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Comparative Effectiveness Reviews are systematic reviews of existing research on the effectiveness, comparative effectiveness, and harms of different health care interventions. They provide syntheses of relevant evidence to inform real-world health care decisions for patients, providers, and policymakers. Strong methodologic approaches to systematic review improve the transparency, consistency, and scientific rigor of these reports. Through a collaborative effort of the Effective Health Care (EHC) Program, the Agency for Healthcare Research and Quality (AHRQ), the EHC Program Scientific Resource Center, and the AHRQ Evidence-based Practice Centers have developed a Methods Guide for Comparative Effectiveness Reviews. This Guide presents issues key to the development of Comparative Effectiveness Reviews and describes recommended approaches for addressing difficult, frequently encountered methodological issues.
The Methods Guide for Comparative Effectiveness Reviews is a living document, and will be updated as further empiric evidence develops and our understanding of better methods improves. Comments and suggestions on the Methods Guide for Comparative Effectiveness Reviews and the Effective Health Care Program can be made at www.effectivehealthcare.ahrq.gov.
Contents
- Comparing Medical Interventions: AHRQ and the Effective Health Care ProgramJean Slutsky, PA, MSPH, David Atkins, MD, MPH, Stephanie Chang, MD, MPH, and Beth A Collins Sharp, PhD.Published: November 18, 2008.
- Principles in Developing and Applying GuidanceMark Helfand, MD and Howard Balshem, MS.Published: August 8, 2009.
- Identifying, Selecting, and Refining TopicsEvelyn P Whitlock, MD, MPH, Sarah A Lopez, BA, Stephanie Chang, MD, MPH, Mark Helfand, MD, MS, MPH, Michelle Eder, PhD, and Nicole Floyd, MPH.Published: April 27, 2009.
- Finding Evidence for Comparing Medical InterventionsRose Relevo, MLIS, MS, AHIP and Howard Balshem, MS.Published: January 5, 2011.
- Key Points
- Introduction
- Regulatory and Clinical Trials Searching
- Scientific Information Packets: Requests to Industry
- Developing the Published Literature Search
- Strategies for Finding Observational Studies
- Specialized Database Searching
- Using Key Articles
- Hand Searching Journals
- Corresponding With Researchers
- Updating and Reporting the Search Strategy
- Concluding Remarks
- References
- Appendix A Techniques for Observational Studies and/or Harms
- Appendix B Specialized Databases
- Appendix C CONSORT-Style Flow Diagram of Literature Search, Annotated
- Selecting Observational Studies for Comparing Medical InterventionsSusan Norris, MD, MPH, David Atkins, MD, MPH, Wendy Bruening, PhD, Steven Fox, MD, SM, MPH, Eric Johnson, PhD, Robert Kane, MD, Sally C Morton, PhD, Mark Oremus, PhD, Maria Ospina, MSc, Gurvaneet Randhawa, MD, MPH, Karen Schoelles, MD, SM, Paul Shekelle, MD, PhD, MPH, and Meera Viswanathan, PhD.Published: June 14, 2010.
- Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care InterventionsMeera Viswanathan, PhD, Mohammed T Ansari, MBBS, MMedSc, MPhil, Nancy D Berkman, PhD, Stephanie Chang, MD, MPH, Lisa Hartling, PhD, Melissa McPheeters, MPH, PhD, P Lina Santaguida, PT, PhD, Tatyana Shamliyan, MD, MS, Kavita Singh, MPH, Alexander Tsertsvadze, MD, MSc, and Jonathan R Treadwell, PhD.Published: March 8, 2012.
- Key Points
- Introduction
- Terminology and Constructs
- Stages in Assessing the Risk of Bias of Studies
- Design-Specific Criteria To Assess Risk of Bias
- Tools for Assessing Risk of Bias
- Assessing the Risk of Bias for Harms
- Summarizing the Risk of Bias of a Study
- Conclusion
- References
- Appendix A Tools To Assess Risk of Bias of Individual Outcomes
- Assessing the Applicability of Studies When Comparing Medical InterventionsDavid Atkins, MD, MPH, Stephanie Chang, MD, MPH, Gerald Gartlehner, MD, MPH, David I Buckley, MD, MPH, Evelyn P Whitlock, MD, MPH, Elise Berliner, PhD, and David Matchar, MD, FACP.Published: December 30, 2010.
- Assessing Harms When Comparing Medical InterventionsRoger Chou, MD, Naomi Aronson, PhD, David Atkins, MD, MPH, Afisi S Ismaila, Pasqualina Santaguida, PhD, David H Smith, PhD, Evelyn Whitlock, MD, MPH, Timothy J Wilt, MD, MPH, and David Moher, PhD.Published: November 18, 2008.
- Conducting Quantitative Synthesis When Comparing Medical Interventions: AHRQ and the Effective Health Care ProgramRongwei Fu, Gerald Gartlehner, Mark Grant, Tatyana Shamliyan, Art Sedrakyan, Timothy J Wilt, Lauren Griffith, Mark Oremus, Parminder Raina, Afisi Ismaila, Pasqualina Santaguida, Joseph Lau, and Thomas A Trikalinos.Published: October 25, 2010.
- Grading the Strength of a Body of Evidence When Comparing Medical InterventionsDouglas K Owens, MD, MS, Kathleen N Lohr, PhD, David Atkins, MD, MPH, Jonathan R Treadwell, PhD, James T Reston, PhD, MPH, Eric B Bass, MD, MPH, Stephanie Chang, MD, MPH, and Mark Helfand, MD.Published: August 5, 2009.
- Using Existing Systematic Reviews To Replace De Novo Processes in Conducting Comparative Effectiveness ReviewsC Michael White, PharmD, FCP, FCCP, Stanley Ip, MD, Melissa McPheeters, PhD, MPH, Tim S Carey, MD, MPH, Roger Chou, MD, Kathleen N Lohr, PhD, Karen Robinson, PhD, Kathryn McDonald, MM, and Evelyn Whitlock, MD, MPH.Published: October 5, 2009.
- Updating Comparative Effectiveness ReviewsAlexander Tsertsvadze, MD, MSc, Margaret Maglione, MPP, Roger Chou, MD, Chantelle Garritty, MSc, Craig Coleman, PharmD, Linda Lux, MPA, Eric Bass, MD, MPH, Howard Balshem, MS, and David Moher, PhD.Published: July 27, 2011.
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Comparative effectiveness research: Challenges for medical journals.
[Cochrane Database Syst Rev. 2010]
Comparative effectiveness research: Challenges for medical journals.Sox HC, Helfand M, Grimshaw J, Dickersin K, Tovey D, Knottnerus JA, Tugwell P. Cochrane Database Syst Rev. 2010 Apr 27; 8:ED000003. Epub 2010 Apr 27.
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Assessment of the Need to Update Comparative Effectiveness Reviews: Report of an Initial Rapid Program Assessment (2005–2009)
[ 2009]
Assessment of the Need to Update Comparative Effectiveness Reviews: Report of an Initial Rapid Program Assessment (2005–2009)Shekelle P, Newberry S, Maglione M, Shanman R, Johnsen B, Carter J, Motala A, Hulley B, Wang Z, Bravata D, et al. 2009 Sep 10
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Comparing Medical Interventions: AHRQ and the Effective Health Care Program
[Methods Guide for Effectiveness and Compara...]
Comparing Medical Interventions: AHRQ and the Effective Health Care ProgramSlutsky J, Atkins D, Chang S, Collins Sharp BA. Methods Guide for Effectiveness and Comparative Effectiveness Reviews. 2008
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Review AHRQ series paper 4: assessing harms when comparing medical interventions: AHRQ and the effective health-care program.
[J Clin Epidemiol. 2010]
Review AHRQ series paper 4: assessing harms when comparing medical interventions: AHRQ and the effective health-care program.Chou R, Aronson N, Atkins D, Ismaila AS, Santaguida P, Smith DH, Whitlock E, Wilt TJ, Moher D. J Clin Epidemiol. 2010 May; 63(5):502-12. Epub 2008 Sep 26.
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Review Better information for better health care: the Evidence-based Practice Center program and the Agency for Healthcare Research and Quality.
[Ann Intern Med. 2005]
Review Better information for better health care: the Evidence-based Practice Center program and the Agency for Healthcare Research and Quality.Atkins D, Fink K, Slutsky J, Agency for Healthcare Research and Quality, North American Evidence-based Practice Centers. Ann Intern Med. 2005 Jun 21; 142(12 Pt 2):1035-41.
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