Part 2. Summary of AHRQ Performance Objectives

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Performance Plans for Fiscal Year 2001 and 2002 and Performance Report for Fiscal Year 2000

Part 2. Summary of AHRQ Performance Objectives

Budget Line 1: Research on Health Costs, Quality, and Outcomes
          Goal 1: Establish Research Agenda Based on Users' Needs
          Goal 2: Make Significant Contributions to Effective Functioning of the U.S. Health Care System
          Through Creation of New Knowledge
          Goal 3: Foster Translation and Dissemination of New Knowledge into Practice by Developing
          and Providing Information, Products, and Tools on Outcomes, Quality, and Access, Cost, and
          Use of Care
          Goal 4: Evaluate the Effectiveness and Impact of AHRQ Research and Associated Activities
          Goal 5: Support Initiative to Improve Health Care Quality Through Leadership and Research
Budget Line 2: Medical Expenditure Panel Survey
          Goal 6: Collect current data and create data tapes and associated products on health care use
          and expenditure for use by public and private-sector decision makers and researchers
Budget Line 3: Program Support

Budget Line 1: Research on Health Costs, Quality, and Outcomes

Funding Levels:

Fiscal Year 1999: $139,314,000 (Actual).
Fiscal Year 2000: $165,293,000 (Enacted).
Fiscal Year 2001: $226,446,000 (Appropriation).
Fiscal Year 2002: $255,145,000 (President's Budget).

Goal 1: Establish Research Agenda Based on Users' Needs.

Objective 1.1: Define direction of Fiscal Year project funding priorities, in large part, by needs assessment activities.

Target, Fiscal Year 2002: Agency research agenda covering strategic goal areas for Fiscal Year 2002 priorities (investigator-initiated research, national quality report, national disparities report) is documented by March 2002 based on consultations with various groups.
Reference: Commitment Base.

Target, Fiscal Year 2001: Agency research agenda covering strategic goal areas for Fiscal Year 2001 priorities (patient safety and informatics) is documented based on consultations with various groups.
Reference: Commitment Base.

Target, Fiscal Year 2000: Agency research agenda covering the three strategic research goals and the new Fiscal Year 2000 closing the gap initiatives are documented based on consultations with various groups.
Actual Performance: Completed.
Reference: Mission Statement.

Target, Fiscal Year 1999: Agency research agenda covering the three strategic research goals is developed in Fiscal Year 1999 and documented based on consultations with various groups.
Actual Performance: Completed. For Details, Select GPRA Goal 7 and Appendix 5.

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Goal 2: Make Significant Contributions to the Effective Functioning of the U.S. Health Care System Through the Creation of New Knowledge

Fiscal Years 2001 and 2002 Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes, quality, and cost, access, and use) and develop a plan for next steps (translation and dissemination.)

Targets, Fiscal Year 2002:

Produce an annual report on at least 18 science advances covering the three research goal areas (outcomes; quality; cost, access, and use).
For each finding, specific steps in translation and dissemination are identified and initiated.
Generate 2 - 3 synthesis reports on research findings and practical applications on Agency priority topics.

Reference: Commitment Base.

Targets, Fiscal Year 2001:

Produce an annual report on at least 12 science advances covering the three research goal areas (outcomes; quality; cost, access, and use).
For each finding, specific steps in translation and dissemination are identified and initiated.
Generate 2 to 3 synthesis reports on research findings and practical applications on Agency priority topics.

Reference: Commitment Base.

Fiscal Year 2000 Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes; quality; and cost, access, and use) and develop plan for next steps (translation and dissemination.)

Targets, Fiscal Year 2000:

Annual report on science advances in three research goal areas.
Actual Performance: Completed.
Reference: Commitment Base.
At least four major findings in each area that have potential to save significant amounts of money, improve quality, save lives or prevent physical suffering, or change the organization and delivery of health care.
Actual Performance: Completed.
For each finding, specific steps in translation and dissemination are identified and initiated.
Actual Performance: Completed.

Fiscal Year 1999 Objective 2.1: Determine the salient findings from research for three priority populations and develop plan for next steps in translation and dissemination.

Target, Fiscal Year 1999: A report produced that synthesizes research on the major health concerns of at least three priority populations.
Actual Performance: Completed. For Details, Select GPRA: Appendix 6.

((CHECK APPENDIX NUMBER))

Objective 2.2: Achieve significant findings from AHRQ sponsored and conducted research.

Target, Fiscal Year 2002: Findings form at least 20 AHRQ sponsored or conducted research are used by public and private partners to improve health care.
Reference: Commitment Base.

Target, Fiscal Year 2001: same as 2000, except changed to 40 findings.
Reference: Commitment Base.

Target, Fiscal Year 2000: Findings from at least 25 AHRQ sponsored or conducted research projects are published in major peer reviewed professional publications (New England Journal of Medicine, Journal of American Medical Association, etc.); receive national press coverage; are used in Federal or State policymaking; are used by professional associations or health plans as the basis of strategies to achieve quality; or are used to establish coverage decisions by health care purchasers, managed care organizations, or insurers, including Medicare or Medicaid.
Actual Performance: 400 percent increase: 250 citations for AHRQ findings (20 listed). 32 examples of major media coverage; 7 examples of use.
Reference: Commitment Base.

Target, Fiscal Year 1999: Findings from at least 10 AHRQ sponsored or funded research projects are published in major peer reviewed professional publications (New England Journal of Medicine, Journal of American Medical Association, etc.); receive national press coverage; are used in Federal or State policymaking; are used by professional associations or health plans as the basis of strategies to achieve quality; or are used to establish coverage decisions by health care purchasers, managed care organizations, or insurers, including Medicare or Medicaid.
Actual Performance: 50 citations for AHRQ findings; 7 examples of major media coverage; 7 examples of use.

Fiscal Years 2001 and 2002 Objective 2.3: Initiate Fiscal Year Research Initiatives

Target, Fiscal Year 2002: Funding of a minimum of 100 projects; 30 percent of these projects address priority populations.
Reference: For details, select Budget.

Targets, Fiscal Year 2001: Funding of a minimum of 60 projects in the following areas:

40 projects in reducing medical errors and enhancing patient safety.
Reference: For details, select Budget: Patient Safety.
10 projects in informatics applications in health care.
Reference: For details, select Budget: Informatics.
10 projects in quality improvement through improvements in health care working conditions.
Reference: For details, select Budget: Healthcare Working Conditions.

Fiscal Year 2000 Objective 2.3: Implement Fiscal Year 2000 priority (1) "New Research on Priority Health Issues."

Targets, Fiscal Year 2000:

Funding of a minimum of 10 projects that address gaps in knowledge about the priority problems faced by Medicare and Medicaid.
Actual Performance: 43 projects funded.
Reference: For details, see Budget: Health of the Elderly.
Funding of a minimum of 10 projects to address eliminating disparities in health care with particular emphasis on disparities that exist for racial and ethnic minorities.
Actual Performance: More then 30 projects funded.
Reference: For details, see Budget: EXCEED.

Fiscal Year 1999 Objective 2.3: Initiate Fiscal Year 1999 Research Initiatives

Targets, Fiscal Year 1999: Funding of a minimum of 21 projects in:

Consumers' use of information on quality.
Strengthen value-based purchasing.
Measure national health care quality.
Vulnerable populations.
Translating research into practice.

Actual Performance: 56 projects funded.

Targets, Fiscal Year 1999: Funding of a minimum of 17 projects in:

Outcomes for the elderly and chronically ill.
Clinical preventive services.
CERTS^TM
Improving the quality of children's health.

Actual Performance: 51 projects funded. For details, select GPRA: Disparities.

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Goal 3: Foster translation and dissemination of new knowledge into practice by developing and providing information, products, and tools on outcomes; quality; and access, cost, and use of care.

Fiscal Years 2002 and 2001 Objective 3.1: Maximize dissemination of information, tools, and products developed from research results for use in practice settings. NOTE: in the Fiscal Year 2001 plan, objective 3.1 and 3.2 have been consolidated.

Targets, Fiscal Year 2002:

Number of state and local governments trained and/or receiving technical assistance through User Liaison Program (ULP).
At least 20 partnerships to disseminate and implement research findings are formed with public and private-sector organizations.
Synthesis of at least five grant portfolio areas on quality of care across Agency's goals for persons with chronic care needs produced and disseminated with particular focus on outreach to managed care executives.

Reference: Commitment Base.

Target, Fiscal Year 2001:

At least five public-private partnerships are formed to implement research findings for decisionmakers.
Reference: Commitment Base.
Formation of a minimum of 10 partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
Reference: Commitment Base.
Number of hits on the Web site.
Reference: Commitment Base for all Web site measures and ULP.
Number of inquiries handled on Web site.
Reference: Commitment Base for all Web site measures and ULP.
Number of uploaded documents.
Reference: Commitment Base for all Web site measures and ULP.
Number of State and local governments trained in understanding and using health services research findings through ULP Workshops.
Reference: Commitment Base for all Web site measures and ULP.

Fiscal Years 2000 and 1999 Objective 3.1: Promote distribution of AHRQ publications, products, and tools through intermediary organizations.

Target, Fiscal Year 2000: Formation of a minimum of five partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
Actual Performance: Over 30 public/private and public/public partnerships formed.
Reference: Commitment Base.

Target, Fiscal Year 1999: Formation of a minimum of five partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
Actual Performance: Over 30 public/private and public/public partnerships formed.

Fiscal Years 2001 and 2002 Objective 3.2: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio. (This is objective 3.3 in Fiscal Year 1999-2000)

Targets, Fiscal Year 2002:

Produce evidence summaries for use in Federal direct care providers' efforts to create guidelines.
Reference: Commitment Base.
Evidence-based practice centers (EPCs) will produce a minimum of 18 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
Reference: Commitment Base.
Fund at least 10 projects in tool and data development.
Reference: Commitment Base.

Targets, Fiscal Year 2001:

Produce evidence summaries for use in Federal direct care providers' efforts to create guidelines.
Reference: Commitment Base.
EPCs will produce a minimum of 12 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
Reference: Commitment Base.
Support a minimum of 165 pre- and post-doctoral trainees.
Reference: Commitment Base.
Support up to 3 Minority Research Infrastructure Support Program IM-RISP) grants in order to develop the health services research capabilities of traditionally minority-serving institutions.
Reference: Commitment Base.
Support up to 6 Building Research Infrastructure and Capacity (BRIC) two-year planning grants in EPSCOR states and states which historically have received little or no research support from AHRQ.
Reference: Commitment Base.
Fund at least 10 projects in tool development.
Reference: Commitment Base.

Fiscal Years 1999 and 2000 Objective 3.2: Maximize dissemination of information, tools, and products developed from research results for use in practice settings. (Becomes Objective 3.1 in Fiscal Year 2001.)

Targets, Fiscal Year 2000:

Number of hits on the Web site.
Actual Performance: 18.8 million hits.
Reference: For details, select Budget: AHRQ's Web site.
Number of inquiries handled on Web site.
Actual Performance: 3,500.
Reference: For details, select Budget: AHRQ's Web site.
Number of Uploaded documents.
Actual Performance: 4,400.
Reference: For details, select Budget: AHRQ's Web site.
Reports from user surveys on how the information requested was used.
Actual Performance: Completed.
Reference: For details, select Budget: AHRQ's Web site.
Number of State and local governments trained in the understanding and use of health services research findings through User Liaison Program (ULP) Workshops.
Actual Performance: State - 50, Local - 29.
Reference: Commitment Base.
- Meetings held.
  Actual Performance: 17 meetings.
  Reference: Commitment Base.
- Number of attendees.
  Actual Performance: 1196 attendees.
  Reference: Commitment Base.
- States represented.
  Actual Performance: 50 states + Washington, DC.
  Reference: Commitment Base.
Reports from annual participants on how the information was used in decisionmaking.
Actual Performance: Met.
Reference: Commitment Base.
Statistics on use of National Guideline Clearinghouse™ including number of hits, requests, organizations, and total users.
Actual Performance: Hits: 32,234,401; requests: 18,207,430; organizations: 58,803; user sessions: 1.5 million.
Reference: For details, select Budget: NGC.
Survey of a sample of NGC users to understand the impact of use on decisions and patient care.
Actual Performance: 902 respondents. Evaluation to be completed in mid-year 2001.
Reference: For details, select Budget: NGC.
At least 10 purchasers/businesses use AHRQ findings to make decisions.
Actual Performance: 11 examples listed.

Targets, Fiscal Year 1999:

Number of hits on the Web site.
Actual Performance: 15.5 million.
Number of inquiries handled on web site.
Actual Performance: 2,950.
Number of uploaded documents.
Actual Performance: 4,000.
Number of State and local governments trained in the understanding and use of health services research findings through User Liaison Program (ULP) Workshops.
Actual Performance: 48 states; 4 territories; 30 county governments; 9 city governments.
- Meetings held.
  Actual Performance: 18 meetings.
- Number of attendees.
  Actual Performance: 834 attendees.
- States represented.
  Actual Performance: 48 states.
Statistics on usage of National Guideline Clearinghouse™ including number of hits, requests, organizations, and total users.
Actual Performance: 13,590,013.
At least 5 purchasers/businesses use AHRQ findings to make decisions.
Actual Performance: 21 examples listed.

Objective 3.3: (This becomes objective 3.2 in Fiscal Year 2001. Objective 3.3 is discontinued in Fiscal Year 2001.)

Fiscal Years 1999 and 2000 Objective 3.3: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio.

Targets, Fiscal Year 2000:

Demonstration of use of at least 3 AHRQ research findings in systematic efforts to Translate Research Into Practice.
Actual Performance: Met.
Funding of a minimum of 5 major projects that will develop products, tools, or methodologies for implementing research findings into practice in significant segments of the health care system (i.e., potential to be generalizable across health care systems, provider-types, or clinical areas.)
Actual Performance: 29 projects funded.
At least 2 new tools, products, or methodologies become available from projects funded between Fiscal Year 1993 and Fiscal Year 1996.
Actual Performance: 23 listed
Support a 5 percent increase, at a minimum, in number of pre- and post-doctoral trainees.
Actual Performance: 40 percent increase. For details, select Indicator 4.

Target, Fiscal Year 1999:

Evidence-based Practice Centers (EPCs) produce a minimum of 12 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice (i.e., practice guidelines, quality measures, and other quality improvement tools). At least four reports are being used by customers to develop practice guidelines or other interventions.
Actual Performance: 10 produced; 3 "in press"; 30 under development.
The AHRQ software product, CONQUEST 2.0 released in Fiscal Year 1999, contains new measures, including measures for new conditions, and updated measures. Contract awarded to create Web-based product for more timely updating of information contained within product.
Actual Performance: Released March 1999; contract to be awarded 9/00.
Funding of a minimum of 5 major projects that will develop products, tools, or methodologies for implementing research findings into practice in significant segments of the health care system (i.e., potential to be generalizable across health care systems, provider-types, or clinical areas.)
Actual Performance: 13 examples provided.
At least two new tools, products, or methodologies become available from projects funded between Fiscal Year 1993 and Fiscal Year 1996.
Actual Performance: 15 examples provided.
Support a minimum of 150 pre- and post-doctoral trainees.
Actual Performance: 167 trainees. For details, select Indicator 4.

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Goal 4: Evaluate the effectiveness and impact of AHRQ research and associated activities.

Fiscal Years 2001 and 2002 Objective 4.1: Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care. NOTE: 1999 - 2000 Objectives 4.1 and 4.2 have been consolidated in the Fiscal Year 2001 plan.

Targets, Fiscal Year 2002:

Evaluate the impact of the CERTS^TM program in disseminating information regarding therapeutics to at least 3 health care providers or others in order to improve practice.
Evaluation to determine whether AHRQ funded studies in methodological development have been effective in developing at least 3 new research techniques, whether the techniques are being implemented, and how these studies could be improved.
Evaluation of the outcomes of the pharmaceutical studies the Agency has funded to assess impact.
Interim assessment of the impact of the management system for tracking project profiles.
Qualitative review by experts of results of one major research initiative to assess quality and productivity and potential impact.
Evaluate private sector use of at least 5 AHRQ findings.
Identify at least 5 private sector uses of AHRQ findings, and describe any assessment of the impact on clinical practice and/or patient care.

Reference: Commitment Base.

Evidence-based Practice Centers

Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
Findings from at least 3 evidence reports or technology assessments will effect State or Federal health policy decisions.
Use of evidence reports or technology assessments and access to NGC site informed organizational decision making in at least 4 cases and resulted in changes in health care processes, quality, or health outcomes.

Reference: Commitment Base.

Targets, Fiscal Year 2001:

Evidence-based Practice Centers
- Use of Evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
- For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
- Findings from at least 3 evidence reports or technology assessments will effect State or Federal health policy decisions.
- Use of evidence reports or technology assessments and access to NGC site informed organizational decisionmaking in at least 4 cases and resulted in changes in health care procedures or health outcomes.
Reference: Commitment Base.
Research
- At least 3 examples of how research informed changes in policies or practices in other Federal agencies.
Reference: Commitment Base.
Quality Measures
- Achievable Benchmarks of Care are used for quality improvement activities by Peer Review Organizations.
- Use of dental performance measures by dental service and insurance organizations.
- HCUP quality indicators incorporated into efforts by hospital associations and hospitals to improve the quality of care.
Reference: Commitment Base.
National Guideline Clearinghouse™
- At least 10 users of the National Guideline Clearinghouse™ will use site to inform clinical care decisions.
- Guideline development or quality improvement efforts by users will be facilitated through use of NGC in at least 5 cases.
- NGC information will be used to inform health policy decisions in at least 2 cases.
- Improvements in clinical care will result from utilization of NGC information in at least 3 cases.
Reference: Commitment Base.
Training Programs
- Two thirds of former pre- and postdoctoral institutional award trainees are active in the conduct or administration of health services research.
Reference: Commitment Base.

Fiscal Year 2000 Objective 4.1 (and 4.2): Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care.

Note: Objectives 4.1 and 4.2 were inadvertently the same. They have been consolidated to simplify the reporting.

Targets, Fiscal Year 2000:

AHRQ's HCUP Quality Indicators (QI's) will be redesigned based on consultations with state policy makers, researchers, hospital associations, and others about their past use of the QI's. By the end of March 2001, a new set of quality indicators will be defined and feedback obtained from a new set of HCUP QI users. In addition, AHRQ will provide access to recent national-level QI information via both the Internet and through published reports, with special focus on disseminating information to hospital users and organizations with responsibility for hospital quality reporting.
Actual Performance: HCUP QI's Defined.
Reference: Commitment Base.
Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
Actual Performance: National-level QI Information Posted to Internet September 2000.
For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decisionmaking and patient care.
Actual Performance: 16 examples listed.
At least three examples of how research informed changes in policies or practices in other Federal agencies.
Actual Performance: 4 examples listed.
AHRQ will report on the extent to which CONQUEST assists those who are charged with carrying out quality measurement and improvement activities and the extent to which it helps further state-of-the-art in clinical performance measurement.
Actual Performance: 4 examples listed., Completed (Objective 4.1)
CAHPS® has assisted the Health Care Financing Administration (HCFA) in informing Medicare beneficiaries about their health care choices. The use and impact of this information is determined by surveying a sample of these beneficiaries.
Actual Performance: Completed. Results to be Published in July 2001
At least one quality measure from Q-span (or instances where AHRQ research contributes to the development of measures) are used in the Health Plan Employer Data Information Set (HEDIS®) by the National Committee for Quality Assurance (NCQA), measurement activities of the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO), or other organizations monitoring health care quality.
Actual Performance: ABC System of Performance Profiling Cited (Objective 4.2)

Fiscal Year 1999 Objective 4.1: Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care.

Targets, Fiscal Year 1999:

An evaluation of the outcomes of outcomes research and the impact of AHRQ-supported outcomes and effectiveness research on clinical practice.
Actual Performance: Completed.
An evaluation and synthesis of (1) primary care research supported by AHRQ and (2) an assessment of the current state of the science and future directions for primary care research.
Actual Performance: Progress Report ((details, page 64)).
AHRQ's state data strategy will be redesigned based on consultations with state policy makers, researchers, hospital associations, and others about their past use of data from the Healthcare Cost and Utilization Project (HCUP) as well as additional data needs.
Actual Performance: Completed.
Results of the evaluation of the Consumer Assessment of Health Plan Study (CAHPS®) will be used to improve the usability and usefulness of the tool. Findings are expected to show whether (a) the survey-based information from CAHPS® helps consumers make better health care decisions, (b) the information increases consumer confidence when choosing health care plan, and (c) CAHPS® is used by public and private organizations.
Actual Performance: Preliminary Results.
Evaluation studies on: (1) the quality and usefulness of the evidence reports and technology assessments produced by the Evidence-based Practice Centers and (2) the impact of the use of these products on the health care system will be developed and initiated in Fiscal Year 1999.
Actual Performance: Final Report Received in June 2000.

Fiscal Years 2002-2001 Objective 4.2: Evaluate the impact of MEPS data and associated products on policymaking and research products.

Targets, Fiscal Year 2002:

Have a fully functional MEPS-based MEDSIM model to allow simulation of the potential impact of programmatic changes in health care financing and delivery Dec. 2002.
Reference: Commitment Base.
Produce baseline Fiscal Year statistics on number of MEPS-based articles published in peer review journals.
Reference: Commitment Base.
Conduct customer satisfaction survey for MEPS workshop participants to assess how MEPS data are being used to inform research and public policy.
Reference: Commitment Base.
Develop marketing plan to promote the MEPS-IC data to state officials Dec. 2002.
Reference: Commitment Base.
At least 5 examples of how research using MEPS has been used to inform decisions by Federal, state and private sector policymakers.
Reference: Commitment Base.

Targets, Fiscal Year 2001:

Use of MEPS data in AHRQ research applications will increase by 10 percent over number received in baseline period of 2000.
Reference: Commitment Base.
Feedback from MEPS workshop participants indicating that they were useful and timely.
Reference: Commitment Base.
At least 5 examples of how research using MEPS has been used to inform decisions by Federal, state and private sector policymakers.
Reference: Commitment Base.

Targets, Fiscal Year 2000: See above 4.1 for 2000.

Fiscal Year 1999 Objective 4.2: Evaluate major dissemination mechanisms.

AHRQ Clearinghouse customer satisfaction rated at 98 percent.
Actual Performance: Met.
Reference: Commitment Base.
Customer satisfaction data on AHRQ consumer publications (useful/relevant) rated at 90 percent.
Actual Performance: 81.3 percent

Fiscal Year 2001 Objective 4.3: N/A.

Fiscal Year 2000 Objective 4.3: Evaluate the impact of MEPS data and associated products on policymaking and research projects.

Targets, Fiscal Year 2000:

Use of MEPS data in 1 percent of research applications received by AHRQ.
Actual Performance: MEPS Used in 31 percent of Funded Projects.
Distribution of MEPS data sets to at least 2500 requestors.
Actual Performance: 5,700 Data Sets; 379 CD ROM's.
At least 5 examples of how research using MEPS has been used to inform decisions by Federal, State, and private sector policymakers.
Actual Performance: 15 Examples Given.
Feedback from recipients of MEPS data indicating that the data were timely, useful, and of high significance.
Actual Performance: Met.

Fiscal Year 1999 Objective 4.3: N/A.

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