AHRQ Series
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 field
A 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.Finding evidence for comparing medical interventions: AHRQ and the Effective Health Care Program
This article discusses search methodology to identify evidence for comparative effectiveness reviews (CERs) as practiced by the Effective Health Care program.Updating comparative effectiveness reviews: Current efforts in AHRQ's Effective Health Care Program
To review the current knowledge and efforts on updating systematic reviews (SRs) as applied to comparative effectiveness reviews (CERs).Observational studies in systemic reviews of comparative effectiveness: AHRQ and the Effective Health Care Program
Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs).Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program
This article is to establish recommendations for conducting quantitative synthesis, or meta-analysis, using study-level data in comparative effectiveness reviews (CERs) for the Evidence-based Practice Center (EPC) program of the Agency for Healthcare Research and Quality.Assessing applicability when comparing medical interventions: AHRQ and the Effective Health Care Program
To describe a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review according to the Population, Intervention, Comparator, Outcome, Setting domains.AHRQ Series Editorial: Public involvement improves methods development in comparative effectiveness reviews
Since 2004, the 14 Evidence-based Practice Centers (EPCs) in the United States and Canada have prepared comparative effectiveness reviews (CERs) for the Agency for Healthcare Research and Quality's (AHRQ) Effective Health Care program [1]. From its inception, the Effective Health Care program has invited the public to comment on draft CERs. The articles in this issue of the Journal of Clinical Epidemiology address some of the most frequently mentioned methodological inconsistencies encountered in the first year and a half of public and peer comment on these reviews.AHRQ Series Commentary 2: Informative, timely, and valuable: an outsider view of the Comparative Effectiveness Review articles
The 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 [1]. 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 Program
In 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” [1]. 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 reviews
Authorities 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 2: Principles for developing guidance: AHRQ and the Effective Health-Care Program
This article describes some of the fundamental principles that have been developed to guide the work of producing comparative effectiveness reviews (CERs).AHRQ Series Paper 5: Grading the strength of a body of evidence when comparing medical interventions—Agency for Healthcare Research and Quality and the Effective Health-Care Program
To establish guidance on grading strength of evidence for the Evidence-based Practice Center (EPC) program of the U.S. Agency for Healthcare Research and Quality.AHRQ Series Paper 3: Identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the Effective Health-Care program
This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality's Effective Health Care (EHC) program.AHRQ Series Paper 1: Comparing medical interventions: AHRQ and the Effective Health-Care Program
In 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.AHRQ Series Paper 4: Assessing harms when comparing medical interventions: AHRQ and the Effective Health-Care Program
Comparative effectiveness reviews (CERs) are systematic reviews that evaluate evidence on alternative interventions to help clinicians, policy makers, and patients make informed treatment choices. Reviews should assess harms and benefits to provide balanced assessments of alternative interventions. Identifying important harms of treatment and quantifying the magnitude of any risks require CER authors to consider a broad range of data sources, including randomized controlled trials (RCTs) and observational studies.
