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Perm J. 2013 Fall;17(4):4-13. doi: 10.7812/TPP/13-036.

Comparative effectiveness topics from a large, integrated delivery system.

Author information

1
Research Scientist for the Department of Research and Evaluation, Kaiser Permanente Southern California in Pasadena. kim.n.danforth@kp.org.
2
Research Associate for the Center for Health Research-Northwest, Kaiser Permanente Northwest in Portland, OR. carrie.d.patnode@kpchr.org.
3
Research Associate for the Center for Health Research-Northwest, Kaiser Permanente Northwest in Portland, and Lead Clinician at Virginia Garcia Memorial Health Center in Hillsboro, OR. tkapka@vgmhc.org.
4
Assistant Investigator for the Center for Health Research-Southeast, Kaiser Permanente Georgia in Atlanta. melissa.g.butler@kp.org.
5
Consulting Practice Leader for the Division of Research in Oakland, CA. bernie.collins@kp.org.
6
Associate Executive Director for The Permanente Federation in Oakland, CA. amy.l.compton-phillips@kp.org.
7
Senior Vice President of Community Benefit, Research and Health Policy for Kaiser Foundation Health Plan and Hospitals in Oakland, CA. raymond.j.baxter@kp.org.
8
Senior Vice President, Hospitals, Quality and Care Delivery Excellence for Kaiser Foundation Health Plan and Hospitals in Oakland, CA. jed.weissberg@kp.org.
9
Director for the Kaiser Permanente Center for Effectiveness and Safety Research in Pasadena, CA. elizabeth.a.mcglynn@kp.org.
10
Senior Investigator for the Center for Health Research-Northwest, Kaiser Permanente Northwest in Portland, OR. evelyn.whitlock@kpchr.org.

Abstract

OBJECTIVE:

To identify high-priority comparative effectiveness questions directly relevant to care delivery in a large, US integrated health care system.

METHODS:

In 2010, a total of 792 clinical and operational leaders in Kaiser Permanente were sent an electronic survey requesting nominations of comparative effectiveness research questions; most recipients (83%) had direct clinical roles. Nominated questions were divided into 18 surveys of related topics that included 9 to 23 questions for prioritization. The next year, 648 recipients were electronically sent 1 of the 18 surveys to prioritize nominated questions. Surveys were assigned to recipients on the basis of their nominations or specialty. High-priority questions were identified by comparing the frequency a question was selected to an "expected" frequency, calculated to account for the varying number of questions and respondents across prioritization surveys. High-priority questions were those selected more frequently than expected.

RESULTS:

More than 320 research questions were nominated from 181 individuals. Questions most frequently addressed cardiovascular and peripheral vascular disease; obesity, diabetes, endocrinology, and metabolic disorders; or service delivery and systems-level questions. Ninety-five high-priority research questions were identified, encompassing a wide range of health questions that ranged from prevention and screening to treatment and quality of life. Many were complex questions from a systems perspective regarding how to deliver the best care.

CONCLUSIONS:

The 95 questions identified and prioritized by leaders on the front lines of health care delivery may inform the national discussion regarding comparative effectiveness research. Additionally, our experience provides insight in engaging real-world stakeholders in setting a health care research agenda.

PMID:
24361013
PMCID:
PMC3854801
DOI:
10.7812/TPP/13-036
[Indexed for MEDLINE]
Free PMC Article

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