The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program Methods Guide for Comparative Effectiveness Reviews: keeping up-to-date in a rapidly evolving fieldA challenge for any research program is to ensure consistent use of the most current scientific methods, especially in a rapidly evolving field. Systematic review is a field that is moving into maturity from its adolescence. This issue of the Journal of Clinical Epidemiology includes 5 papers that nearly complete version 1.0 of the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program Methods Guide for Comparative Effectiveness Reviews (Methods Guide). The Methods Guide is a collaborative effort among participating scientists at the 14 Evidence-based Practice Centers (EPCs) and AHRQ to identify the best methods for conducting systematic reviews on comparative effectiveness of interventions.
AHRQ Series Commentary 2: Informative, timely, and valuable: an outsider view of the Comparative Effectiveness Review articlesThe development of the Methods Guidefor Comparative Effectiveness Reviews (CERs) by the Agency for Healthcare Research and Quality (AHRQ) and Effective Health Care (EHC) Program is an important and timely development . The articles published within the Journal of Clinical Epidemiology (JCE) represent a sample from the work completed so far and are informative in describing current strategic thinking within the program. They will also have relevance for many others who are responsible for conducting systematic reviews both within and beyond the United States.
AHRQ Series Commentary 3: The United States addresses comparative effectiveness but not cost-effectiveness through the Effective Health-Care ProgramIn this issue of the journal, authors from the Effective Health-Care Program of the Agency for Healthcare Research & Quality (AHRQ) outline their approach for appraising research evidence and providing “… understandable and actionable information for patients, clinicians, and policy makers” . The methods outlined are not controversial, and it is clear that the program of work is of a high standard. However, in matters of health technology appraisal, the devil is often in the detail or at least in the implementation, and it is interesting to observe controversy emerging when vested interests are challenged.
AHRQ Series Commentary 1: Rating the evidence in comparative effectiveness reviewsAuthorities acknowledge that systematic reviews provide the optimal basis for collecting and assessing the evidence that bears on patient management recommendations. In his article introducing JCE's series describing the Agency for Healthcare Research and Quality (AHRQ)'s effective health care program, Mark Helfand distinguishes between systematic reviews and “complex evidence reports” that address a broader range of questions, including “definition, diagnosis, management, and follow-up of a disease or condition.” Aside from definition, all these questions appear to us as an examination of alternative approaches to managing patients.
AHRQ Series Paper 1: Comparing medical interventions: AHRQ and the Effective Health-Care ProgramIn 2005, the Agency for Healthcare Research and Quality established the Effective Health Care (EHC) Program. The EHC Program aims to provide understandable and actionable information for patients, clinicians, and policy makers. The Evidence-based Practice Centers are one of the cornerstones of the EHC Program. Three key elements guide the EHC Program and thus, the conduct of Comparative Effectiveness Reviews by the EPC Program. Comparative Effectiveness Reviews introduce several specific challenges in addition to the familiar issues raised in a systematic review or meta-analysis of a single intervention.