128- quality of evidence, 90, 93-94, 100-104, 129, 139, 140, 165 108, 159 panel composition, 121, 129-130, 134- strength of findings, 101, 108 135, 140, 143, 144, 145-146 subpopulations, 8, 59, 61, 93, 94, 96, quality issues, 9, 12, 47, 123, 125-132, 105, 166, 199, 200, 202 135, 142, 153, 154 synthesis of available evidence, 25, 42, recommendations, 11, 15, 121, 139, 43-45 145, 146, 173 transparency, 7, 49-50, 51 resource requirements, 124, 126, 156 Clinical practice guideline development standardization and consistency in, 11, adherence to standards in, 11, 15, 121, 121, 126, 134, 135-137, 139-142, 122, 124, 139-140, 142, 146-147, 146-147, 231-235 155 systematic reviews and, 83, 85, 105, AGREE Instrument, 231-232 111, 123, 127, 133, 134 benefit assessments, 128-129, 142 transparency, 11, 50, 121, 125, 126, bias, 11, 15, 121, 122, 129-132, 136, 139-140, 144, 147 139, 140, 142-146 updating/currency, 124, 125, 138, COGS Checklist, 233-235 140-141 comorbidities and, 48 USPSTF model, 8, 45-47, 94, 123, 124, conflicts of interest, 11, 15, 121, 122, 125, 132-133, 139, 186, 191 124, 130-132, 140, 142-146, 154 Cochrane Central Register of Controlled consensus building, 9, 134-135, 140, Trials, 99, 112 141

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0 KNOWING WHAT WORKS IN HEALTH CARE D Cochrane Collaboration, 20, 25, 27, 43, 44, 61, 62, 72, 73, 84, 86, 99, 101, Dartmouth-Hitchcock Department of 102, 104, 111, 155, 158, 189 Orthopedic Surgery, 20-21, 190 Cochrane Library, 36, 44, 84, 215 Decision modeling/support, 27, 51, 58, 95, Cohort studies, 24, 91, 92, 102, 103, 226 122, 129, 137 Comorbidities, 3, 48, 49, 88, 90, 94-95, Delivery of health services, variation in, 13, 138 34, 38 Comparative effectiveness research, 19, 22, Delphi technique, 5, 58 24, 25, 43, 83 Denmark, national program, 161 Conference on Guidelines Standardization Depression, 63, 66, 67, 69, 72, 85, 96 (COGS) Checklist, 136, 137, Device evaluation, 24, 26, 42, 43, 62, 70, 233-235 83, 92, 93, 158, 161, 162, 189, 190, Conflicts of interest. See also Bias 218, 229 in clinical effectiveness research, 25, 97 Diabetes mellitus, 46, 63, 72, 92, 96, 107, federal guidelines, 131-132 135, 221, 227 financial, 50-51, 130-132, 143, 144, Drug Effectiveness Review Project (DERP), 145, 154, 157-158 45, 60, 62, 63, 71 guidance for managing, 158 Drug evaluation, 42-43, 45, 50, 93, individual-level, 132, 140, 143, 145 161-163 in information, 143-145 Duke University, 86 organizational-level, 132, 140, 143, Duplication of efforts, 5, 6, 51-52, 66-68, 144, 146 69-70, 73, 156 panel-level, 11, 130-131, 140, 143, 145-146 in priority setting, 57, 75 E public disclosure, 132, 140, 143, 146 restrictive measures, 50, 125, 143-145 ECRI Institute, 20, 26, 43, 60, 67, 69-70, Consolidated Standards for Reporting 84, 111, 112, 190 Trials (CONSORT), 105, 106-107, quick turnaround reports, 44, 205-217 159 Effective Health Care Program, 28 Consumer-directed health care, 1, 2-3, 5, Effectiveness. See Clinical effectiveness 21, 40 EMBASE (Excerpta Medica), 99, 100, 110, Consumers Union’s Best Buy Drugs 112, 218, 220 Program, 20, 186 End-of-life care, 2, 13, 18, 38, 59, 66, 76, Cost criteria for priority setting, 6, 11, 13, 190 71, 72, 73, 74, 76, 133, 173, 174, Epilepsy guidelines, 134 197, 232 Erythropoietin, 50-51 Cost-effectiveness analysis, 19, 27, 71, 72, European Network for Health Technology 73, 161, 162, 163, 174, 195, 207, Assessment, 160 214, 226, 228 Evidence assessment. See Clinical Costs of health care, 1, 3, 17-18, 19, 27, effectiveness research; Priority 33, 34-35, 36, 40, 44, 45, 67, 160, setting for evidence assessment; 197 Systematic reviews Medicare expenditures, 37, 38, 39, 50- Evidence of effectiveness, defined, 3, 21 51, 163 as selection criterion, 6, 9, 71, 72, Council of Linkages Between Academia 90-92 and Public Health Practice, 65 Experimental studies. See also Randomized Council of Medical Specialty Societies, 27, controlled trials 187 defined, 24 Cross-sectional studies, 4, 23, 24 value of, 7, 100

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 INDEX F coverage decisions, 5, 33, 41 geographic variation in utilization, 5, Federal Food, Drug, and Cosmetic Act, 26 33, 37-40 Fogarty International Center for Advanced quality of care, 5, 33, 40 Study in the Health Sciences, 65 Hierarchies of evidence, 7, 102-104, 108, France, national program, 161 136 Horizon scanning, 63-70, 74 Hypertension, 8, 36, 51, 63, 67, 107, 133, G 134 Germany, national program, 161 Grading systems for strength of evidence, I 49, 90, 108, 123, 128, 129, 132- 133, 135-136, 140, 141-142, 146, Identifying effective services. See also 234 Priority setting for evidence Guideline(s), 2, 3, 4, 5, 8-9, 10, 11, 12, 14, assessment 15, 17, 19-20, 22, 23, 24-25, 26-28, charge to committee, 1, 2, 17, 18 36, 41, 43-44, 45-47, 48, 49, 50-51, conceptual framework, 2-3, 21-24 59, 61, 63, 67, 68, 76, 83, 85, 86, international approaches, 8, 84, 88, 90, 94, 102, 103, 104, 107, 160-164 111, 121-153, 154, 155, 156, 157, milestones, 25, 26-28 158, 162, 163, 164, 165-172, 173, Innovations in health care. See also 174, 186, 191, 203, 220, 231-235. Technology assessments See also Clinical practice guideline funding for research, 41-42 development horizon scanning for, 63-71 ineffective or harmful interventions, 64- 65, 68 H pace of, 34, 35 systematic reviews of new and emerging Harmful or ineffective interventions, 3, 5, technologies, 111-112 26, 37, 41, 47, 50-51, 64-65, 68, Institute of Medicine (IOM), 28 73, 81, 82, 88, 89, 91, 92, 93, 94, Committee on Conflict of Interest in 96, 97, 99, 101, 105, 110, 123, 128, Medical Research, Education, and 129, 132, 138, 142, 234 Practice, 158 Hayes, Inc., 43, 44, 60, 67, 69-70, 84, 85, Committee on Priorities for Assessment 111, 112, 218-229 and Reassessment of Health Care Health care decision maker, defined, 21-22 Technologies, 58, 155 Health plan coverage. See also Centers for Committee on Quality of Health Care Medicare & Medicaid Services in America, 155 decisions, 5, 33, 140 Committee on Setting Priorities for experimental or investigational services, Guidelines Development, 155 41 Committee to Advise the Public FDA approval and, 41 Health Service on Clinical Practice medical necessity, 41, 51 Guidelines, 130 priorities for evidence reviews, 72-73 reports with recommendations related synthesis of evidence for, 43, 83, 85 to priority setting, 59 n.1 Health Plan Employer Data and Insurance. See Health plan coverage Information Set, 48, 187 International initiatives, 84, 124, 135- Health policy challenges, 36 136, 137. See also Cochrane consumer-directed care, 5, 33, 40 Collaboration; indiidual countries costs of health care, 3, 33, 37

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 KNOWING WHAT WORKS IN HEALTH CARE J Meta-analyses analytic considerations, 104 John M. Eisenberg Clinical Decisions and defined, 24, 82 Communications Science Center, 43 journal standards for reporting, 105, Johnson & Johnson, 20, 190, 219-220 159, 199-203 Joint Commission, 20, 48, 147, 187 origins, 85, 86 Journals producers, 43 standards for reporting systematic synthesis of systematic reviews, 7, 82, reviews, 105-108, 159, 199-203 102, 104 Strength of Recommendation Meta-analysis Of Observational Studies in Taxonomy, 135-136 Epidemiology (MOOSE), 105-108, 159, 202-203 Myocardial infarction, 38, 51, 66, 68, 82 K Kaiser Permanente, 44, 67, 69-70 N Kefauver-Harris Drug Amendments, 26 Knowledge transfer issues, 19 National Center for Biotechnology Information, 36 National Center for Health Care L Technology, 26 National Center of Complementary and Language/terminology standards, 7, 9-10, Alternative Medicine, 65 11, 14, 81, 104, 108, 126, 141-142, National Cholesterol Education Program, 146-147, 155-156, 159, 167, 171, 133, 135 172, 173 National clinical effectiveness assessment Latin American Caribbean Health Sciences program Literature (LILACS), 99 accountability, 12, 155, 156, 167 Literature reviews, 86-87 administrative structure, 165, 170 Lung cancer, 66, 92, 94, 96 alternative approaches compared, 153, 164-170 central agency model, 153, 165, M 166-170 Macular degeneration, 20, 68, 92, 95, 182, consistency, 12, 155-156, 160, 167 183 efficiency, 12, 156-157, 168 Mathematical modeling, 95 evaluation of Program, 172-173 Medicaid, 37, 38, 45, 60, 62, 163, 197. feasibility, 12, 156, 157, 168 See also Centers for Medicare & guiding principles, 12, 74, 154-159 Medicaid Services hybrid model, 153, 165, 166-170 Medical Device Amendments, 26 independent forum, 171-172 Medical Services Advisory Committee international experiences, 160-164 (Australia), 162 mission and functions, 1-2, 9-10, 19, Medicare and Medicaid. See Centers for 165 Medicare & Medicaid Services objectivity, 12, 75-76, 156, 157-158, Medicare Payment Advisory Commission, 168 19, 28, 154 recommendations for infrastructure Medicare Prescription Drug, Improvement, building, 1-2, 9-12, 58, 170-173 and Modernization Act of 2003, responsiveness, 12, 158, 169 28, 43 scientific rigor, 12, 159, 160, 169, 170 MEDLINE, 35, 98, 99, 100-101, 110, 112, status quo compared to, 153, 155, 164- 218, 220, 225 166, 167-169

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 INDEX transparency, 12, 159, 160, 163, 169 quality of, 101, 109 unanswered questions about, 173-174 value of, 7, 91 National Committee for Quality Assurance Outcomes of health care (NCQA), 20, 48, 147, 187 expenditures and, 39 National Guideline Clearinghouse (NGC), negative effects of approval, 51, 64-65, 8, 27, 36, 45, 124, 126, 133-134, 68 138, 215 racial/ethnic disparities as selection National Health Service (UK), 62, 161 criterion, 73, 77, 88, 91 National Heart, Lung, and Blood Institute Overviews, 85-86 (NHLBI), 46, 133, 135 Oxford Database of Perinatal Trials, 86 National Horizon Scanning Centre (UK), 62, 162 P National Institute for Health and Clinical Excellence (NICE) (UK), 62, 71, Pay-for-performance incentives, 40, 122 124, 135, 161, 162 Pearson, Karl, 86 National Institutes of Health (NIH), 35 Performance measurement n.1, 36, 51, 65, 99 n.11, 183 adherence to clinical practice guidelines, clinical guideline development, 133, 143 122, 137, 147 conflicts of interest, 50, 131, 143 basis for, 40, 43 Consensus Development Program, 45, organizations, 47, 48 59, 60, 62, 83, 133 Pharmaceutical Benefits Advisory funding/budget, 41, 42 Committee (Australia), 162, 163 Office of Dietary Supplements, 65 Pharmaceutical Research and Office of Management Analysis and Manufacturers of America Review, 65, 71 (PhRMA), 42 Office of Medical Applications of Physician Consortium for Performance Research (OMAR), 63, 71 Improvement, 20, 187 Office of Research on Women’s Health, PICO format, 87-88 65 Positron emission tomography research training programs, 109 for Alzheimer’s disease, 20, 88, 92, 181, systematic reviews, 59 182, 183 National Library of Medicine, 35 n.1, 36, Potential impact criterion, 71, 72 99 n.11, 214 Preventive services National Quality Forum (NQF), 20, 48, analytic framework for systematic 155, 187 reviews, 89-90, 92 National Rural Health Association, 65 study designs, 7, 91, 92 New-evidence criterion, 6, 71, 72, 73, 77, for subpopulation, 94, 96 111, 141, 158 topic nominations, 63, 64, 66, 94, 96 USPSTF recommendations, 8, 45-47, O 94, 123, 125, 132-133, 186, 191 Objectivity Priority Setting Advisory Committee in guideline development, 50-51, 121, (PSAC), 13 122, 127, 128-129, 139, 140, 165 composition and size, 13-14 in priority setting, 75-76 meeting frequency, 77 in systematic reviews, 6, 7, 86, 157, membership, 13, 57, 74-75 165 mission, 73, 165, 170 Observational or nonexperimental studies nomination process, 14 defined, 24 scope of topics, 76 journal reporting standards for meta- transparency, 76 analyses, 105, 159, 202-203

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 KNOWING WHAT WORKS IN HEALTH CARE R Priority setting for evidence assessment basic principles, 57, 74, 75-76 RAND Corporation, 26, 130 conflicts of interest, 57, 75 Randomized controlled trials (RCTs), 4, 7, contexts for, 2-3, 59-61 23, 24, 25, 35, 90, 91, 92, 97, 99, horizon scanning, 63-70, 74 100, 102, 103, 104, 105, 106, 109, identifying topics, 5, 13, 57, 61-71, 76- 159, 199-201, 207, 208, 218, 223, 77, 161 224, 227 methods, 5-6, 14, 58, 59, 61-72, Ranibizumab (Lucentis®) for age-related 75-76 macular degeneration, 20, 92, 183 recommendations, 13-14, 73-77, Rare and orphan diseases, 48-49, 134, 141 172-173 Recommendations responsiveness, 75 clinical practice guideline development, selection criteria for high-priority 11, 15, 121, 139, 145, 146, 173 topics, 5, 6, 11, 13, 57, 58, 71-72, national clinical effectiveness assessment 73, 74, 76-77, 172-173, 197 program, 9-12, 73-77, 170-173 sources of nominations, 61, 64, 65, 74 systematic reviews, 11, 13-15, 81-82, standardization of procedures, 75-76 108-110, 173 for systematic reviews, 13-14, 62-63 Robert Wood Johnson Foundation (RWJF), template for submission of topics to 1, 18, 19 AHRQ, 193-198 topics nominated, 61, 64, 66-67, 72 updating priorities and processes, 73, S 75, 77 Professional societies. See also indiidual Saliba Burns Institute, 65 societies Scientific rigor, 15, 127-129, 130, 139, 165 clinical practice guideline development, Scope of this study, 18-20 2, 8, 12, 22, 43, 45, 47, 111, 124, Scotland, national program, 161, 163 125, 126, 134, 139, 170 Scottish Intercollegiate Guidelines conflicts of interest, 144 Network, 103, 124, 126, 163 evidence assessments, 51, 60, 61, 156 Scottish Medicines Consortium, 161, 163 intellectual bias, 75, 129-130 Selection criteria “ownership” of medical conditions, for high-priority topics, 5, 6, 11, 13, 134 57, 58, 71-72, 73, 74, 76-77, 172- quality of guidelines, 125, 139 173, 197 topic nominations, 63, 64, 193-198 for systematic reviews, 89-92, 110, 127 Prostate cancer, 22, 69, 88, 92, 94, 95, 96, Singapore, national program, 160 134 Society of Vascular Surgery, 65 Public controversy criterion, 6, 71, 72 Spinal Cord Consortium, 65 Public/provider interest criterion, 71, 72 Stakeholders, 13-14, 25, 48, 51, 74-75, PubMed database, 36, 84, 209-214, 225 132, 135, 144, 185, 190-191 Standards for Reporting of Diagnostic Accuracy (STARD), 105 Q State Children’s Health Insurance Program, 163 Quality of health care, 1, 2, 5, 21, 122 Strengthening the Reporting of IOM aims for patient care, 40 Observational Studies in Quality of life, 51, 72, 88, 133 Epidemiology (STROBE), 105 Quality of Reporting of Meta-analyses Stroke guidelines, 8, 63, 67, 68, 133-134 (QUOROM), 105-108, 159, Study methods, 20-21 199-201

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 INDEX Subpopulations, 8, 59, 61, 93, 94, 96, 105, searching for evidence, 95-100, 127 138, 166, 199, 200, 202 selection criteria for studies, 89-92, Substance Abuse and Mental Health 110, 127 Services Administration (SAMHSA), sources of evidence, 86, 94-95, 98-100 83, 84 standards, 14, 81, 100, 108, 155-156, Synthesis of results of studies, 7-8, 45, 49, 159, 199-203 82, 104-108, 109, 110, 126-132. subscription fees, 84 See also Meta-analyses synthesis of results of studies, 7-8, 45, Systematic reviews 49, 82, 104-108, 109, 110, 126- analytic framework, 89-95 132, 159; see also Meta-analyses appraising evidence, 100-104, 110 transparency, 7, 49-50, 51, 86, 104, availability of evidence, 93-94 105, 155, 159 best-evidence approach, 91, 92, 98 updating, 73, 111, 158 bias, 7, 8, 91, 97-98, 100, 102, 108, value of, 3, 6-8, 82, 83 158, 159 and clinical practice guideline T development, 83, 85, 105, 111, 123, 127, 133, 134 Technology assessments data extraction errors, 102 defined, 24 database searches, 98-99, 101 milestones, 25, 26 defined, 3, 24, 82-83 priority setting, 6 fundamentals, 14-15, 87-108 producers, 43, 44, 163 hand searches, 99-100 Transatlantic Inter-Society Consensus, 65 hierarchies of evidence, 7, 102-104, 108 Transparency international efforts, 84 in guideline development, 11, 50, 121, journal standards for reporting, 105- 125, 126, 139-140, 144, 147 108, 155, 159, 199-203 in systematic reviews, 7, 49-50, 51, 86, language/terminology standards, 7, 104, 105 9-10, 11, 14, 81, 104, 108, 146, 155-156, 159, 166, 171, 172, 173 methods, 6-8, 14-15, 81, 85-87, 109, U 110, 154, 159 new and emerging technologies, 6, 111- Union County Health Committee, 65 112, 166 United Kingdom, national program, number annually, 58, 59 161-163 objectivity, 6, 7, 86, 157, 165 UnitedHealthcare, 20, 66, 67-68, 189 origins, 85-87 University of California at Los Angeles, priority setting for, 13-14, 62-63 130 producers and users, 43, 46-47, 61, 83- Up-to-Date database, 47 85, 133, 156-157, 186 U.S. Breastfeeding Committee, 65 public access to, 84, 155 U.S. Department of Defense, 42, 163 quality issues, 6-8, 49, 81, 86, 100-104, U.S. Department of Health and Human 108, 123, 127, 134, 153, 154, 159, Services (HHS), 9, 10, 61, 153, 164, 165-166 171, 172 question formulation, 87-88, 92 U.S. Food and Drug Administration (FDA), recommendations for, 11, 13-15, 81-82, 26, 42-43, 50, 51, 64, 83, 84, 93, 108-110, 173 112, 131, 143, 207, 216, 218 research workforce, 8, 11, 14-15, 36, U.S. Office of Technology Assessment 82, 109-110 (OTA), 26, 27 resource requirements, 124

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6 KNOWING WHAT WORKS IN HEALTH CARE V U.S. Preventive Services Task Force (USPSTF), 8, 20, 27, 28, 45-46, Veterans Health Administration (VHA), 47, 60, 61, 62, 65, 71, 72, 83, 84, 26, 42, 83, 84, 103, 136, 163 89-90, 93-94, 96, 123, 125, 128, 132-133, 135, 139, 186, 191 U.S. Public Health Service, 46 W Utilization of health services benchmarks for optimal use, 39-40 Web of Science, 99 geographic variation in, 5, 37-40 WellPoint, 67, 69-70 insurance coverage and, 51 Workforce qualifications and training, 8, and outcomes, 39 11, 14-15, 36, 82, 109-110 variation as selection criterion, 6, 71, World Health Organization (WHO), 72, 73, 76-77 Collaborating Center, 44 Utilization Review Accreditation Commission, 147