TABLE 3-3 AHRQ EPC Study Nominations by Source and Topic Area, 2005-2006

Source or Topic Area

Number

Total

2005

2006

Number

Percent

All nominations

40

36

76

100.0

Funded nominations

24

15

39

51.3

Source (n = 47)

 

 

 

 

Federal agencies

15

5

20

42.6

Health plans

2

1

3

6.4

Medical professional societies

10

6

16

34.0

Other

4

4

8

17.0

Total

31

16

47

100.0

Topic area (n = 76)

 

 

 

 

Prevention

3

4

7

9.2

Diagnosis

5

8

13

17.1

Treatment

17

19

36

47.4

Rehabilitation

0

1

1

1.3

Organization and finance

2

4

6

7.9

Quality improvement and patient safety

8

0

8

10.5

Other

5

0

5

6.6

NOTE: Excludes studies requested by CMS and USPSTF.

SOURCE: Personal communication, J. Slutsky, Agency for Healthcare Research and Quality, May 10, 2007.

health news sources; CMS and U.S. Food and Drug Administration notices; announcements of proposed and new current procedural terminology codes; and abstracts, posters, and presentations from scientific meetings of major specialty societies for topics. There is no evidence or apparent consensus on the elements of an effective horizon-scanning system (Murphy et al., 2007).

Nevertheless, past experience has shown, sometimes with tragic consequences, the risks of failing to assess new and emerging health technologies before they are widely adopted. Although it is not clear that early effectiveness assessment would deter the rapid adoption of unproven interventions, assessments of the early evidence could underscore the risks of early adoption. A compelling example of what can go horribly wrong when a high-risk, untested procedure is promoted is high-dose chemotherapy with autologous bone marrow transplantation (HDC/ABMT) for breast cancer. Rettig and colleagues (2007) showed in an in-depth history of HDC/ABMT that no central entity required that the controversial new procedure be adequately evaluated before its use became widespread. At the time that HDC/ABMT began to be used, its potential risks and benefits were not known. With this void as the backdrop, the procedure was evaluated not by parties with the appropriate clinical or research expertise, but by the



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