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"stakeholder"

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Applicability Resources. Clinical experts and stakeholders can provide general information important to framing applicability issues. What does the population of interest looks like? What types of care or procedures are routine or represent standard of care? Are certain subpopulations characteristically different from others?
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Applicability Resources

Presentation: Assessing Applicability
Keywords: Effective Health Care Program | comparative effectiveness review | stakeholder | population
Key Messages (I) The PICOS framework is useful for organizing contextual factors of interest. Input from clinical experts/stakeholders and a review of current practices can help identify specific applicability issues. Population-based surveys, pharmacoepidemiologic studies, and large case series or registries can help determine how trial populations and circumstances differ from normal practice. PICOS = population, intervention, comparators, outcomes, and setting.
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Key Messages (I)

Presentation: Assessing Applicability
Keywords: PICOS | applicability | case series | PICOTS
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The Comparative Effectiveness Review Development Process

Presentation: Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer
Keywords: comparative effectiveness review
The CER Development Process (1) The comparative effectiveness review (CER) topic, Comparative Effectiveness of Recombinant Factor VIIa for Off-Label Uses vs. Usual Care in the Hospital Setting, was nominated in a public process. The nominated topic was reviewed and selected based on need, importance, and feasibility. Sufficient research into the current literature by experts in the field and stakeholders determined that a CER on the off-label usage trends and benefits and harms for select patient populations was needed and would not duplicate existing work. Based on this research, key clinical questions that the report would address were developed and made available for public comment. The Agency for Healthcare Research and Quality (AHRQ) then commissioned the Stanford-UCSF Evidence-Based Practice Center to prepare the CER with input from a Technical Expert Panel. This advisory panel was comprised of experts in different specialties, including anesthesiology, pediatric hematology/oncology, transplantation, pathology, hematology, pharmacology, trauma surgery, and drug risk management. The panel identified important issues, reviewed proposed methods, defined parameters for the review of evidence, and helped develop the draft report.
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The CER Development Process (1)

Presentation: Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care
Keywords: comparative effectiveness | recombinant factor VIIa | off-label | topic nomination | stakeholder | technical expert panel | research process
The CER Development Process The comparative effectiveness review (CER) topic, Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears, was nominated in a public process. The nominated topic was reviewed and selected based on need, importance, and feasibility. Sufficient research into the current literature by experts in the field and stakeholders determined that a CER on the operative and nonoperative treatments and postoperative rehabilitation of rotator cuff tears was needed and would not duplicate existing work. Based on this research, key clinical questions that the report would address were developed and made available for public comment. The Agency for Healthcare Research and Quality (AHRQ) then commissioned the University of Alberta Evidence-Based Practice Center to prepare the CER with input from a Technical Expert Panel. This advisory panel was comprised of experts in different specialties, including sports medicine, preventative medicine, physical therapy, internal medicine, and orthopedic surgery. The panel identified important issues, reviewed proposed methods, defined parameters for the review of evidence, and helped develop the draft report.
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The CER Development Process (1)

Presentation: Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
Keywords: comparative effectiveness | topic nomination | stakeholder | technical expert panel | research process
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Outline of Material

Presentation: Comparator Selection in Observational Comparative Effectiveness Research
Keywords: comparative effectiveness research | comparator selection | key considerations | minimization of bias | source population | time 0 | outline
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Conclusions

Presentation: Comparator Selection in Observational Comparative Effectiveness Research
Keywords: conclusion | comparator selection
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Heterogeneity of Treatment Effect

Presentation: Estimation and Reporting of Heterogeneity of Treatment Effects in Observational Comparative Effectiveness Research
Keywords: heterogeneity of treatment effect | CER | sub-populations
Strength of Evidence Grades (I). Reflect a global assessment that: Takes the required domains directly into account. Incorporates judgments about the additional domains as needed. Aim to: Provide “actionable” information for a variety of different users, readers, and stakeholders. Be transparent in how the strength-of-evidence grades are reached.
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Strength of Evidence Grades (I)

Presentation: Grading Strength of Evidence
Keywords: strength of evidence | transparency
Comparison With the GRADE System. The grading system used by the Evidence-based Practice Centers (EPCs) is similar to the GRADE system. The EPC grading system reflects the needs of AHRQ stakeholders for reviews on a wide variety of topics and not for recommendations or guidelines. The main differences between the two grading systems: The definitions of domains differ slightly; in the EPC system “directness” excludes “applicability,” which is handled separately. In the EPC system, observational studies are considered to have less risk of bias for outcomes such as harms, which can raise the initial grade to “moderate.” The definition of overall grade differs; the EPC system emphasizes confidence in estimate, whereas the GRADE system emphasizes effect of future research. The EPC system permits three different ways to reach an overall strength-of -evidence grade; the GRADE formula has one.
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Comparison With the GRADE System

Presentation: Grading Strength of Evidence
Keywords: Evidence-based Practice Center | GRADE system | systematic review | stakeholder | strength of evidence | organizational studies | applicability
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Evidence-Based Health Care

Presentation: Introduction to the User’s Guide for Developing a Protocol for Observational Comparative Effectiveness Research
Keywords: evidence-based health care | patient-centered outcomes research | informed treatment decisions
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Aims of the User’s Guide in Designing Observational Comparative Effectiveness Research Protocols

Presentation: Introduction to the User’s Guide for Developing a Protocol for Observational Comparative Effectiveness Research
Keywords: observational study protocol | standards and practices for comparative effectiveness research
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