Assessing applicability when comparing medical interventions

AHRQ and the Effective Health Care Program

David Atkins, Stephanie M. Chang, Gerald Gartlehner, David Buckley, Evelyn P. Whitlock, Elise Berliner, David Matchar

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To describe a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review according to the Population, Intervention, Comparator, Outcome, Setting domains. Study Design and Setting: Comparative effectiveness reviews need to consider whether available evidence is applicable to specific clinical or policy questions to be useful to decision makers. Authors reviewed the literature and developed guidance for the Effective Health Care program. Results: Because applicability depends on the specific questions and needs of the users, it is difficult to devise a valid uniform scale for rating the overall applicability of individual studies or body of evidence. We recommend consulting stakeholders to identify the factors most relevant to applicability for their decisions. Applicability should be considered separately for benefits and harms. Observational studies can help determine whether trial populations and interventions are representative of "real world" practice. Reviewers should describe differences between available evidence and the ideally applicable evidence for the question being asked and offer a qualitative judgment about the importance and potential effect of those differences. Conclusion: Careful consideration of applicability may improve the usefulness of systematic reviews in informing practice and policy.

Original languageEnglish (US)
Pages (from-to)1198-1207
Number of pages10
JournalJournal of Clinical Epidemiology
Volume64
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

Delivery of Health Care
Population
Observational Studies

Keywords

  • Applicability
  • Comparative effectiveness
  • External validity
  • Generalizability
  • Heterogeneity of treatment effect
  • Systematic review

ASJC Scopus subject areas

  • Epidemiology

Cite this

Assessing applicability when comparing medical interventions : AHRQ and the Effective Health Care Program. / Atkins, David; Chang, Stephanie M.; Gartlehner, Gerald; Buckley, David; Whitlock, Evelyn P.; Berliner, Elise; Matchar, David.

In: Journal of Clinical Epidemiology, Vol. 64, No. 11, 11.2011, p. 1198-1207.

Research output: Contribution to journalArticle

Atkins, David ; Chang, Stephanie M. ; Gartlehner, Gerald ; Buckley, David ; Whitlock, Evelyn P. ; Berliner, Elise ; Matchar, David. / Assessing applicability when comparing medical interventions : AHRQ and the Effective Health Care Program. In: Journal of Clinical Epidemiology. 2011 ; Vol. 64, No. 11. pp. 1198-1207.
@article{1f9d0ca291f8432fad2f1c8be91c39de,
title = "Assessing applicability when comparing medical interventions: AHRQ and the Effective Health Care Program",
abstract = "Objective: To describe a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review according to the Population, Intervention, Comparator, Outcome, Setting domains. Study Design and Setting: Comparative effectiveness reviews need to consider whether available evidence is applicable to specific clinical or policy questions to be useful to decision makers. Authors reviewed the literature and developed guidance for the Effective Health Care program. Results: Because applicability depends on the specific questions and needs of the users, it is difficult to devise a valid uniform scale for rating the overall applicability of individual studies or body of evidence. We recommend consulting stakeholders to identify the factors most relevant to applicability for their decisions. Applicability should be considered separately for benefits and harms. Observational studies can help determine whether trial populations and interventions are representative of {"}real world{"} practice. Reviewers should describe differences between available evidence and the ideally applicable evidence for the question being asked and offer a qualitative judgment about the importance and potential effect of those differences. Conclusion: Careful consideration of applicability may improve the usefulness of systematic reviews in informing practice and policy.",
keywords = "Applicability, Comparative effectiveness, External validity, Generalizability, Heterogeneity of treatment effect, Systematic review",
author = "David Atkins and Chang, {Stephanie M.} and Gerald Gartlehner and David Buckley and Whitlock, {Evelyn P.} and Elise Berliner and David Matchar",
year = "2011",
month = "11",
doi = "10.1016/j.jclinepi.2010.11.021",
language = "English (US)",
volume = "64",
pages = "1198--1207",
journal = "Journal of Clinical Epidemiology",
issn = "0895-4356",
publisher = "Elsevier USA",
number = "11",

}

TY - JOUR

T1 - Assessing applicability when comparing medical interventions

T2 - AHRQ and the Effective Health Care Program

AU - Atkins, David

AU - Chang, Stephanie M.

AU - Gartlehner, Gerald

AU - Buckley, David

AU - Whitlock, Evelyn P.

AU - Berliner, Elise

AU - Matchar, David

PY - 2011/11

Y1 - 2011/11

N2 - Objective: To describe a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review according to the Population, Intervention, Comparator, Outcome, Setting domains. Study Design and Setting: Comparative effectiveness reviews need to consider whether available evidence is applicable to specific clinical or policy questions to be useful to decision makers. Authors reviewed the literature and developed guidance for the Effective Health Care program. Results: Because applicability depends on the specific questions and needs of the users, it is difficult to devise a valid uniform scale for rating the overall applicability of individual studies or body of evidence. We recommend consulting stakeholders to identify the factors most relevant to applicability for their decisions. Applicability should be considered separately for benefits and harms. Observational studies can help determine whether trial populations and interventions are representative of "real world" practice. Reviewers should describe differences between available evidence and the ideally applicable evidence for the question being asked and offer a qualitative judgment about the importance and potential effect of those differences. Conclusion: Careful consideration of applicability may improve the usefulness of systematic reviews in informing practice and policy.

AB - Objective: To describe a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review according to the Population, Intervention, Comparator, Outcome, Setting domains. Study Design and Setting: Comparative effectiveness reviews need to consider whether available evidence is applicable to specific clinical or policy questions to be useful to decision makers. Authors reviewed the literature and developed guidance for the Effective Health Care program. Results: Because applicability depends on the specific questions and needs of the users, it is difficult to devise a valid uniform scale for rating the overall applicability of individual studies or body of evidence. We recommend consulting stakeholders to identify the factors most relevant to applicability for their decisions. Applicability should be considered separately for benefits and harms. Observational studies can help determine whether trial populations and interventions are representative of "real world" practice. Reviewers should describe differences between available evidence and the ideally applicable evidence for the question being asked and offer a qualitative judgment about the importance and potential effect of those differences. Conclusion: Careful consideration of applicability may improve the usefulness of systematic reviews in informing practice and policy.

KW - Applicability

KW - Comparative effectiveness

KW - External validity

KW - Generalizability

KW - Heterogeneity of treatment effect

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=80053370203&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053370203&partnerID=8YFLogxK

U2 - 10.1016/j.jclinepi.2010.11.021

DO - 10.1016/j.jclinepi.2010.11.021

M3 - Article

VL - 64

SP - 1198

EP - 1207

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

SN - 0895-4356

IS - 11

ER -