Afterward they are periodically reviewed by the agency study section that first awarded the grant.

PORT RESEARCH TOPICS

Each PORT focuses on a specific acute or chronic condition "to identify and analyze the outcomes and costs of current alternative practice patterns in order to determine the best treatment strategy and to develop and test methods for reducing inappropriate variations" (AHCPR, 1990:2). In selecting conditions to study, MEDTEP has given priority to conditions occurring frequently, especially among Medicare beneficiaries, conditions and interventions for which risks and costs are particularly high, treatments are particularly variable, and outcomes uncertain. PORTs also evaluate the effects of their findings and recommendations on practice patterns.

PORT STRUCTURE

PORTs are large multidisciplinary projects that employ larger and more diverse groups of researchers than is typical in health services research. MEDTEP requires that each PORT include academic and practicing community-based health care providers, and that each team have expertise in the following areas: pertinent clinical specialties, research design, literature synthesis (including meta-analysis), epidemiology, biostatistics, economics, decision analysis, survey research, data management, and research dissemination. PORTs are multi-institutional and, in some cases, international in composition. Box 2.1 shows the disciplines, institutions, and professional affiliations of members of the currently funded PORTs.

To enhance inter-PORT coordination MEDTEP has established six work groups to focus on specific methodological issues: meta-analysis, decision analysis, outcomes assessment, use of claims data, cost of care, and dissemination. Each work group comprises designated PORT representatives who will meet to discuss common problems and possibly common solutions for use by PORTs and other researchers.

PORT METHODS

According to AHCPR's Program Note on medical treatment effectiveness research (AHCPR, 1990), PORTs must include at least the following four components in their research:



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