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- Slide Presentation Jun. 26, 2010
Methods Guide for Effectiveness and Comparative Effectiveness Reviews -- Overview and Chapters
- Comparing Medical Interventions: AHRQ and the Effective Health Care Program
- Principles in Developing and Applying Guidance for Comparing Medical Interventions
- Identifying, Selecting and Refining Topics for Comparative Effectiveness Systematic Reviews
- Developing and Selecting Topic Nominations for Systematic Reviews
- Finding Evidence for Comparing Medical Interventions
- Finding Grey Literature Evidence and Assessing for Outcome and Analysis Reporting Biases When Comparing Medical Interventions: AHRQ and the Effective Health Care Program
- Avoiding Bias in Selecting Studies
- Selecting Observational Studies for Comparing Medical Interventions
- Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions
- Assessing the Applicability of Studies When Comparing Medical Interventions
- Assessing Harms when Comparing Medical Interventions
- Conducting Quantitative Synthesis When Comparing Medical Interventions: AHRQ and the Effective Health Care Program
- Expanded Guidance on Selected Quantitative Synthesis Topics
- Handling Continuous Outcomes in Quantitative Synthesis
- 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
- Integrating Bodies of Evidence: Existing Systematic Reviews and Primary Studies
- Guidance for the Conduct and Reporting of Modeling and Simulation Studies in the Context of Health Technology Assessment
- Using Existing Systematic Reviews to Replace de Novo Processes in CERs
- Updating Comparative Effectiveness Reviews: Current Efforts in AHRQ's Effective Health Care Program
Training Modules for the Methods Guide for Effectiveness and Comparative Effectiveness Reviews
Methods Guide – Chapter – Jan. 24, 2013
The Refinement of Topics for Systematic Reviews: Lessons and Recommendations From the Effective Health Care Program
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This report has also been published in edited form: 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.
The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program conducts systematic reviews on a range of health care topics. Topics are nominated by a variety of stakeholders. Nominated topics undergo a refinement process to ensure that the Key Questions are relevant, of appropriate scope, and will ultimately yield a useful systematic review. Topic refinement investigators gather input from Key Informants, topical experts, and a literature scan to inform changes in the PICOTS (population, intervention, comparator, outcomes, timing, and setting), analytic framework and Key Questions. Evidence-based Practice Centers (EPCs) have approached the topic refinement process in similar and different ways. AHRQ convened a work group to assess current approaches and to develop recommendations for best practices; we report our findings here.
Design and Stting
We formed a workgroup of four investigators from four different EPCs in the United States and Canada and one AHRQ Project Officer. All participants held experience in topic refinement. We generated a prioritized list of methodological questions and possible guiding principles considered in the topic refinement process. We discussed each issue until we reached agreement.
A refined topic should address an important health care question or dilemma; consider the priorities and values of relevant stakeholders; reflect the state of the science; and be consistent with systematic review research methods. The guiding principles of topic refinement are: fidelity to the original nomination, public health and/or clinical relevance, research feasibility, responsiveness to stakeholder input, reducing investigator bias, transparency, and suitable scope. We describe the mechanics of the topic refinement process, and discuss approaches and variability in methods used by EPCs to engage Key Informants, integrate and synthesize input, and report findings. Practical suggestions and challenges in preparing and recruiting Key Informants, facilitating engagement, synthesis, and reporting are described and discussed. Decisions about integrating input from various sources require investigator judgment in the application and balance of the guiding principles. The relative importance and application of these principles will vary by topic and purpose of the systematic review. Variability in topics precludes a prescriptive approach to application of the guiding principles. Transparency and consistent documentation of decisions are important for public accountability and integrity of the topic refinement process.
Systematic reviews that are accurate, methodologically rigorous, and as relevant and useful as possible for stakeholders require that topics be well refined. This report details guiding principles and methodological recommendations that may help investigators to better refine topics for systematic reviews, both within and outside of the EHC Program.