AHRQ Series Paper 2

Principles for developing guidance: AHRQ and the Effective Health-Care Program

Mark Helfand, Howard Balshem

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: This article describes some of the fundamental principles that have been developed to guide the work of producing comparative effectiveness reviews (CERs). Study Design and Setting: We briefly describe the role stakeholders play in providing important insights that inform the evidence-gathering process, and discuss the critical role of analytic frameworks in illuminating the relationship between surrogate measures and health outcomes, providing an understanding of the context in which clinical decisions are made and the uncertainties that underlie clinical controversies. Results: We describe the Effective Health Care program conceptual model for considering different types of evidence that emphasizes minimizing the risk of bias, but places high-quality, highly applicable evidence about effectiveness at the top of the hierarchy. Finally, we briefly describe areas of future methodological research. Conclusion: CERs have become a foundation for decision-making in clinical practice and health policy. To be useful, CERs must approach the evidence from a patient-centered perspective; explore the clinical logic underlying the rationale for a service; cast a broad net with respect to types of evidence, placing a high value on effectiveness and applicability, in addition to internal validity; and, present benefits and harms for treatments and tests in a consistent way.

Original languageEnglish (US)
Pages (from-to)484-490
Number of pages7
JournalJournal of Clinical Epidemiology
Volume63
Issue number5
DOIs
StatePublished - May 2010

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Health Policy
Uncertainty
Outcome Assessment (Health Care)
Delivery of Health Care
Health
Research
Therapeutics
Clinical Decision-Making

Keywords

  • Avoiding bias
  • Comparative effectiveness reviews
  • Evidence-based medicine
  • Hierarchy of evidence
  • Patient-centered care
  • Stakeholders

ASJC Scopus subject areas

  • Epidemiology

Cite this

AHRQ Series Paper 2 : Principles for developing guidance: AHRQ and the Effective Health-Care Program. / Helfand, Mark; Balshem, Howard.

In: Journal of Clinical Epidemiology, Vol. 63, No. 5, 05.2010, p. 484-490.

Research output: Contribution to journalArticle

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