EBM & Health Tech Assess (HTA)
Thought-provoking article suggesting that evidence-based medicine today has become evidence-burdened instead. (Source: Hegde, Mangalorean.com, Nov. 2009)
A Format for Submission of Clinical and Economic Evidence of Pharmaceuticals in Support of Formulary Consideration. FMCP Format Executive Committee. (Source: Journal of Managed Care Pharmacy, Jan. 2010)
Article examins the attempt to develop a robust and defensible means of measuring and describing the degree of patient access in mixed NICE decisions.(Source: Pharmacoeconomics, O'Neill et al)
Support for prospective registration of protocols for systematic reviews has been gathering momentum and this article review the PRISMA statement, a guideline for reporting systematic reviews and meta-analyses of studies that evaluate health-care interventions, advocates registration. (Source: Lancet, July 2010)
DB Wright comments on a recent editorial by Dr. Norbert Gleicher in The Wall Street Journal that roundly criticizes the proposed role of expert panels.(Source: D. Brad Wright, Huffinton Post, Oct 2009)
Dr. John Ioannidis is known as a meta-researcher, and he's become one of the world's foremost experts on the credibility of medical research. He and his team have shown that much of what biomedical researchers conclude in published studies is misleading, exaggerated, and often flat-out wrong.(Source: World of DTC Marketing)
In the Age of Metrics, vocation after vocation is discovering numbers. Doctors are going quant with evidence-based medicine, which promises to improve care by quantifying different treatments’ probabilities of success. (NYT, Nov. 21. 2009)
Overview of Risk Evaluation and Mitigation Strategies (REMS) and Risk Management Plans (RMPs) in US and Europe.
This creates a decision framework for "best evidence" approaches in systematic reviews. This will be Phase I of a larger project (Phase II would involve a formal evaluation of the impact of variations in inclusion criteria on a review's conclusions).
Provides data on regional costs and spending for healthcare. Website provides access to all Atlas reports and publications, as well as interactive tools to allow visitors to view specific regions and perform their own comparisons and analyses.
Kent Bottles discusses David Eddy's history and recent speech in this posting. (Source: ICSI Health Care Blog, Nov. 30, 2009)
Emphasis on understanding the comparative effectiveness of health care interventions has increased attention on the applicability of research. As a result, systematic reviews aiming to inform clinical practice have expanded beyond randomized controlled trials, which have limited generalizability, to include nonrandomized studies
National Academic Mailing List Service, known as 'JISCMail', is a service designed specifically for the further and higher education and research communities and is one of a number of services provided by JISC Advance therefore making it the foremost strategic collaboration tool within the academic community.
Eventually, clinicians won't have a choice about using evidence-based medicine and decision support in the exam room.
DERP is a collaboration of public entities (the Center for Evidence-based Policy and the Oregon Evidence-based Practice Center) who have joined together to produce systematic, evidence-based reviews of the comparative effectiveness and safety of drugs in many widely used drug classes, and to apply the findings to inform public policy and related activities in local settings
Unique, concise and easy-to-use collection of clinical guidelines for primary care combined with the best available evidence. Continuously updated EBM Guidelines follows the latest developments in clinical medicine and brings evidence into practice. Searchable database
The goal was to evaluate the educational effectiveness of a clinically integrated e-learning course for teaching basic evidence-based medicine(EBM) among postgraduate medical trainees compared to a traditional lecture-based course of equivalent content.
Clinical guidelines are designed with the major aim of improving quality of health care. This is reflected in the utilization of evidence based practices and the employment of a series of models. The paper shall look at some of the intended impacts of clinical guidelines as a method of changing behavior and the actual impacts caused by them.
A list of topics for which work has begun on evidence reports from the Evidence-based Practice Centers (EPCs) from AHRQ.
When discussing pharma pricing analysis, we are very careful to examine all of the strategic options. In order to maximize market access and pharma reimbursement, it is critical understand all of the compounding pricing factors. In the past, we have scrupulously examined global prescription revenues across various therapeutic disease indications
Presentation at ISPOR Europe, Nov. 2011, by Mira Pavlovic, MD, Deputy Director, DEMESP, French National Authority for Health (HAS), Saint-Denis la Plaine, France
EBM can't possibly take all possible variables into account, so EBM will always be only a partial answer-even after a dozen or more studies (many of which just repeat themselves with minor corrections).
Evidence-based health benefit design is "an empirical approach...that focuses relentlessly on workforce health and productivity [and] offers an alternative to the traditional method of continually increased cost sharing," writes a team of health and productivity experts, led by Dr. William B. Bunn III of Northwestern University School of Medicine, Chicago.
Healthcare systems around the world are failing to use evidence obtained through research, according to Sharon E. Straus, MD, MSc, FRCPC, a geriatrician and director of knowledge translation at St. Michael's Hospital in Toronto. The result: reduced length and quality of life, she and her colleagues write in a recent paper.(Source: HealthLeaders Media)
The aim of this study was to explore the current status of EBM among different medical specialists in Iran. This cross-sectional study was conducted from August 2007 until March 2009 on a sample of 181 doctors in different medical specialties practising in Isfahan, Iran, not including faculty members.(Source:Mozafarpour S, et.al,January 30, 2011, Journal of Evaluation in Clinical Practice)
If you are interested in "Evidence-Based Medicine" PowerPoint themes, you can download to use this PowerPoint template for your own presentation template.
Includes definition, steps, research designs, and resources
Very nice compilation of relevant resources.
Does an EBM workshop improved internal medicine residents' EBM knowledge and skills and use of secondary evidence resources (Source: 7th Space Interactive).
Based on workshops. Great resource
This unpublished opinion from the Second Circuit is instructive in showing that evidence-based protocols, e.g., clinical studies, may exceed what is required to show medical necessity, even under an abuse of discretion standard of review. (Source: Roy Harmon III, Health Plan Law, Nov. 18, 2009)
Blog posting about November 2010 lecture questioning the value of EBM, by one of the formidable experts in the field. (Source: ICSI Health Care Blog)
Adding evidence-based medicine information to the sales call can increase the value of the sales reps' role and help drive physician prescribing behavior. Learn how to create a successful service model, make the rep essential in today's environment, and learn a new go-to-market strategy.
This is the third and last article in the series about the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to grading the quality of evidence and the strength of recommendations in clinical practice guidelines and its application in the field of allergy.(Source: Pubmed, Brozek, JL et. al.)
Full list of available quality of care reports, EBM guides, etc.
Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems.
This report examines the current role of HTA in Europe, from its impact on reimbursement and pricing to market access. The report focuses on the experiences of five European nations, reviewing the history of HTA and the key agencies in each.
By Marcial Velasco Garrido, Finn Børlum Kristensen, Camilla
The following papers from the Value in Health Special Issue, Health Technology Assessment in Evidence-Based Health Care Reimbursement Decisions Around the World: Lessons Learned [Volume 12 Issue s2, Pages S1 - S53 (June 2009)] were developed to inform the ongoing debate on the nature and role of HTA. Leading academicians and practitioners from around the world offer their perspectives on HTA in their country and identify lessons learned.
In May, Isabelle Boutron, highlighted in JAMA the reporting and interpretation of randomized controlled trials with statistically nonsignificant results for primary outcomes. (Source: Blog:Carl Heneghan, Trust The Evidence)
Health systems around the world are under increasing strain because of the rising prevalence of chronic conditions, including diabetes, heart disease, and asthma. For more than 15 years, disease-management programs (DMPs) have been promoted as a solution to this problem. By carefully coordinating the delivery of high-quality care to patients with chronic conditions, the programs are supposed to enhance the patients’ health, reduce hospitalization rates, and lower treatment costs.
Sign up at Media Search to read this paper by Trisha Greenhalgh. How to Read a Paper is one of the bestselling texts on evidence-based medicine, used by health care professionals and medical students worldwide. (Source: chanozh-overblog)
HTA in Germany: Evidence Requirements, The Role of Benefit/Cost Assessment, First Experiences and Challenges with the German Health Bill AMNOG. Presentation at ISPOR Europe, Nov. 2011 by Jens Grueger, PhD, Vice President & Head, Global Market Access Primary Care, Pfizer Ltd., Tadworth, Surrey, UK
Presentation at ISPOR Europe, Nov. 2011 by Anne Kilburg, MSc, Senior Director, Market Access and Outcomes Strategy - Europe, RTI Health Solutions, Manchester, UK
Presentation at ISPOR Europe, Nov. 2011, by Dr. Antonio Sarría-Santamera, MD, PhD, Director, Department of Social Medicine, Agency for Health Technology Assessment, Madrid, Spain
The purpose of this OHE monograph is to inform and stimulate debate about the way different sorts of evidence and considerations are taken into account in decisions about new health care technologies.
Through a unique collaboration with patients, clinicians, manufacturers, insurers and other healthcare stakeholders, the Institute for Clinical and Economic Review (ICER) develops tools to support patient decisions and medical policy that share the goal of achieving maximum value for every healthcare dollar.
This publication presents overviews of the health care systems of 13 countries—Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. A summary table presents information on population, health care spending, number of physicians, hospital spending and utilization, use of health information technology, and number of potentially avoidable deaths.
The primary purposes of the ISPOR Health Outcomes Research Index of Open Source Code are to promote estimator transparency and to clarify alternative approaches in health econometric research. Estimator transparency refers to open source code, where all relevant code is accessible, interpretable, operational, and modifiable for alternative use. This Index of Open Source Code is composed of brief descriptions and hyperlinks to open-source code that can be downloaded for free [at the time of publication in this index]. Proprietary code and code for in silico experiments (e.g., simulations) are excluded from the index. The Index of Open Source Code is arranged according to Topic [Treatment Effects, Health Costs, Health Care Utilization, Quality of Life and Utility, Censoring and Survival, Other], Sub-Topics as given below and Base Software.
An AMCP-sponsored review of the published scientific literature concludes there is strong evidence to demonstrate the effectiveness of managed care pharmacy tools in achieving intended outcomes, such as increased utilization of preferred drugs, formulary compliance and decreased prescription drug spending. The study also concludes that additional research is required to provide a comprehensive understanding of the value of managed care pharmacy tools.
Help Physicians with care pathways, with major focus on the role of pathology and laboratory results in diagnosis. (Source: Dark Daily, Nov. 16, 2009)
One-stop portal for return-to-work and treatment guidelines.
While evidence-based medicine (EBM) has advanced medical practice, the health care system has been inconsistent in translating EBM into improvements in health. Disparities in health and health care play out through patients' limited ability to incorporate the advances of EBM into their daily lives.(Source:Pub Med.gov)
The National Centre for Pharmacoeconomics conducts the health technology assessment (HTA) of pharmaceutical products for the Health Service Executive (HSE) in Ireland in collaboration with the HSE Corporate Pharmaceutical Unit (HSE-CPU). The aim of the centre is to promote expertise in Ireland for the advancement of the discipline of pharmacoeconomics through practice, research and education.
Article on the early formation of NICE
The 'Equity and Excellence: Liberating the NHS' White Paper unveiled by the Health Secretary Andrew Lansley has, as would be expected, generated a wide variety of responses on both sides of the argument, ranging from "a serious attempt at major and lasting reform" to an "expensive Trojan Horse in political dogma". (Source:www.Public Service.co.uk, July 13, 2010)
Suggest evidence-based quality measures and measure sets for possible inclusion in the National Quality Measures Clearinghouse™ (NQMC)
Association between PCP's EBM knowledge and quality of care found that physicians with higher total EBM knowledge correlated modestly with better quality of care, but this explained only a small portion in the variance of clinical performance. Results indicate that there might be a need to focus on teaching all the components of EBM rather than EBM microskills. (Source: International Journal for Quality in Health Care, Jan 2010)
Presentation at ISPOR Europe, Nov. 2011
Presentation at ISPOR Europe, Nov. 2011
This article provides a summary of testimony that Donna Sweet, MD, MACP to the Subcommittee on Health of the House Energy and Commerce Committee. She addresses the recent breast cancer screening guidlines. (Source: ACP - American College of Physicians, Dec. 2009)
Presentation by Kenneth LaPensee, Ph.D., MPH, Senior Director, Competitive Strategy, The Medicines Company
AHRQ Slide sets for policymakers involved in healthcare quality.
Easy methods to weigh and understand the available evidence are indeed essential for readers and reviewers. The third updated and expanded edition of Systematic Reviews by the Centre for Reviews and Dissemination are now available.
This presentation contains: Policy context of NICE, NICE methods, Are devices different?, The role of randomised trials, When do we have sufficient evidence?, Impact of NICE guidance
The report addresses use of HTA in establishing health care policy in Asia.
There are now over 40 national agencies globally, each with its own standards and procedures for HTA evaluation, but evaluation methods vary and are continuously changing. In order to understand the landscape for HTAs across the world, United BioSource Corporation (UBC) conducted a review of HTA requirements in 10 markets. (Source: United BioSource Corporation Evidence Matters Newsletter, March 2010).
This paper shows how current malpractice laws encourage physicians to follow local standards versus national standard-of-care laws, and thus lead to divergent practices. (Source: Michael Frakes, SSRN, Oct 2009)
Medical decision making has gone through a fundamental change in the last 40 years. Simply put, the foundation for decision making has shifted away from subjective judgments and reliance on authorities toward a formal analysis of evidence. (Source: AMA Journal of Ethics, David M. Eddy, MD, PhD)
Earlier this year, NICE was given the power to oversee the review of clinical and health elements of The Quality and Outcomes Framework (QOF). They have recently proposed a list of potential new indicators for QOF, and are awaiting negotiations between NHS employers and the British Medical Association who have the final say. (Source: PharmaTimes)
Technology assessment in health care is a multidisciplinary field of policy analysis. It encompasses the medical, social, ethical, and economic implications of development, diffusion, and use of health technology.(Source:United BioSource Corp."Evidence Matters” Newsletter, Oct 2010,Ware, C. et. al.)
Overview of EBM, from a lay-person's perspective.
In this comprehensive podcast, Chrissie Fletcher, HEOR/Amgen, discussed how she sees health economists and statisticians interacting going forwards, why there is so much emphasis on reporting for reimbursement and whether she expects pharma companies will try and do this more in-house, in the future. She also offered her thoughts on health economists who don't have a statistical background, how she sees the HTA evolving and its place in the next 5-10 years. (Source: pharmiweb.com)
AHRQ Report, prepared August 2009, to help inform CMS if there is a causal relationship between the timing of initiating coverage for new technology and beneficiary participation in clinical trials to provide evidence of effectiveness.
Use of Comparative Effectiveness Research in Drug Coverage and Pricing Decisions: A Six-Country Comp
This issue brief comparatively examines the use of CER across six countries—Denmark, England, France, Germany, the Netherlands, and Sweden. With CER gaining traction in the United States, these international experiences offer insights and potential lessons.
The “essential” companion to the landmark Users’ Guides to the Medical Literature – completely revised and updated!
Policymakers often use the research these organizations generate to determine the content of publicly provided health benefits—for example, to decide whether a new drug should be covered under regional or national formularies. Other uses include negotiating pricing arrangements with drug companies or designing “value-based” cost-sharing arrangements, wherein patients pay more out-of-pocket for drugs deemed less effective than their alternative.
Value-Based Purchasing and Comparative Effectiveness Research:
Why the Pharmaceutical, Biotechnology, and Medical-Surgical Device Industries Should Embrace the Coming Market Evolution. (Source: MarCom Group International, Inc.)
Pricing, reimbursements, and coverage decisions for medical innovations and services are complex. In many countries, valuing medical technologies is the responsibility of national health-care systems that strive for distributive efficiency under fiscal constraints on medical spending (Source: Wiley On-Line Library).
Variations in health care in the NHS are a persistent and ubiquitous problem. But which variations are acceptable or warranted – for example, variations driven by clinical need and informed patient choice – and which are not? The important question is how to promote ‘good’ variation and minimise ‘bad’ variation. (Source: The King's Fund, Author: Appleby, et.al.)
The argument against evidence-based care says that no two patients are alike, so doctors must be flexible in their use of evidence and can't be bound by rigid protocols based on large studies. But Intermountain Healthcare, a network of hospitals and clinics in Utah and Idaho, has been pushing for more evidence-based care at its facilities for a while now, with some pretty interesting results. (Source: WSJ -- Health Blog, Nov. 5, 2009)
Is the low use of medications before the procedure the result of patient preference? Unfortunately, studies indicate that patients undergoing these procedures often do not understand the evidence.
