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C Workshop Agenda and Questions to Panelists January 14, 2010 Keck Center of The National Academies 500 Fifth Street, N.W., Room 100 Washington, DC Workshop Objective: To learn how various stakeholders use and develop systematic reviews (SRs), including expert developers of SRs, professional specialty societies, payers, and consumer advocates. 8:00 Breakfast served 8:30 Welcome and Introductory Remarks Alfred O. Berg, Chair, Institute of Medicine Committee 8:45 Systematic Review Experts Panel Kalipso Chalkidou, Director, NICE International, National Institute for Health and Clinical Excellence Naomi Aronson, Executive Director, Technology Evaluation Center, Blue Cross and Blue Shield Association David B. Wilson, Crime and Justice Group Cochair, Steering Committee, The Campbell Collaboration Moderator: Kay Dickersin, Professor of Epidemiology, Johns Hopkins Bloomberg School of Public Health 243

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244 FINDING WHAT WORKS IN HEALTH CARE 9:45 Professional Specialty Societies Panel Virginia Moyer, Section Head, Academic General Pediatrics, Baylor College of Medicine Sandra Zelman Lewis, Assistant Vice President, Health & Science Policy, American College of Chest Physicians Rebekah Gee, Assistant Professor of Clinical Medicine, Department of Obstetrics and Gynecology, Tulane University Moderator: Harold C. Sox, Editor Emeritus, Annals of Internal Medicine 10:45 Break 11:00 The Payer Perspective Panel Louis B. Jacques, Director, Coverage & Analysis Group, Office of Clinical Standards & Quality, Centers for Medicare & Medicaid Services Alan Rosenberg, Vice President of Technology Assessment, WellPoint Health Networks Edmund Pezalla, National Medical Director and Chief Clinical Officer, Aetna Pharmacy Management Moderator: Paul Wallace, Medical Director, The Permanente Federation, Kaiser Permanente 12:00 Lunch 12:30 Consumer Panel Gail Shearer, Former Director, Consumer Reports Best Buy Drugs, and Former Director, Health Policy Analysis, Consumers Union David Shern, President and Chief Executive Officer, Mental Health America Carol Sakala, Director of Programs, Childbirth Connection Moderator: Katie Maslow, Director, Policy Development, Alzheimer’s Association 1:30 Adjourn

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245 APPENDIX C Questions for the Panelists Systematic Review Experts Panel •  How do you develop your review questions?  o To what extent is the user involved in developing the research question? •  How do you determine the inclusion criteria for studies in  your evidence synthesis? o Do you incorporate observational and other nonran- domized data? If yes, what are the parameters for their use? o Do you incorporate unpublished and grey literature? Please explain. o How do you protect against publication and report- ing (outcome) bias? What have been the challenges (if any)? •  Do you use any specific instruments or methods to ensure  the quality of your SRs? •  What  are  the  greatest  challenges  in  producing  SRs  that  meaningfully support users’ decisions? •  How do your “customers” use your reviews?  •  How  are  your  reviews  funded?  Do  you  accept  industry  funding? How do you identify and address potential con- flicts of interest (COIs)? •  This Institute of Medicine (IOM) committee is charged with  recommending standards for SRs of comparative effective- ness research (CER). Are there steps in your SR process that could be standardized? •  What  would  be  the  implications  if  the  IOM  were  to  rec- ommend a standard grading scheme for characterizing the strength of evidence? Professional Specialty Societies Panel •  Does your organization produce its own SRs?  o If yes, have you developed or adopted standards or guidance for the process? Please describe. o If no, who produces your SRs? To what extent does your organization participate in the review? •  What  are  the  greatest  challenges  in  using  SRs  to  develop  clinical practice guidelines (CPGs)? •  How are your SRs funded? Do you accept industry funding?  How do you identify and address potential COIs?

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246 FINDING WHAT WORKS IN HEALTH CARE •  Do you use any specific instruments or methods to ensure  the quality of your SRs? •  This  IOM  committee  is  charged  with  recommending  stan- dards for SRs of CER. Are there steps in your SR process that could be standardized? •  What would be the implications for your organization if the  IOM were to recommend a standard grading scheme for characterizing the strength of evidence? Payer Perspective Panel •  Does your organization produce its own SRs?  o If yes, have you developed or adopted standards or guidance for the process? Please explain. o If no, who produces your SRs? Does your organization participate in the review? Please explain. •  Do  you  incorporate  observational  and  other  nonrandom- ized data in your evidence syntheses? If yes, what are the parameters for their use? •  How do use SRs to make coverage decisions?  •  What  are  the  greatest  challenges  in  using  SRs  to  inform  coverage decisions? •  This  IOM  committee  is  charged  with  recommending  stan- dards for SRs of CER. Are there steps in the SR process that could be standardized? •  What would be the implications for your organization if the  IOM were to recommend a standard grading scheme for characterizing the strength of evidence? Consumer Panel •  What should be the role of the patient/consumer in the SR  process? •  Who  should  be  considered  a  consumer  (e.g.,  members  or  representatives of organized groups; patients with personal experiences with a disease; any member of the public, care- givers, and parents)? •  What  lessons  can  be  learned  from  existing  models  of  con- sumer involvement? Based on your personal experience, where do you think that involving consumers made a real difference to the process and to the results? What aspects of consumer involvement are working well and what aspects are not working well? •  Do consumers need training/education to participate mean- ingfully in the SR process?

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247 APPENDIX C •  This  IOM  committee  is  charged  with  recommending  stan- dards for SRs of CER. Should the consumer role in SR be standardized? •  What would be the implications for consumers if the IOM  were to recommend a standard grading scheme for charac- terizing the strength of evidence?

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