TABLE 4-1 Key U.S. Producers and Users of Systematic Reviews


Government Agencies
















• Produces reviews





• Sponsors or purchases reviews



Principal use








• Development of practice guidelines and recommendations



• Decisions regarding health coverage




• Regulatory approval







NOTE: BCBSA TEC = Blue Cross and Blue Shield Association Technology Evaluation Center.

health interventions and to improve the underlying research methods (CDC, 2007).

The Blue Cross and Blue Shield Association (BCBSA) Technology Evaluation Center (TEC) produces systematic reviews that assess medical technologies for decision makers in its member plans but also provides the results of these reviews to the public for free.2 Many other health plans look to private research organizations, such as the ECRI Institute and Hayes, Inc., that produce systematic evidence assessments available by subscription or for purchase (ECRI, 2006a,b; Hayes, Inc., 2007). Because the reviews are proprietary, they are not free to the public and the subscription fees are considerable. At Hayes, Inc., for example, subscriptions range from $10,000 to $300,000, depending on the size of the subscribing organizations and the types of products licensed.3

The Cochrane Collaboration is an international effort that produces systematic reviews of health interventions; 11 percent (nearly 1,700 individuals) of its active contributors are in the United States (Allen and Clarke, 2007). Cochrane reviews are available by subscription to The Cochrane Library, and abstracts are available for free through PubMed or




Personal communication, W. S. Hayes, Hayes, Inc., August 29, 2007.

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