JOHNS HOPKINS UNIVERSITY, THE

The goal of this funding initiative on ?Comprehensive Comparative Effectiveness Reviews for Effective Health Care? was to improve understanding of the comparative effectiveness and safety of medications, procedures, tests, and management strategies for patients with diabetes mellitus, obesity, or gastrointestinal disease. To address this goal, the Johns Hopkins University Evidence-based Practice Center (EPC) performed work in 3 areas: 1) develop and refine questions for comparative effectiveness reviews that address decision making needs of stakeholders; 2) conduct comparative effectiveness reviews with systematic and transparent methods; and 3) identify and characterize future research needs to inform health care decisions. In the first area of work, the EPC prepared ?Topic Identification? and ?Topic Development? reports on specific clinical topics. The purpose of Topic Identification was to identify potential topics that could be addressed by the EPC. In Topic Development, questions were defined in specific terms that address stakeholder needs. The EPC engaged representatives of relevant clinical disciplines in the process of defining questions for the evidence reviews. The EPC also sought input from representatives of patients and other consumers of health care, as well as other stakeholders, such as governmental agencies, health plans, and manufacturers. In the second area of work, the EPC prepared comprehensive ?Evidence Reports? on topics in the management of diabetes mellitus, obesity, or gastrointestinal disease. Each Evidence Report included a presentation of the key questions, a description of systematic methods used to conduct the review, a synthesis of available evidence, and a discussion of the implications of the findings. In the third area of work, the EPC prepared reports on ?Future Research Needs.? Each report included a description of research gaps identified in the corresponding evidence report, with an indication of the priority assigned to each future research question. The EPC used a structured format to specify populations, interventions, comparisons, outcomes, timing, and settings of interest. Through this work, the EPC sought to advance the methods for defining future research needs. The Lead Investigator for each project was an expert in the clinical area, and had expertise in study methods. The EPC recruited faculty who were qualified to serve as co-investigators in the topic areas. The co-investigators contributed to tasks such as the design of data abstraction instruments, participation in the review of studies, and preparation of the report. Advisors met periodically with each project team to give advice on key aspects of the work, such as refinement of key questions, selection of study eligibility criteria, development of methods for addressing important issues, and prioritization of future research needs.

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