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  • Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Methods Guide for Effectiveness and Comparative Effectiveness Reviews -- Overview and Chapters

Training Modules for the Methods Guide for Effectiveness and Comparative Effectiveness Reviews

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Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Overview – Nov. 18, 2013 (Update)

Methods Guide for Effectiveness and Comparative Effectiveness Reviews

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Table of Contents published 18 Nov 2008, updated 25 July 2013.

Effectiveness and Comparative Effectiveness Reviews, systematic reviews of existing research on the effectiveness, comparative effectiveness, and comparative harms of different health care interventions, are intended to provide relevant evidence to inform real-world health care decisions for patients, providers, and policymakers. In an effort to improve the transparency, consistency, and scientific rigor of the work of the Effective Health Care (EHC) Program, through a collaborative effort, the Agency for Healthcare Research and Quality (AHRQ), the Scientific Resource Center, and the Evidence-based Practice Centers (EPCs) have developed a Methods Guide for Comparative Effectiveness Reviews. We intend that these documents will serve as a resource for our EPCs as well as for other investigators interested in conducting Comparative Effectiveness Reviews.

As further empiric evidence develops and our understanding of better methods improves, we anticipate that there will be subsequent updates and additional chapters to this Methods Guide and that it will continue to be a living document. Please contact us with your comments and suggestions on the Methods Guide for Comparative Effectiveness Reviews and the Effective Health Care Program.

Due to greater interest in comparative effectiveness research and a desire to expand capacity to conduct Comparative Effectiveness Reviews, AHRQ has produced training modules to familiarize new investigators with the methodological framework and guidance outlined in AHRQ's Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews. The AHRQ Training Modules for the Systematic Reviews Methods Guide are a series of 13 slide talks in the EHC Program Slide Library that can be used by faculty engaged in educating investigators and clinicians interested in systematic review methods.

Systematic reviews on medical tests have unique challenges. To complement the EPC Methods Guide for Comparative Effectiveness Reviews, the EPC Program has developed a Methods Guide for Medical Test Reviews. This series of guidance papers applies the same principles for assessing treatments to the issues and challenges in assessing medical tests and highlights particular areas where the inherently different qualities of medical tests necessitate a different or variation of the approach to systematic review compared to a review on treatments.

Working Table of Contents

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Foreword: Comparing Medical Interventions: AHRQ and the Effective Health Care Program
AHRQ Manuscript: Published 18 Nov 2008. Select for HTML or PDF (329 kb).
Other publication(s): Slutsky J, Atkins D, Chang S, et al. AHRQ Series Paper 1: Comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2010; 63: 481-483.

Principles in Developing and Applying Guidance for Comparing Medical Interventions
AHRQ Manuscript: Published 08 Aug 2009. Select for HTML or PDF (113 kb).
Other publication(s): Helfand M, Balshem H. AHRQ Series Paper 2: Principles for developing guidance: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2010; 63: 484-490.

Identifying, Selecting and Refining Topics for Comparative Effectiveness Systematic Reviews
AHRQ Manuscript: Published 27 Apr 2009. Select for HTML or PDF (589 kb).
Other publication(s): Whitlock E, Lopez S, Chang S, et al. AHRQ Series Paper 3: Identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2010; 63: 491-501.

Developing and Selecting Topic Nominations for Systematic Reviews
AHRQ Manuscript: Published 19 Nov 2012. Select for HTML or PDF (743 kB).

The Refinement of Topics for Systematic Reviews: Lessons and Recommendations From the Effective Health Care Program
AHRQ Manuscript: Published 24 January 2013. Select for HTML or PDF (743 kB).
Other publication(s): Buckley DI, Ansari M, Butler M, et al. The Refinement of Topics for Systematic Reviews: Lessons and Recommendations From the Effective Health Care Program. J Clin Epidemiol. 2014; 67:425-432. 

Finding Evidence for Comparing Medical Interventions
AHRQ Manuscript: Published 06 Jan 2011. Select for HTML or PDF (357 kB).
Other publication(s): Relevo R, Balshem H. Finding evidence for comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011 Nov;64(11):1168-77. PMID: 21684115.

Finding Grey Literature Evidence and Assessing for Outcome and Analysis Reporting Biases When Comparing Medical Interventions: AHRQ and the Effective Health Care Program
AHRQ Manuscript: Published 18 Nov 2013. Select for HTML or PDF (364 kB).

Avoiding Bias in Selecting Studies
AHRQ Manuscript: Published 20 February 2013. Select for HTML or PDF (201 kB).

Selecting Observational Studies for Comparing Medical Interventions
AHRQ Manuscript: Published 14 June 2010. Select for HTML or PDF (297 kB).
Other publication(s): Norris S, Atkins D, Bruening W, et al. Observational Studies in Systematic Reviews of Comparative Effectiveness. J Clin Epidemiol 2010; 63.

Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions
AHRQ Manuscript: Published 08 March 2012. Select for HTML or PDF (325 kB).

Assessing the Applicability of Studies when Comparing Medical Interventions
AHRQ Manuscript: Published 05 Jan 2011. Select for HTML or PDF (340 kB).
Other publication(s): Atkins D, Chang SM, Gartlehner G, et al. Assessing applicability when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011 Nov;64(11):1198-207. PMID: 21463926.

Assessing Harms when Comparing Medical Interventions
AHRQ Manuscript: Published 18 Nov 2008. Select for HTML or PDF (524 kb).
Other publication(s): Chou R, Aronson N, Atkins D, et al. AHRQ Series Paper 4: Assessing harms when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2010; 63: 502-512.

Conducting Quantitative Synthesis When Comparing Medical Interventions
AHRQ Manuscript: Published 25 Oct 2010. Select for HTML or PDF (171 kb).
Other publication(s): Fu R, Gartlehner G, Grant M, et al. Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011 Nov;64(11):1187-97. PMID: 21477993.

Expanded Guidance on Selected Quantitative Synthesis Topics.
AHRQ Manuscript: Published 13 Mar 2013. Select for HTML or PDF (144 kB).

Handling Continuous Outcomes in Quantitative Synthesis.
AHRQ Manuscript: Published 25 July 2013. Select for HTML or PDF (377 kB).

Grading the Strength of a Body of Evidence When Assessing Health Care Interventions for the Effective Health Care Program of the Agency for Healthcare Research and Quality: An Update
AHRQ Manuscript: Published 18 Nov 2013. Select for HTML or PDF (334 kb).
AHRQ Original Manuscript: Published 05 Aug 2009. Select for HTML or PDF (193 kb).
Other publication(s): Owens D, Lohr K, Atkins D, et al. AHRQ Series Paper 5: Grading the strength of a body of evidence when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2010; 63: 513-523.

Using Existing Systematic Reviews to Replace de Novo Processes in CERs
AHRQ Manuscript: Published 05 Oct 2009. Select for HTML or PDF (77 kb).

Integrating Bodies of Evidence: Existing Systematic Reviews and Primary Studies
AHRQ Manuscript: Published in draft format 10 September 2014. In PDF only.

Updating Comparative Effectiveness Reviews: Current Efforts in AHRQ's Effective Health Care Program
AHRQ Manuscript: Published 05 Aug 2011. Select for HTML or PDF (213 kb).
Other publication(s): Tsertsvadze A, Maglione M, Chou R, et al. Updating comparative effectiveness reviews: current efforts in AHRQ's Effective Health Care Program. J Clin Epidemiol 2011 Nov;64(11):1208-15. PMID: 21684114.

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