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Methods Symposium Papers Published

Papers originally presented at the June 2009 invitational symposium on research methods for clinical and comparative Cover of the journal, "Medical Care."effectiveness studies have now been published in the June 2010 supplemental issue of the journal Medical Care. The collection is available free online or through PubMed.

The symposium brought together an international group of scientists to continue the ongoing discussion and subsequent development of research methods for comparative effectiveness research, a timely endeavor in light of the additional funding provided by the American Recovery and Reinvestment Act (ARRA) of 2009. Symposium speakers and authors addressed two main themes: (1) including more data from clinically heterogeneous populations into comparative effectiveness research projects, and (2) employing longitudinal investigative methods intended to capture patient-reported outcomes over a longer term.

“As this field is relatively new, continuing to pave the road of improved methods through publications of peer-reviewed literature that are reachable around the globe is critically important.”

Kathleen N. Lohr, Ph.D.
RTI International

More than 75 abstracts were reviewed by a planning committee of experts from academia, the private sector, and the Federal Government. Authors of chosen abstracts were also invited to submit a manuscript for publication in the Medical Care supplement. Submitted manuscripts went through a blind editorial review, and the final collection of accepted articles was published in record time. “We were able to get the papers published in a short time by academic journal standards,” said Kathleen N. Lohr, Ph.D., of RTI International, who led the staff of the RTI DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Center in organizing the event and supplemental publication. “As this field is relatively new, continuing to pave the road of improved methods through publications of peer-reviewed literature that are reachable around the globe is critically important.”

The collection includes an editorial from AHRQ Program Director Scott R. Smith, Ph.D., that provides an overview of the crucial role of AHRQ and its Effective Health Care Program in advancing methods for comparative effectiveness research, an overview of the original symposium by Dr. Lohr; and an introduction by Harold C. Sox, M.D., who served as the chair of the Committee on Comparative Effectiveness Research Priorities convened by the Institute of Medicine and is a past president of the American College of Physicians.

In his introduction, Dr. Sox focused on the importance of having a clear definition of comparative effectiveness research to guide the methods process. In his article based on the Symposium’s keynote address, he states: “Defining CER [comparative effectiveness research] forces decisionmakers—health professionals and patients—to identify the information that they need. The definitions of CER all focus on making head-to-head comparisons in study populations that are typical of clinical practice. That health professionals seem to agree on these attributes of the inputs to decisionmaking is reason to celebrate.”

An additional 20 articles round out the collection and fall under one of four major content areas: (1) study design, (2) data collection, (3) statistics and analytic methods, and (4) policy issues and applications. Several of the articles address specific methodological approaches such as prediction modeling and Bayesian meta-analysis; others focus on particular patient populations such as the elderly or cancer patients.

The 2009 event marks the second time that an AHRQ-supported effort to advance methods was developed by members of the DEcIDE Network, whose primary duty is to generate new comparative evidence for the Effective Health Care Program. Papers from the 2006 AHRQ Conference on Emerging Methods in Comparative Effectiveness and Safety, which was also published as a supplement in Medical Care, focused primarily on methods for generating data on the benefits and safety of pharmaceutical interventions.

Dr. Lohr believes that both publications represent an ongoing conversation that will continue for many years. “Nothing in these articles puts an end to the issues, but certainly they add materially to the literature and to the knowledge base. I give great credit to AHRQ for recognizing and supporting the importance of developing methods for DEcIDE researchers and others, and I hope we’ll see more symposiums and publications in the future,” she said.

A printed copy of the supplement, AHRQ Publication No. OM10-0067, is available free of charge through the AHRQ Publications Clearinghouse. To order the supplement, call 800-358-9295 or send an e-mail to