Patient Outcomes Research Teams (PORTS) Managing Conflict of Interest (1991) / Chapter Skim
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2 Patient Outcomes Research Teams
2 Patient Outcomes Research Teams
Pages 13-26
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From page 13... ...
To fulfill this charge MEDTEP supports multidisciplinary research groups called PORTs—patient outcomes research teams.t In fiscal year 1990, AHCPR received $100 million, $38 million of which was allocated to MEDTEP, including the PORTs. Table 2.1 lists the 11 PORTs that had been funded as of October 1990.
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From page 14... ...
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)
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From page 15... ...
To obtain primary data about outcomes and preferences that are not available from insurance data bases, PORTs may also conduct patient and practitioner interviews or surveys and abstract patient records. For instance, the Indiana PORT, which is evaluating total knee replacement, is gathering information directly from patients by conducting crosssectional telephone surveys every six months in Indiana, western Pennsylvania, and Ontario to assess functional status and perceived pain (Freund et al., 1990~.
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From page 16... ...
The claims data will be used to define longitudinal cohorts of AMI patients starting in 1987 and in all available subsequent years to measure utilization, including hospital admissions for AMI-related procedures, and outcomes. The PORrs decision-analysis working group will develop probability estimates for decisions to perform elective coronary angiography during the period immediately following an AMI; the group will then compare the results of this analysis to actual use of the diagnostic procedure as measured in claims data bases.
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From page 17... ...
The Dartmouth assessment team study of benign prostatic hypertrophy (BPH) and localized cancer of the prostate actually antedates PORT funding.
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First, PORT research will be used in the development of practice guidelines. As such, PORT findings can be expected to influence medical practice more directly and broadly than the results of a clinical trial of a particular modality.
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From page 19... ...
Clinical trials attempt to control for as much of this variability as possible by defining patient populations narrowly, using selected sites and practitioners, and restricting changes in technology. This makes it virtually impossible for clinical trials to be generalized to practice outside of highly skilled and carefully controlled settings.
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From page 20... ...
These methods include: review of the literature, including meta-analysis; data collection, including claims analysis, prospective data collection from records and patients, and decision analysis; dissemination of findings; and evaluation of the effects of dissemination. The chapter identifies special aspects of PORT research that distinguish it from clinical research and that justify giving PORTs special attention in relation to conflicts of interest.
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From page 21... ...
Replacement Outcome Assessment Program David B Pryor in Ischemic Heart Disease Duke University Outcome Assessment of Patients J
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From page 22... ...
The first four PORTs listed were funded through the Patient Outcome Assessment Research Program of the National Center for Health Services Research. b This study is funded through a contract.
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Sinai Hospital, Boston Department of Veterans Affairs Medical Center, West Roxbury Dartmouth University Duke University Back Pain Outcome Assessment Team University of Washington, Department of Health Services, School of Medicine, School of Public Health Department of Veterans Affairs Medical Center, Seattle Group Health Cooperative of Puget Sound Maine Medical Assessment Foundation Massachusetts General Hospital Variations in Cataract Management: Patient and Economic Outcomes Johns Hopkins University School of Medicine, Center for Hospital Finance and Management, Health Services Research and Development Center, Dana Center for Preventive Ophthamology, School of Hygiene and Public Health Georgetown University Medical Center
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From page 24... ...
Medical College of Pennsylvania New England Medical Center Tufts University Yale University School of Medicine Geisinger Medical Center Lancaster General Hospital, Lancaster, Pa. Williamsport Hospital, Williamsport, Pa.
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From page 25... ...
PATIENT OUTCOMES RESEARCH TEAMS Variations in the Management and Outcomes of Diabetes New England Medical Center Indiana University School of Medicine Kaiser Permanente of Portland, Oregon Massachusetts General Hospital University of Michigan School of Public Health 25 Assmsme~ of the Variation arid Outcomes of Pneumonia Universitr of Pittsburgh School of Medicine, Graduate School of Public Health Dalhousie University, Halifax, Nova Scotia Harvard University School of Medicine, School of Public Health University of Toronto Variations in Obstetric Practice and Patient Outcomes The RAND Corporation University of California at Los Angeles School of Medicine aThis table includes affiliations of the principal investigator (PI) , all co-PIs, and subcontractors as of October 1990 indicated in year 1 grant applications.
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