76 FR 30364 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... professionals, and other clinicians. This activity is designed to raise awareness of and utility of comparative... proposed information collection project: ``Comparative Effectiveness Research-Continuing Education.'' In... Comparative Effectiveness Research-Continuing Education Previous dissemination efforts in health care research...

Comparative effectiveness research in clinical practice.

PubMed

Lawrence, William F; Chang, Stephanie; Kane, Robert L; Wilt, Timothy J

2014-08-01

The Agency for Healthcare Research and Quality (AHRQ) has funded systematic reviews of comparative effectiveness research in 17 areas over the last 10 years as part of a federal mandate. These reviews provide a reliable and unbiased source of comprehensive information about the effectiveness and risks of treatment alternatives for patients and clinicians. This article describes comparative effectiveness research, provides an overview of how physicians can use it in clinical practice, and references important contributions made by the Minnesota Evidence-based Practice Center.

Decline in placebo-controlled trial results suggests new directions for comparative effectiveness research.

PubMed

Olfson, Mark; Marcus, Steven C

2013-06-01

The Affordable Care Act offers strong support for comparative effectiveness research, which entails comparisons among active treatments, to provide the foundation for evidence-based practice. Traditionally, a key form of research into the effectiveness of therapeutic treatments has been placebo-controlled trials, in which a specified treatment is compared to placebo. These trials feature high-contrast comparisons between treatments. Historical trends in placebo-controlled trials have been evaluated to help guide the comparative effectiveness research agenda. We investigated placebo-controlled trials reported in four leading medical journals between 1966 and 2010. We found that there was a significant decline in average effect size or average difference in efficacy (the ability to produce a desired effect) between the active treatment and placebo. On average, recently studied treatments offered only small benefits in efficacy over placebo. A decline in effect sizes in conventional placebo-controlled trials supports an increased emphasis on other avenues of research, including comparative studies on the safety, tolerability, and cost of treatments with established efficacy.

76 FR 10367 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

.... Proposed Project: Research Evaluation and Impact Assessment of ARRA Comparative Effectiveness Research... under real-world conditions in diverse populations and clinical practice settings, that is, comparative... Coordinating Council on Comparative Effectiveness Research (FCCCER) to help coordinate and minimize duplicative...

Does comparative effectiveness research promote rationing of cancer care?

PubMed

Peppercorn, Jeffrey; Zafar, S Yousuf; Houck, Kevin; Ubel, Peter; Meropol, Neal J

2014-03-01

Comparative effectiveness research aims to inform health-care decisions by patients, clinicians, and policy makers. However, questions related to what information is relevant, and how to view the relative attributes of alternative interventions have political, social, and medical considerations. In particular, questions about whether cost is a relevant factor, and whether cost-effectiveness is a desirable or necessary component of such research, have become increasingly controversial as the area has gained prominence. Debate has emerged about whether comparative effectiveness research promotes rationing of cancer care. At the heart of this debate are questions related to the role and limits of patient autonomy, physician discretion in health-care decision making, and the nature of scientific knowledge as an objective good. In this article, we examine the role of comparative effectiveness research in the USA, UK, Canada, and other health-care systems, and the relation between research and policy. As we show, all health systems struggle to balance access to cancer care and control of costs; comparative effectiveness data can clarify choices, but does not itself determine policy or promote rationing of care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

PubMed

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Bm, Berman

2012-10-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

Feasibility and Design Options for a Potential Entity to Research the Comparative Effectiveness of Medical Treatments.

PubMed

Hussey, Peter S; Gillen, Emily M; McGlynn, Elizabeth A

2011-01-01

In 2008, the Massachusetts state legislature mandated an examination of the feasibility of the state's participation in establishing a comparative effectiveness center (CEC) and requested recommendations for the entity's design. "Comparative effectiveness" research involves the direct comparative assessment of the efficacy and cost-effectiveness of health care interventions and strategies. The center's findings would guide purchasing and payment decisions related to medical procedures, devices, drugs, and biologics by public- and private-sector organizations. The state has several options in terms of its approach to comparative effectiveness research. It could establish an interstate CEC that synthesizes existing findings for regional decisionmakers, it could establish an interstate CEC that supports new research, it could join an existing CEC, it could join the Drug Effectiveness Review Project and the Medicare Evidence-Based Decisions Project and also establish a regional center, or it could elect not to establish a CEC at all. An exploration of the options and the types of research that could be sponsored reveals that all of the options are potentially feasible, but the legislature's decision with regard to design must consider the level of prioritization of comparative effectiveness research relative to other approaches to improving health care quality and reducing spending growth.

Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.

PubMed

Schmittdiel, Julie A; Desai, Jay; Schroeder, Emily B; Paolino, Andrea R; Nichols, Gregory A; Lawrence, Jean M; O'Connor, Patrick J; Ohnsorg, Kris A; Newton, Katherine M; Steiner, John F

2015-06-01

Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience. Online patient community surveys can elicit important topic areas for comparative effectiveness research. Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects. Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their 'voice' is heard. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.

Comparative-effectiveness research in distributed health data networks.

PubMed

Toh, S; Platt, R; Steiner, J F; Brown, J S

2011-12-01

Comparative-effectiveness research (CER) can be conducted within a distributed health data network. Such networks allow secure access to separate data sets from different data partners and overcome many practical obstacles related to patient privacy, data security, and proprietary concerns. A scalable network architecture supports a wide range of CER activities and meets the data infrastructure needs envisioned by the Federal Coordinating Council for Comparative Effectiveness Research.

Osteopathic manipulative treatment: A systematic review and critical appraisal of comparative effectiveness and health economics research.

PubMed

Steel, Amie; Sundberg, Tobias; Reid, Rebecca; Ward, Lesley; Bishop, Felicity L; Leach, Matthew; Cramer, Holger; Wardle, Jon; Adams, Jon

2017-02-01

In recent years, evidence has emerged regarding the effectiveness of osteopathic manipulative treatments (OMT). Despite growing evidence in this field, there is need for appropriate research designs that effectively reflect the person-centred system of care promoted in osteopathy and provide data which can inform policy decisions within the healthcare system. The purpose of this systematic review is to identify, appraise and synthesise the evidence from comparative effectiveness and economic evaluation research involving OMT. A database search was conducted using CINAHL, PubMed, PEDro, AMED, SCOPUS and OSTMED.DR, from their inception to May 2015. Two separate searches were undertaken to identify original research articles encompassing the economic evaluation and comparative effectiveness of OMT. Identified comparative effectives studies were evaluated using the Cochrane risk of bias tool and appraised using the Good Reporting of Comparative Effectiveness (GRACE) principles. Identified economic studies were assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Sixteen studies reporting the findings of comparative effectiveness (n = 9) and economic evaluation (n = 7) research were included. The comparative effectiveness studies reported outcomes for varied health conditions and the majority (n = 6) demonstrated a high risk of bias. The economic evaluations included a range of analyses and considerable differences in the quality of reporting were evident. Despite some positive findings, published comparative effectiveness and health economic studies in OMT are of insufficient quality and quantity to inform policy and practice. High quality, well-designed, research that aligns with international best practice is greatly needed to build a pragmatic evidence base for OMT. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparative and cost-effectiveness research: Competencies, opportunities, and training for nurse scientists.

PubMed

Stone, Patricia W; Cohen, Catherine; Pincus, Harold Alan

Comparative and cost-effectiveness research develops knowledge on the everyday effectiveness and value of treatments and care delivery models. To describe comparative and cost-effectiveness research; identify needed competencies for this research; identify federal funding; and describe current training opportunities. Published recommended competencies were reviewed. Current federal funding and training opportunities were identified. A federally funded training program and other training opportunities are described. Fourteen core competencies were identified that have both analytic and theoretical foci from nursing and other fields. There are multiple sources of federal funding for research and training. Interdisciplinary training is needed. Comparative and cost-effectiveness research has the opportunity to transform health care delivery and improve the outcomes of patients. Nurses, as clinicians and scientists, are in a unique position to contribute to this important research. We encourage nurses to seek the needed interdisciplinary research training to participate in this important endeavor. We also encourage educators to use the competencies and processes identified in current training programs to help shape their doctoral programs. Copyright © 2017 Elsevier Inc. All rights reserved.

ECONOMICS OF INDIVIDUALIZATION IN COMPARATIVE EFFECTIVENESS RESEARCH AND A BASIS FOR A PATIENT-CENTERED HEALTH CARE

PubMed Central

Basu, Anirban

2011-01-01

The United States aspires to use information from comparative effectiveness research (CER) to reduce waste and contain costs without instituting a formal rationing mechanism or compromising patient or physician autonomy with regard to treatment choices. With such ambitious goals, traditional combinations of research designs and analytical methods used in CER may lead to disappointing results. In this paper, I study how alternate regimes of comparative effectiveness information help shape the marginal benefits (demand) curve in the population and how such perceived demand curves impact decision-making at the individual patient level and welfare at the societal level. I highlight the need to individualize comparative effectiveness research in order to generate the true (normative) demand curve for treatments. I discuss methodological principles that guide research designs for such studies. Using an example of the comparative effect of substance abuse treatments on crime, I use novel econometric methods to salvage individualized information from an existing dataset. PMID:21601299

Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care.

PubMed

Basu, Anirban

2011-05-01

The United States aspires to use information from comparative effectiveness research (CER) to reduce waste and contain costs without instituting a formal rationing mechanism or compromising patient or physician autonomy with regard to treatment choices. With such ambitious goals, traditional combinations of research designs and analytical methods used in CER may lead to disappointing results. In this paper, I study how alternate regimes of comparative effectiveness information help shape the marginal benefits (demand) curve in the population and how such perceived demand curves impact decision-making at the individual patient level and welfare at the societal level. I highlight the need to individualize comparative effectiveness research in order to generate the true (normative) demand curve for treatments. I discuss methodological principles that guide research designs for such studies. Using an example of the comparative effect of substance abuse treatments on crime, I use novel econometric methods to salvage individualized information from an existing dataset. Copyright © 2011 Elsevier B.V. All rights reserved.

Measure once, cut twice--adding patient-reported outcome measures to the electronic health record for comparative effectiveness research.

PubMed

Wu, Albert W; Kharrazi, Hadi; Boulware, L Ebony; Snyder, Claire F

2013-08-01

This article presents the current state of patient-reported outcome measures and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient centeredness and digitization. We pose the question, "What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?" We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; and the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other electronic health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. Copyright © 2013 Elsevier Inc. All rights reserved.

How the Recovery Act's Federal Coordinating Council paved the way for the Patient-Centered Outcomes Research Institute.

PubMed

Conway, Patrick H

2010-11-01

The American Recovery and Reinvestment Act of 2009 provided $1.1 billion for comparative effectiveness research and established the Federal Coordinating Council for Comparative Effectiveness Research to direct that investment. The council laid a critical foundation for comparative effectiveness research in the steps it took to gather information, invite public input, set priorities, coordinate project solicitations, and stress the importance of evaluating research investments. Although the council has been superseded by a successor--the Patient-Centered Outcomes Research Institute--the experiences of the council can and should inform the work of the new institute as it begins its operations.

75 FR 18848 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Prevention...

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2010-04-13

... Comparative Effectiveness Research Program, DP 10-003, Initial Review In accordance with Section 10(a)(2) of... to ``Prevention Research Centers Comparative Effectiveness Research Program, DP 10-003.'' Contact...

78 FR 38981 - Notice of Meeting

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2013-06-28

... ``LIMITED COMPETITION: ENHANCING INVESTMENTS COMPARATIVE EFFECTIVENESS RESEARCH RESOURCES GRANTS (R01... COMPETITION: ENHANCING INVESTMENTS COMPARATIVE EFFECTIVENESS RESEARCH RESOURCES GRANTS (R01)'' are to be...

Methods for Engaging Stakeholders in Comparative Effectiveness Research: A Patient-Centered Approach to Improving Diabetes Care

PubMed Central

Schmittdiel, Julie A.; Desai, Jay; Schroeder, Emily B.; Paolino, Andrea R.; Nichols, Gregory A.; Lawrence, Jean M.; O’Connor, Patrick J.; Ohnsorg, Kris A.; Newton, Katherine M.; Steiner, John F.

2016-01-01

ABSTRACT/Implementation Lessons Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience.Online patient community surveys can elicit important topic areas for comparative effectiveness research.Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects.Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their ‘voice’ is heard.Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research. PMID:26179728

Can a science-based definition of acupuncture improve clinical outcomes?

PubMed

Priebe, Ted; Stumpf, Steven H; Zalunardo, Rod

2017-05-01

Research on acupuncture has been muddled by attempts to bridge the ancient with the modern. Barriers to effectiveness research are reflected in recurring conflicts that include disagreement on use of the most basic terms, lack of standard intervention controls, and the absence of functional measures for assessing treatment effect. Acupuncture research has stalled at the "placebo barrier" wherein acupuncture is "no better than placebo." The most widely recognized comparative effectiveness research in acupuncture does not compare acupuncture treatment protocols within groups, thereby, mutating large scale effectiveness studies into large scale efficacy trials. Too often research in acupuncture attempts to tie outcomes to traditional belief systems thereby limiting usefulness of the research. The acupuncture research paradigm needs to focus more closely on a scientific definition of treatments and outcomes that compare protocols in terms of prevalent clinical issues such as relative effectiveness for treating pain.

The pragmatist's guide to comparative effectiveness research.

PubMed

Chandra, Amitabh; Jena, Anupam B; Skinner, Jonathan S

2011-01-01

Following an acrimonious health care reform debate involving charges of "death panels," in 2010, Congress explicitly forbade the use of cost-effectiveness analysis in government programs of the Patient Protection and Affordable Care Act. In this context, comparative effectiveness research emerged as an alternative strategy to understand better what works in health care. Put simply, comparative effectiveness research compares the efficacy of two or more diagnostic tests, treatments, or health care delivery methods without any explicit consideration of costs. To economists, the omission of costs from an assessment might seem nonsensical, but we argue that comparative effectiveness research still holds promise. First, it sidesteps one problem facing cost-effectiveness analysis--the widespread political resistance to the idea of using prices in health care. Second, there is little or no evidence on comparative effectiveness for a vast array of treatments: for example, we don't know whether proton-beam therapy, a very expensive treatment for prostate cancer (which requires building a cyclotron and a facility the size of a football field) offers any advantage over conventional approaches. Most drug studies compare new drugs to placebos, rather than "head-to-head" with other drugs on the market, leaving a vacuum as to which drug works best. Finally, the comparative effectiveness research can prove a useful first step even in the absence of cost information if it provides key estimates of treatment effects. After all, such effects are typically expensive to determine and require years or even decades of data. Costs are much easier to measure, and can be appended at a later date as financial Armageddon draws closer.

Alternative Fuels Data Center: Idle Reduction Research and Development

Science.gov Websites

researchers at Argonne National Laboratory completed their analysis of the full fuel-cycle effects of idle Laboratory analyzed the full fuel-cycle effects of current idle reduction technologies. Researchers compared , electrified parking spaces, APUs, and several combinations of these. They compared effects for the United

The patient-centered outcomes research institute should focus on high-impact problems that can be solved quickly.

PubMed

Sox, Harold

2012-10-01

The Affordable Care Act created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, clinicians, and policy makers make well-informed decisions about health care. Because its funding expires in 2019, the institute has little time in which to produce timely, practice-changing results that will build public support for comparative effectiveness research. PCORI should plan its research agenda strategically, so that it addresses research questions that comparative effectiveness research could answer quickly and decisively. To date, the institute has not chosen this path. In January 2012 PCORI's first research agenda described broad research priorities rather than specific clinical questions. The institute must drive the burgeoning discipline of comparative effectiveness research forward, starting with a research project agenda that conveys a sense of urgency and strategic direction.

Measure Once, Cut Twice – Adding Patient-Reported Outcome Measures to the Electronic Health Record for Comparative Effectiveness Research

PubMed Central

Wu, Albert W.; Kharrazi, Hadi; Boulware, L. Ebony; Snyder, Claire F.

2013-01-01

Objective This paper presents the current state of patient-reported outcome measures, and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Study Design and Setting Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient-centeredness and digitization. We pose the question: “What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?” Results We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. Conclusion The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other e-health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. PMID:23849145

Supporting Imagers' VOICE: A National Training Program in Comparative Effectiveness Research and Big Data Analytics.

PubMed

Kang, Stella K; Rawson, James V; Recht, Michael P

2017-12-05

Provided methodologic training, more imagers can contribute to the evidence basis on improved health outcomes and value in diagnostic imaging. The Value of Imaging Through Comparative Effectiveness Research Program was developed to provide hands-on, practical training in five core areas for comparative effectiveness and big biomedical data research: decision analysis, cost-effectiveness analysis, evidence synthesis, big data principles, and applications of big data analytics. The program's mixed format consists of web-based modules for asynchronous learning as well as in-person sessions for practical skills and group discussion. Seven diagnostic radiology subspecialties and cardiology are represented in the first group of program participants, showing the collective potential for greater depth of comparative effectiveness research in the imaging community. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Comparative effectiveness of colony-stimulating factors in febrile neutropenia prophylaxis: how results are affected by research design.

PubMed

Henk, Henry J; Li, Xiaoyan; Becker, Laura K; Xu, Hairong; Gong, Qi; Deeter, Robert G; Barron, Richard L

2015-01-01

To examine the impact of research design on results in two published comparative effectiveness studies. Guidelines for comparative effectiveness research have recommended incorporating disease process in study design. Based on the recommendations, we develop a checklist of considerations and apply the checklist in review of two published studies on comparative effectiveness of colony-stimulating factors. Both studies used similar administrative claims data, but different methods, which resulted in directionally different estimates. Major design differences between the two studies include: whether the timing of intervention in disease process was identified and whether study cohort and outcome assessment period were defined based on this temporal relationship. Disease process and timing of intervention should be incorporated into the design of comparative effectiveness studies.

Comparative effectiveness research in hand surgery.

PubMed

Johnson, Shepard P; Chung, Kevin C

2014-08-01

Comparative effectiveness research (CER) is a concept initiated by the Institute of Medicine and financially supported by the federal government. The primary objective of CER is to improve decision making in medicine. This research is intended to evaluate the effectiveness, benefits, and harmful effects of alternative interventions. CER studies are commonly large, simple, observational, and conducted using electronic databases. To date, there is little comparative effectiveness evidence within hand surgery to guide therapeutic decisions. To draw conclusions on effectiveness through electronic health records, databases must contain clinical information and outcomes relevant to hand surgery interventions, such as patient-related outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 1616 - Agency Information Collection Request; 60-Day Public Comment Request

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2011-01-11

.... Proposed Project: Comparative Effectiveness Research Inventory--OMB No. 0990-New-Assistant Secretary for... directly to a web-based inventory of comparative effectiveness research (CER). The CER Inventory will...: Research, human & scientific capital (e.g., training/education, methods development), data infrastructure...

75 FR 80504 - Agency Information Collection Request. 60-Day Public Comment Request

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2010-12-22

.... Proposed Project: Comparative Effectiveness Research Inventory--OMB No. 0990-New-Assistant Secretary for... directly to a web-based inventory of comparative effectiveness research (CER). The CER Inventory will...: research, human & scientific capital (e.g., training/education, methods development), data infrastructure...

Comparative Effectiveness and Implementation Research: Directions for Neurology

PubMed Central

Vickrey, Barbara G.; Hirtz, Deborah; Waddy, Salina; Cheng, Eric M.; Johnston, S. Claiborne

2013-01-01

There is an enormous unmet need for knowledge about how new insights from discovery and translational research can yield measurable, population-level improvements in health and reduction in mortality among those having or at risk for neurological disease. Once several, well-conducted randomized controlled trials establish the efficacy of a given therapy, implementation research can generate new knowledge about barriers to uptake of the therapy into widespread clinical care, and what strategies are effective in overcoming those barriers and in addressing health disparities. Comparative effectiveness research aims to elucidate the relative value (including clinical benefit, clinical harms, and/or costs) of alternative efficacious management approaches to a neurological disorder, generally through direct comparisons, and may include comparisons of methodologies for implementation. Congress has recently appropriated resources and established an institute to prioritize funding for such research. Neurologists and neuroscientists should understand the scope and objectives of comparative effectiveness and implementation research, their range of methodological approaches (formal literature syntheses, randomized trials, observational studies, modeling), and existing research resources (centers for literature synthesis, registries, practice networks) relevant to research for neurological conditions, in order to close the well-documented “evidence-to-practice gap.” Future directions include building this research resource capacity, producing scientists trained to conduct rigorous comparative effectiveness and implementation research, and embracing innovative strategies to set research priorities in these areas. PMID:22718542

Addressing Informatics Barriers to Conducting Observational Comparative Effectiveness Research: A Comparative Case Analysis

ERIC Educational Resources Information Center

Boone, Christopher P. D.

2013-01-01

Background: The U.S. health care system has been under immense scrutiny for ever-increasing costs and poor health outcomes for its patients. Comparative Effectiveness Research (CER) has emerged as a generally accepted practice by providers, policy makers, and scientists as an approach to identify the most clinical- and cost-effective interventions…

The missing link in preconceptional care: the role of comparative effectiveness research.

PubMed

Salihu, Hamisu M; Salinas, Abraham; Mogos, Mulubrhan

2013-07-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions.

The Missing Link in Preconceptional Care: The Role of Comparative Effectiveness Research

PubMed Central

Salihu, Hamisu M.; Salinas, Abraham; Mogos, Mulubrhan

2012-01-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions. PMID:22718466

Better research reporting to improve the utility of routine data for making better treatment decisions.

PubMed

Hemkens, Lars G; Langan, Sinéad M; Benchimol, Eric I

2016-03-01

The availability of routinely collected health data, such as health administrative data, electronic health records, prescription records and disease registries, has increased in the information age. This has led to an explosion of reports of comparativeness effectiveness research using such data. Guidelines for the REporting of studies Conducted using Observational Routinely-collected Data (RECORD) will improve the completeness and transparency of reporting of research using routinely collected health data. The Journal of Comparative Effectiveness Research has endorsed these guidelines. In this commentary, the RECORD checklist is reprinted and members of the RECORD working committee reflect on the importance of these reporting guidelines for the field of comparative effectiveness research.

75 FR 20852 - Notice of Meeting

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2010-04-21

... Dissemination of AHRQ Comparative Effectiveness Research Products (iADAPT) (R18) applications are to be reviewed... Dissemination of AHRQ Comparative Effectiveness Research Products (iADAPT) (R18). Date: April 29-30, 2010 (Open...

Comparative effectiveness in urology: a state of the art review utilizing a systematic approach.

PubMed

Bandari, Jathin; Wessel, Charles B; Jacobs, Bruce L

2017-07-01

Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals. There have been major advancements in comparative effectiveness research in urology in 2016.

HETEROGENEITY IN TREATMENT EFFECT AND COMPARATIVE EFFECTIVENESS RESEARCH.

PubMed

Luo, Zhehui

2011-10-01

The ultimate goal of comparative effectiveness research (CER) is to develop and disseminate evidence-based information about which interventions are most effective for which patients under what circumstances. To achieve this goal it is crucial that researchers in methodology development find appropriate methods for detecting the presence and sources of heterogeneity in treatment effect (HTE). Comparing with the typically reported average treatment effect (ATE) in randomized controlled trials and non-experimental (i.e., observational) studies, identifying and reporting HTE better reflect the nature and purposes of CER. Methodologies of CER include meta-analysis, systematic review, design of experiments that encompasses HTE, and statistical correction of various types of estimation bias, which is the focus of this review.

Comparative effectiveness research: what to do when experts disagree about risks.

PubMed

Lie, Reidar K; Chan, Francis K L; Grady, Christine; Ng, Vincent H; Wendler, David

2017-06-19

Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees (ERCs) should evaluate the risks of comparative effectiveness research. We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when "nothing is known" about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. Rather, we should focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative(s). We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation.

78 FR 5805 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... comparative effectiveness research. The Effective Health Care Program also translates research findings into a... that are currently available are designed to help practicing clinicians, consumers/patients, and..., such as faculty slide sets based on comparative effectiveness reviews of the literature, to reach this...

Comparative effectiveness research methodology using secondary data: A starting user's guide.

PubMed

Sun, Maxine; Lipsitz, Stuart R

2018-04-01

The use of secondary data, such as claims or administrative data, in comparative effectiveness research has grown tremendously in recent years. We believe that the current review can help investigators relying on secondary data to (1) gain insight into both the methodologies and statistical methods, (2) better understand the necessity of a rigorous planning before initiating a comparative effectiveness investigation, and (3) optimize the quality of their investigations. Specifically, we review concepts of adjusted analyses and confounders, methods of propensity score analyses, and instrumental variable analyses, risk prediction models (logistic and time-to-event), decision-curve analysis, as well as the interpretation of the P value and hypothesis testing. Overall, we hope that the current review article can help research investigators relying on secondary data to perform comparative effectiveness research better understand the necessity of a rigorous planning before study start, and gain better insight in the choice of statistical methods so as to optimize the quality of the research study. Copyright © 2017 Elsevier Inc. All rights reserved.

Instrumental variable methods in comparative safety and effectiveness research.

PubMed

Brookhart, M Alan; Rassen, Jeremy A; Schneeweiss, Sebastian

2010-06-01

Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial.

[Which research is needed to support clinical decision-making on integrative medicine? Can comparative effectiveness research close the gap?].

PubMed

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Berman, Brian M

2013-08-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of best care options. This evidence, more generalizable than evidence generated by traditional randomized clinical trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on CER is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

New NIH Director Dr. Francis Collins on Medical Research That Benefits Everyone's Health

MedlinePlus

... improve outcomes. For instance, in the area of comparative effectiveness, NIH has been studying various clinical problems ... we have been given another $400 million for comparative effectiveness research. What impact will this have, do ...

Futurescapes: evidence expectations in the USA for comparative effectiveness research for drugs in 2020.

PubMed

Messner, Donna A; Mohr, Penny; Towse, Adrian

2015-08-01

Explore key factors influencing future expectations for the production of evidence from comparative effectiveness research for drugs in the USA in 2020 and construct three plausible future scenarios. Semistructured key informant interviews and three rounds of modified Delphi with systematic scenario-building methods. Most influential key factors were: health delivery system integration; electronic health record development; exploitation of very large databases and mixed data sources; and proactive patient engagement in research. The scenario deemed most likely entailed uneven development of large integrated health systems with pockets of increased provider risk for patient care, enhanced data collection systems, changing incentives to do comparative effectiveness research and new opportunities for evidence generation partnerships.

Comparative Effectiveness Research in Pediatric Respiratory Disease: Promise and Pitfalls.

PubMed

Ramos, Kathleen J; Somayaji, Ranjani; Nichols, David P; Goss, Christopher H

2018-02-01

Comparative effectiveness research (CER) has become increasing central to clinical research in medicine. CER seeks to conduct clinical trials that compare different commonly used interventions in real-world settings (pragmatic clinical trials) and use a multitude of sources of evidence (including registries and cohort studies) to inform clinical decision making. CER also ensures that stakeholders (patients, families, care providers, insurers) have a voice in the research process by integrating formal stakeholder engagement as part of the research. This innovative approach to clinical research has distinct benefits and pitfalls. This review first defines what CER is and then describes some of its benefits and then pitfalls. The focus is on the role of CER in pediatrics.

Composite scores in comparative effectiveness research: counterbalancing parsimony and dimensionality in patient-reported outcomes.

PubMed

Schwartz, Carolyn E; Patrick, Donald L

2014-07-01

When planning a comparative effectiveness study comparing disease-modifying treatments, competing demands influence choice of outcomes. Current practice emphasizes parsimony, although understanding multidimensional treatment impact can help to personalize medical decision-making. We discuss both sides of this 'tug of war'. We discuss the assumptions, advantages and drawbacks of composite scores and multidimensional outcomes. We describe possible solutions to the multiple comparison problem, including conceptual hierarchy distinctions, statistical approaches, 'real-world' benchmarks of effectiveness and subgroup analysis. We conclude that comparative effectiveness research should consider multiple outcome dimensions and compare different approaches that fit the individual context of study objectives.

Automatic identification of comparative effectiveness research from Medline citations to support clinicians’ treatment information needs

PubMed Central

Zhang, Mingyuan; Fiol, Guilherme Del; Grout, Randall W.; Jonnalagadda, Siddhartha; Medlin, Richard; Mishra, Rashmi; Weir, Charlene; Liu, Hongfang; Mostafa, Javed; Fiszman, Marcelo

2014-01-01

Online knowledge resources such as Medline can address most clinicians’ patient care information needs. Yet, significant barriers, notably lack of time, limit the use of these sources at the point of care. The most common information needs raised by clinicians are treatment-related. Comparative effectiveness studies allow clinicians to consider multiple treatment alternatives for a particular problem. Still, solutions are needed to enable efficient and effective consumption of comparative effectiveness research at the point of care. Objective Design and assess an algorithm for automatically identifying comparative effectiveness studies and extracting the interventions investigated in these studies. Methods The algorithm combines semantic natural language processing, Medline citation metadata, and machine learning techniques. We assessed the algorithm in a case study of treatment alternatives for depression. Results Both precision and recall for identifying comparative studies was 0.83. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. Conclusion Overall, the algorithm achieved reasonable performance. The method provides building blocks for the automatic summarization of comparative effectiveness research to inform point of care decision-making. PMID:23920677

Patient and clinician views on comparative effectiveness research and engagement in research.

PubMed

Forsythe, Laura P; Frank, Lori; Walker, Kara Odom; Anise, Ayodola; Wegener, Natalie; Weisman, Harlan; Hunt, Gail; Beal, Anne

2015-01-01

Describe and compare patient and primary care clinician attitudes about comparative effectiveness research (CER) and inclusion of patients and clinicians as partners in clinical research. Online survey of patients (n = 900) and primary care clinicians (n = 750) from opt-in survey panels. Nearly half (45%) of clinicians were not familiar with CER, but after reviewing a definition of CER, most (76%) agreed that it can improve patient care. Patients and clinicians indicated interest in engagement as research partners (66% and 55%, respectively). Lack of time was the most commonly endorsed barrier. Attitudes toward CER and engagement in clinical research were generally favorable. Identified facilitators and barriers point to strategies for enhancing patient and clinician engagement in research.

Improving the evidence base for better comparative effectiveness research.

PubMed

Brophy, James M

2015-09-01

The last 20 years has documented that the evidence base for informed clinical decision-making is often suboptimal. It is hoped that high-quality comparative effectiveness research may fill these knowledge gaps. Implicit in these changing paradigms is the underlying assumption that the published evidence, when available, is valid. It is posited here that this assumption is sometimes questionable. However, several recent methods that may improve the design and analysis of comparative effectiveness research have appeared and are discussed here. Examples from the cardiology literature are provided, but it is believed the highlighted principles are applicable to other branches of medicine.

Using indirect comparisons to compare interventions within a Cochrane review: a tool for comparative effectiveness research.

PubMed

Agapova, Maria; Devine, Emily B; Nguyen, Hiep; Wolf, Fredric M; Inoue, Lurdes Y T

2014-07-01

Assessing relative performance among competing interventions is an important part of comparative effectiveness research. Bayesian indirect comparisons add information to existing Cochrane reviews, such as which intervention is likely to perform best. However, heterogeneity variance priors may influence results and, potentially, clinical guidance. We highlight the features of Bayesian indirect comparisons using a case study of a Cochrane review update in asthma care. The probability that one self-management educational intervention outperforms others is estimated. Simulation studies investigate the effect of heterogeneity variance prior distributions. Results suggest a 55% probability that individual education is best, followed by combination (39%) and group (6%). The intervention with few trials was sensitive to prior distributions. Bayesian indirect comparisons updates of Cochrane reviews are valuable comparative effectiveness research tools.

A Comparative Study on Power Point Presentation and Traditional Lecture Method in Material Understandability, Effectiveness and Attitude

ERIC Educational Resources Information Center

Sewasew, Daniel; Mengestle, Missaye; Abate, Gebeyehu

2015-01-01

The aim of this study was to compare PPT and traditional lecture method in material understandability, effectiveness and attitude among university students. Comparative descriptive survey research design was employed to answer the research questions raised. Four hundred and twenty nine participants were selected randomly using stratified sampling…

76 FR 10366 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

...). Abstract: This research leverages best practices in behavior change, interaction design, and service innovation to increase the understanding and adoption of Comparative Effectiveness Research (CER) information..., translation, and adoption of evidence-based, outcomes- oriented CER findings. Comparative Effectiveness...

Bayesian data analysis in observational comparative effectiveness research: rationale and examples.

PubMed

Olson, William H; Crivera, Concetta; Ma, Yi-Wen; Panish, Jessica; Mao, Lian; Lynch, Scott M

2013-11-01

Many comparative effectiveness research and patient-centered outcomes research studies will need to be observational for one or both of two reasons: first, randomized trials are expensive and time-consuming; and second, only observational studies can answer some research questions. It is generally recognized that there is a need to increase the scientific validity and efficiency of observational studies. Bayesian methods for the design and analysis of observational studies are scientifically valid and offer many advantages over frequentist methods, including, importantly, the ability to conduct comparative effectiveness research/patient-centered outcomes research more efficiently. Bayesian data analysis is being introduced into outcomes studies that we are conducting. Our purpose here is to describe our view of some of the advantages of Bayesian methods for observational studies and to illustrate both realized and potential advantages by describing studies we are conducting in which various Bayesian methods have been or could be implemented.

JIM-13-0560 R1: Propensity scores for confounder adjustment when assessing the effects of medical interventions using non-experimental study designs

PubMed Central

Stürmer, Til; Wyss, Richard; Glynn, Robert J.; Brookhart, M. Alan

2014-01-01

Treatment effects, especially when comparing two or more therapeutic alternatives as in comparative effectiveness research, are likely to be heterogeneous across age, gender, co-morbidities, and co-medications. Propensity scores (PSs), an alternative to multivariable outcome models to control for measured confounding, have specific advantages in the presence of heterogeneous treatment effects. Implementing PSs using matching or weighting allows us to estimate different overall treatment effects in differently defined populations. Heterogeneous treatment effects can also be due to unmeasured confounding concentrated in those treated contrary to prediction. Sensitivity analyses based on PSs can help to assess such unmeasured confounding. PSs should be considered a primary or secondary analytic strategy in non-experimental medical research, including pharmacoepidemiology and non-experimental comparative effectiveness research. PMID:24520806

[Overview of design, implementation and analysis of comparative effectiveness research].

PubMed

Liao, Xing; Xie, Yan-Ming; Tian, Feng; Shen, Hao

2013-03-01

Comparative effectiveness research (CER) has been regarded as a hot topic in health care recently. Many medicalresearchers currently deem CER as a potential powerful instrument for improving the quality of healthcare and cut medical cost. However, in the past, classic efficacy studies are always focusing on comparing one new intervention with placebo under complete controlled environment. Now CER turns to comparing different interventions directly in real world of routine practice. This article reviewed a series of literature about the design, implementation and analysis of CER in order to give a clue for Chinese medicine researchers in future.

Timely publication and sharing of trial data: opportunities and challenges for comparative effectiveness research in cardiovascular disease.

PubMed

Naci, Huseyin; Cooper, Jacob; Mossialos, Elias

2015-11-01

There is growing enthusiasm for the timely publication and sharing of clinical trial data. The rationale for open access includes greater transparency, reproducibility, and efficiency of the research enterprise. In cardiovascular diseases, routinely sharing clinical trial data would create opportunities for undertaking comparative effectiveness research, providing much needed evidence on how different interventions compare to each other on key outcomes. Access to individual patient-level data would strengthen the validity of such research. Novel methodological approaches like network meta-analyses using individual patient-level data could reliably compare interventions that have not been compared with each other in head-to-head trials. However, there are significant practical, methodological, financial, and legal challenges to this utopian open access that need to be continually addressed. Sharing clinical trial data openly will only occur when the previously tolerated process of clinical research involving direct ownership and secrecy is abandoned for a new culture in which medical science is open to all of its stakeholders. With this new culture, data will be accessible, reanalysis will be considered commonplace, and comparative effectiveness research through novel synthesis approaches, such as network meta-analyses, can thrive-as long as measures are taken to adequately ensure the goal remains to promote public health.

A framework for assessing the value of diagnostic imaging in the era of comparative effectiveness research.

PubMed

Gazelle, G Scott; Kessler, Larry; Lee, David W; McGinn, Thomas; Menzin, Joseph; Neumann, Peter J; van Amerongen, Derek; White, Leigh Ann

2011-12-01

In June 2009, the Federal Coordinating Council for Comparative Effectiveness Research submitted a report to the President and Congress in which the Council described the purpose of comparative effectiveness research (CER) as developing evidence-based information for interventions and determining under what circumstances an intervention is effective (1). With the enactment of the Patient Protection and Affordable Care Act, a Patient-centered Outcomes Research Institute (PCORI) was established to assist decision makers in making evidence-based health decisions through synthesis and dissemination of clinical CER of health interventions (2). Its founding has underscored a heightened need for health policy makers to consider the impact of health care technologies on final outcomes of interest--for example, functional status, quality of life, disability, major clinical events, and mortality (3-5). © RSNA, 2011.

Towards Building a Bridge between Community Engagement in Research (CEnR) and Comparative Effectiveness Research (CER).

PubMed

Ahmed, Syed M; Nelson, David; Kissack, Anne; Franco, Zeno; Whittle, Jeff; Kotchen, Theodore; Meurer, John R; Morzinski, Jeffrey; Brandenburg, Terry

2015-04-01

A major national priority is establishing an effective infrastructure for translation of scientific discoveries into the community. Knowledge and practice continue to accelerate in health research yet healthcare recommendation adoption remains slow for practitioners, patients, and communities. Two areas of research placed in the later stages of the translational research spectrum, Community Engagement in Research and Comparative Effectiveness Research, are ideal for approaching this challenge collaboratively. The Clinical and Translational Science Institute of Southeastern Wisconsin convened academics and community-based organizations familiar with these fields of research in a 1-day workshop to establish an initial dialogue on similarities and differences with a goal of exploring ways to operationalize a collective effort. Participants represented four academic institutions and twelve other healthcare and community-based service organizations. Primary fields of study included community engaged research, comparative effectiveness research, psychology, clinical research, administration, nursing, public health, education, and other professionals. This initial report outlines the results of this diverse discussion and provides insights into the priorities, diverging issues, and areas for future examination and practice. Key discoveries reveal clear crosscutting issues, value in philosophical and provocative discussions among investigators, a need for practice and lessons learned, and bidirectional exchange with community representation. © 2014 Wiley Periodicals, Inc.

Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning.

PubMed

Hansen, Richard A; Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R; Evans, R Lee

2017-02-25

Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

AHRQ series paper 3: identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the effective health-care program.

PubMed

Whitlock, Evelyn P; Lopez, Sarah A; Chang, Stephanie; Helfand, Mark; Eder, Michelle; Floyd, Nicole

2010-05-01

This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality's Effective Health Care (EHC) program. The EHC program seeks to align its research topic selection with the overall goals of the program, impartially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are "appropriate") to determine how "important" topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the "potential value and impact" of a comparative effectiveness systematic review. As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthesized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness.

Publication patterns of comparative effectiveness research in spine neurosurgery.

PubMed

Hueng, Dueng-Yuan; Tsai, Chia-Lin; Hsu, Shih-Wei; Ma, Hsin-I

2012-07-01

The purpose of this study was to investigate publication patterns for comparative effectiveness research (CER) on spine neurosurgery. The authors searched the PubMed database for the period 1980-2012 using the key words "cost analysis," "utility analysis," "cost-utility," "outcomes research," "practical clinical research," "comparator trial," and "comparative effectiveness research," linked with "effectiveness" and "spine neurosurgery." From 1980 through April 9, 2012, neurosurgery CER publications accounted for 1.38% of worldwide CER publications (8657 of 626,330 articles). Spine neurosurgery CER accounted for only 0.02%, with 132 articles. The journal with the greatest number of publications on spine neurosurgery CER was Spine, followed by the Journal of Neurosurgery: Spine. The average annual publication rate for spine neurosurgery CER during this period was 4 articles (132 articles in 33 years), with 68 (51.52%) of the 132 articles being published within the past 5 years and a rising trend beginning in 2008. The top 3 contributing countries were the US, Turkey, and Japan, with 68, 8, and 7 articles, respectively. Only 8 regular articles (6.06%) focused on cost analysis. There is a paucity of publications using CER methodology in spine neurosurgery. Few articles address the issue of cost analysis. The promotion of continuing medical education in CER methodology is warranted. Further investigations to address cost analysis in comparative effectiveness studies of spine neurosurgery are crucial to expand the application of CER in public health.

Statistical Power of Alternative Structural Models for Comparative Effectiveness Research: Advantages of Modeling Unreliability.

PubMed

Coman, Emil N; Iordache, Eugen; Dierker, Lisa; Fifield, Judith; Schensul, Jean J; Suggs, Suzanne; Barbour, Russell

2014-05-01

The advantages of modeling the unreliability of outcomes when evaluating the comparative effectiveness of health interventions is illustrated. Adding an action-research intervention component to a regular summer job program for youth was expected to help in preventing risk behaviors. A series of simple two-group alternative structural equation models are compared to test the effect of the intervention on one key attitudinal outcome in terms of model fit and statistical power with Monte Carlo simulations. Some models presuming parameters equal across the intervention and comparison groups were underpowered to detect the intervention effect, yet modeling the unreliability of the outcome measure increased their statistical power and helped in the detection of the hypothesized effect. Comparative Effectiveness Research (CER) could benefit from flexible multi-group alternative structural models organized in decision trees, and modeling unreliability of measures can be of tremendous help for both the fit of statistical models to the data and their statistical power.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

Development of Theories of School-Effectiveness.

ERIC Educational Resources Information Center

Scheerens, Jaap; Stoel, Wouter G. R.

Concepts from organizational theory are used to interpret and review major findings of school effectiveness research to develop a broader perspective for understanding school effectiveness. Results of school-effectiveness research in the Netherlands are compared with those from research in the United States and England. A more-or-less established…

Comparing the Effects of Spelling-and Syntax-Based Interventions in Morphological Awareness on Literacy Outcomes

ERIC Educational Resources Information Center

Stark, Kerri L.

2011-01-01

Despite substantial correlational evidence of a relationship between morphological awareness and reading ability, there has been only limited intervention research conducted to document the effects of morphological awareness on various literacy outcomes, particularly reading comprehension, and almost no research comparing the relative…

Comparative effectiveness research - what is it and how does one do it?

PubMed

Goss, Christopher H; Tefft, Nathan

2013-09-01

Recent initiatives have increased focus on medical research that explores robust comparisons of clinical approaches broadly defined as comparative effectiveness research (CER). Federal mandates have generated definitions, established priorities, and offered organizational approaches for coordinating and conducting CER. This review will summarize the various definitions of CER, the role of cost assessment, and key study components of CER including study populations, study design, the use of secondary data, comparators employed in studies, outcome measures, and how results of CER should be disseminated. Copyright © 2013. Published by Elsevier Ltd.

Practice-Based Knowledge Discovery for Comparative Effectiveness Research: An Organizing Framework

PubMed Central

Lucero, Robert J.; Bakken, Suzanne

2014-01-01

Electronic health information systems can increase the ability of health-care organizations to investigate the effects of clinical interventions. The authors present an organizing framework that integrates outcomes and informatics research paradigms to guide knowledge discovery in electronic clinical databases. They illustrate its application using the example of hospital acquired pressure ulcers (HAPU). The Knowledge Discovery through Informatics for Comparative Effectiveness Research (KDI-CER) framework was conceived as a heuristic to conceptualize study designs and address potential methodological limitations imposed by using a single research perspective. Advances in informatics research can play a complementary role in advancing the field of outcomes research including CER. The KDI-CER framework can be used to facilitate knowledge discovery from routinely collected electronic clinical data. PMID:25278645

Research Governance and the Role of Evaluation: A Comparative Study

ERIC Educational Resources Information Center

Molas-Gallart, Jordi

2012-01-01

Through a comparative study of the United Kingdom and Spain, this article addresses the effect of different research governance structures on the functioning and uses of research evaluation. It distinguishes three main evaluation uses: distributive, improvement, and controlling. Research evaluation in the United Kingdom plays important…

Commentary: Precision science and patient-centered care.

PubMed

Clancy, Carolyn M

2011-06-01

Patient-centered outcomes research (PCOR), also known as comparative effectiveness research, offers new opportunities and challenges for academic health centers (AHCs). The author of this commentary summarizes the contributions of some of the articles in this issue that focus on PCOR, and she emphasizes the unique features of this distinctive type of research, which are longitudinal patient follow-up, the inclusion of patient-reported outcomes, and the dynamic interaction among all stakeholders throughout all phases of research.The author advocates that researchers engaged in comparative effectiveness research make every effort, and explore innovative means, to accelerate the translation of their research findings into practice. The opportunities to close the gaps between what physicians and medical scientists do and what they know, to support clinicians and patients who are working together in order to rapidly identify the best option for a unique individual, and to lead the way in addressing barriers to achieving personalized, patient-centered care should engage key members of AHCs in comparative effectiveness research, so that these institutions become a vital link connecting biomedical innovation and its precision application in diverse communities and populations.

Good research practices for comparative effectiveness research: approaches to mitigate bias and confounding in the design of nonrandomized studies of treatment effects using secondary data sources: the International Society for Pharmacoeconomics and Outcomes Research Good Research Practices for Retrospective Database Analysis Task Force Report--Part II.

PubMed

Cox, Emily; Martin, Bradley C; Van Staa, Tjeerd; Garbe, Edeltraut; Siebert, Uwe; Johnson, Michael L

2009-01-01

The goal of comparative effectiveness analysis is to examine the relationship between two variables, treatment, or exposure and effectiveness or outcome. Unlike data obtained through randomized controlled trials, researchers face greater challenges with causal inference with observational studies. Recognizing these challenges, a task force was formed to develop a guidance document on methodological approaches to addresses these biases. The task force was commissioned and a Chair was selected by the International Society for Pharmacoeconomics and Outcomes Research Board of Directors in October 2007. This report, the second of three reported in this issue of the Journal, discusses the inherent biases when using secondary data sources for comparative effectiveness analysis and provides methodological recommendations to help mitigate these biases. The task force report provides recommendations and tools for researchers to mitigate threats to validity from bias and confounding in measurement of exposure and outcome. Recommendations on design of study included: the need for data analysis plan with causal diagrams; detailed attention to classification bias in definition of exposure and clinical outcome; careful and appropriate use of restriction; extreme care to identify and control for confounding factors, including time-dependent confounding. Design of nonrandomized studies of comparative effectiveness face several daunting issues, including measurement of exposure and outcome challenged by misclassification and confounding. Use of causal diagrams and restriction are two techniques that can improve the theoretical basis for analyzing treatment effects in study populations of more homogeneity, with reduced loss of generalizability.

Comparative effectiveness research in cancer with observational data.

PubMed

Giordano, Sharon H

2015-01-01

Observational studies are increasingly being used for comparative effectiveness research. These studies can have the greatest impact when randomized trials are not feasible or when randomized studies have not included the population or outcomes of interest. However, careful attention must be paid to study design to minimize the likelihood of selection biases. Analytic techniques, such as multivariable regression modeling, propensity score analysis, and instrumental variable analysis, also can also be used to help address confounding. Oncology has many existing large and clinically rich observational databases that can be used for comparative effectiveness research. With careful study design, observational studies can produce valid results to assess the benefits and harms of a treatment or intervention in representative real-world populations.

Differences among consumer segments with regard to perceptions of comparative effectiveness research.

PubMed

Williams, Sunyna S; Frost, Sloane L

2014-11-01

To examine differences among health-related decision-making consumer segments with regard to knowledge, skills, attitudes, and behaviors pertinent to comparative effectiveness research. Data were collected via an online survey from 603 adults with chronic conditions. Consumer segment was determined using a two-item tool. Active consumers (high skills and motivation) reported the highest levels of engagement in various behaviors. Passive consumers (low skills and motivation) reported the lowest levels of engagement in various behaviors. High-effort consumers (low skills, high motivation) reported more positive attitudes and opinions and more engagement in various behaviors than did complacent consumers (high skills, low motivation). Effective translation and dissemination of comparative effectiveness research will require the development of approaches tailored to consumers with varying levels of skills and motivation.

How to set up a departmental comparative effectiveness research unit: one department's experience.

PubMed

McDonald, Jennifer S; Port, John D; Bender, Claire E

2014-03-01

Comparative effectiveness research (CER) is the comparison of clinical interventions in real-world settings. The purpose of this article is to discuss the experiences of a CER unit created within the radiology department of one medical institution to provide an example of how to pursue CER within the field of radiology. Medical institutions would benefit from investing in CER by creating research groups specifically devoted to this evolving field.

Health researcher views on comparative effectiveness research and research engagement.

PubMed

Forsythe, Laura P; Frank, Lori B; Workman, Thomas A; Borsky, Amanda; Hilliard, Tandrea; Harwell, Daniel; Fayish, Lauren

2017-05-01

To understand researcher capability for and interest in patient-centered comparative effectiveness research (PC-CER), particularly related to engaging with patients/caregivers. Web-based survey of 508 health researchers recruited via professional health research organizations. Most respondents (94%) were familiar with CER and many (69%) reported having previously conducting some form of CER. Most respondents were familiar with (81%) and interested in (87%) partnering with patients and/or caregivers in research. Resources to assist in training, coordination of partners, guidance in apply for funding and improved infrastructure were commonly cited factors that would help researchers conduct PC-CER. There is a significant opportunity for researchers to engage patients and caregivers as partners in CER. Researchers recognize the need for additional training and expertise to leverage those opportunities.

Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.

PubMed

Vandigo, Joseph; Oloyede, Ebenezer; Aly, Abdalla; Laird, Aurelia L; Cooke, Catherine E; Mullins, C Daniel

2016-01-01

Researchers have produced evidence that identifies interventions that reduce cardiovascular disease (CVD) risk; however, despite a significant investment in research CVD remains the leading cause of death. Engaging patients in the research process has the potential to ensure that evidence-based treatments are adopted in real-world practice to improve patient outcomes. The Patient-Centered Outcomes Research Institute has created an Engagement Rubric to guide meaningful engagement in the research process. A 10-step systematic framework to enhance patient engagement throughout the comparative effectiveness research process also has been proposed. This special report identifies the relationship between these two approaches to patient engagement and describes examples of how patients could be engaged in a hypothetical CVD study.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O’Leary, James; Ruffner, BW; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2013-01-01

Aims The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. Materials & methods The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. Results A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Conclusions Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement. PMID:23459832

Global comparative healthcare effectiveness research: evaluating sustainable programmes in low & middle resource settings.

PubMed

Balkrishnan, Rajesh; Chang, Jongwha; Patel, Isha; Yang, Fang; Merajver, Sofia D

2013-03-01

The need to focus healthcare expenditures on innovative and sustainable health systems that efficiently use existing effective therapies are the major drivers stimulating Comparative Effectiveness Research (CER) across the globe. Lack of adequate access and high cost of essential medicines and technologies in many countries increases morbidity and mortality and cost of care that forces people and families into poverty due to disability and out-of-pocket expenses. This review illustrates the potential of value-added global health care comparative effectiveness research in shaping health systems and health care delivery paradigms in the "global south". Enabling the development of effective CER systems globally paves the way for tangible local and regional definitions of equity in health care because CER fosters the sharing of critical assets, resources, skills, and capabilities and the development of collaborative of multi-sectorial frameworks to improve health outcomes and metrics globally.

Model for a patient-centered comparative effectiveness research center.

PubMed

Costlow, Monica R; Landsittel, Douglas P; James, A Everette; Kahn, Jeremy M; Morton, Sally C

2015-04-01

This special report describes the systematic approach the University of Pittsburgh and the University of Pittsburgh Medical Center (UPMC) undertook in creating an infrastructure for comparative effectiveness and patient-centered outcomes research resources. We specifically highlight the administrative structure, communication and training opportunities, stakeholder engagement resources, and support services offered. © 2015 Wiley Periodicals, Inc.

Is the Allegiance Effect an Epiphenomenon of True Efficacy Differences between Treatments? A Meta-Analysis

ERIC Educational Resources Information Center

Munder, Thomas; Fluckiger, Christoph; Gerger, Heike; Wampold, Bruce E.; Barth, Jurgen

2012-01-01

Many meta-analyses of comparative outcome studies found a substantial association of researcher allegiance (RA) and relative treatment effects. Therefore, RA is regarded as a biasing factor in comparative outcome research (RA bias hypothesis). However, the RA bias hypothesis has been criticized as causality might be reversed. That is, RA might be…

Attention-deficit/hyperactivity disorder: identifying high priority future research needs.

PubMed

Gaynes, Bradley N; Christian, Robert; Saavedra, Lissette M; Wines, Roberta; Jonas, Daniel E; Viswanathan, Meera; Ellis, Alan R; Woodell, Carol; Carey, Timothy S

2014-03-01

With onset often occurring before 6 years of age, attention-deficit/hyperactivity disorder (ADHD) involves attention problems, impulsivity, overactivity, and sometimes disruptive behavior. Impairment usually persists into adulthood, with an estimated worldwide prevalence in adults of 2.5%. Existing gaps in evidence concerning ADHD hinder decision-making about treatment. This article describes and prioritizes future research needs for ADHD in three areas: treatment effectiveness for at-risk preschoolers; long-term treatment effectiveness; and variability in prevalence, diagnosis, and treatment.Using a recent systematic review concerning ADHD completed by a different evidence-based practice center as a foundation, we worked with a diverse group of 12 stakeholders, who represented researchers, funders, healthcare providers, patients, and families, to identify and prioritize research needs. From an initial list of 29 evidence gaps, we enumerated 8 high-priority research needs: a) accurate, brief standardized diagnosis and assessment; b) comparative effectiveness and safety of pharmacologic treatments for children under 6 years of age; c) comparative effectiveness of different combinations of psychosocial and pharmacologic treatments for children under 6 years of age; d) case identification and measurement of prevalence and outcomes; e) comparative effectiveness of psychosocial treatment alone versus pharmacologic and combination treatments for children under 6 years of age; f) comparative long-term treatment effectiveness for people 6 years of age and older; g) relative efficacy of specific psychosocial program components for children under 6 years of age; and h) identification of person-level effect modifiers for people 6 years of age and older. In this article, we describe these future research needs in detail and discuss study designs that could be used to address them.

How Is Pelvic Pain Treated?

MedlinePlus

... chronic pelvic pain therapies for women: Comparative effectiveness (Comparative Effectiveness Review No. 41). Rockville, MD: Agency for Healthcare Research and Quality. National Kidney and Urologic Diseases Information ...

Good research practices for comparative effectiveness research: defining, reporting and interpreting nonrandomized studies of treatment effects using secondary data sources: the ISPOR Good Research Practices for Retrospective Database Analysis Task Force Report--Part I.

PubMed

Berger, Marc L; Mamdani, Muhammad; Atkins, David; Johnson, Michael L

2009-01-01

Health insurers, physicians, and patients worldwide need information on the comparative effectiveness and safety of prescription drugs in routine care. Nonrandomized studies of treatment effects using secondary databases may supplement the evidence based from randomized clinical trials and prospective observational studies. Recognizing the challenges to conducting valid retrospective epidemiologic and health services research studies, a Task Force was formed to develop a guidance document on state of the art approaches to frame research questions and report findings for these studies. The Task Force was commissioned and a Chair was selected by the International Society for Pharmacoeconomics and Outcomes Research Board of Directors in October 2007. This Report, the first of three reported in this issue of the journal, addressed issues of framing the research question and reporting and interpreting findings. The Task Force Report proposes four primary characteristics-relevance, specificity, novelty, and feasibility while defining the research question. Recommendations included: the practice of a priori specification of the research question; transparency of prespecified analytical plans, provision of justifications for any subsequent changes in analytical plan, and reporting the results of prespecified plans as well as results from significant modifications, structured abstracts to report findings with scientific neutrality; and reasoned interpretations of findings to help inform policy decisions. Comparative effectiveness research in the form of nonrandomized studies using secondary databases can be designed with rigorous elements and conducted with sophisticated statistical methods to improve causal inference of treatment effects. Standardized reporting and careful interpretation of results can aid policy and decision-making.

Comparative effectiveness research in practice and policy for radiation oncology.

PubMed

Lawrence, William F

2014-01-01

Interest in comparative effectiveness research (CER) has increased dramatically over the past decade, yet perceptions about what comprises CER varies. CER has several attributes relevant to practice and policy: (1) The goal of CER is to inform decisions about health care. (2) Literature synthesis is used in addition to primary research. (3) CER evaluates not only overall outcomes for the population but also evaluates subgroups that may have heterogeneous outcomes. (4) Research places an emphasis on outcomes in the "real-world" settings. (5) Outcomes studied should be relevant to patients. In radiation oncology, where many of the traditional clinical trials are comparative in nature, the line between CER and "traditional" research may be blurred, but an increased emphasis on CER can help to bridge the research enterprise and clinical practice, helping to inform decision making at the patient, clinician, and policy levels. © 2013 Published by Elsevier Inc.

Building electronic data infrastructure for comparative effectiveness research: accomplishments, lessons learned and future steps.

PubMed

Randhawa, Gurvaneet S

2014-11-01

There are large gaps in our knowledge on the potential impact of diagnostics and therapeutics on outcomes of patients treated in the real world. Comparative effectiveness research aims to fill these gaps to maximize effectiveness of these interventions. Health information technology has the potential to dramatically improve the practice of medicine and of research. This is an overview of about US$100 million of American Recovery and Reinvestment Act investment in 12 projects managed by the Agency for Healthcare Research and Quality to build an electronic clinical data infrastructure that connects research with healthcare delivery. The achievements and lessons learned from these projects provided a foundation for the National Patient-Centered Clinical Research Network (PCORnet)and will help to guide future infrastructure development needed to build an efficient, scalable and sustainable learning health system.

Instrumental variable methods in comparative safety and effectiveness research†

PubMed Central

Brookhart, M. Alan; Rassen, Jeremy A.; Schneeweiss, Sebastian

2010-01-01

Summary Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial. PMID:20354968

[Palliative care: an example of Comparative Effectiveness Research?].

PubMed

Schmacke, Norbert

2012-01-01

Comparative Effectiveness Research (CER) seeks to establish treatment objectives and concepts striving to achieve patient relevant progress in therapy on the basis of published evidence. Using the example of palliative medicine and palliative care, respectively, it will be demonstrated that these two are under-researched areas of care. In addition, it will become clear that the success of this interdisciplinary treatment concept for the seriously ill must be weighed in the light of traditional clinical research - far beyond the cancer diagnosis. The current distinction between curative and palliative research and care urgently needs to be reconsidered. Copyright © 2012. Published by Elsevier GmbH.

Applying comparative effectiveness research to public and population health initiatives.

PubMed

Teutsch, Steven M; Fielding, Jonathan E

2011-02-01

Comparative effectiveness research to date has focused primarily on the diagnosis and treatment of diseases and injuries in individuals. Yet the greatest drivers of people's overall health are found in their social and physical environments. We recommend that the comparative effectiveness research agenda focus on the public health issues responsible for the greatest overall illness and death levels, such as programs to increase high school graduation rates, which are strongly associated with improvements in long-term illness and death rates. In so doing, the agenda should spotlight efforts to address widely recognized social and environmental determinants of health, such as improving access to early childhood development programs and education, as well as interventions aimed at affecting climate change and addressing behavioral risk factors such as smoking. We also urge federal health agencies to invest in further development of methods to compare public health interventions and to use those methods to conduct the studies.

How Are Pelvic Floor Disorders Commonly Treated?

MedlinePlus

... incontinence in adult women: Diagnosis and comparative effectiveness. Comparative effectiveness review no. 36. Rockville, MD: Agency for Healthcare Research and Quality. National Kidney and Urologic Diseases Information ...

Prioritization of patient-centered comparative effectiveness research for osteoarthritis.

PubMed

Gierisch, Jennifer M; Myers, Evan R; Schmit, Kristine M; McCrory, Douglas C; Coeytaux, Remy R; Crowley, Matthew J; Chatterjee, Ranee; Kendrick, Amy S; Sanders, Gillian D

2014-06-17

Osteoarthritis is a leading cause of disability in the United States. This article describes a prioritized research agenda about osteoarthritis management developed for the Patient-Centered Outcomes Research Institute. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to expand and refine gaps. Stakeholders ranked evidence gaps by importance from their perspectives.Prioritized evidence gaps included the need to determine or evaluate key patient-centered outcomes; optimal duration, intensity, and frequency of nonsurgical interventions; whether the comparative effectiveness of nonsurgical interventions varies by socioeconomic factors; when and how to transition from nonsurgical to surgical interventions; effective ways to engage patients in self-management and promote long-term behavior change; standardized screening tools that improve early diagnosis; biomechanical strategies that improve symptoms; mechanisms for promoting and delivering coordinated, longitudinal care; and comparative effectiveness of nonsurgical therapies. Searches of PubMed and ClinicalTrials.gov showed many recent and ongoing studies addressing comparative effectiveness of nonsurgical interventions; relatively few of these evaluated treatments across categories (for example, drug therapy vs. weight management) or combined categories of treatment. Few studies addressed other high-priority evidence gaps.

Revisiting Fixed- and Random-Effects Models: Some Considerations for Policy-Relevant Education Research

ERIC Educational Resources Information Center

Clarke, Paul; Crawford, Claire; Steele, Fiona; Vignoles, Anna

2015-01-01

The use of fixed (FE) and random effects (RE) in two-level hierarchical linear regression is discussed in the context of education research. We compare the robustness of FE models with the modelling flexibility and potential efficiency of those from RE models. We argue that the two should be seen as complementary approaches. We then compare both…

Closing the information gap: informing better medical decisionmaking through the use of post-market safety and comparative effectiveness information.

PubMed

Fox, Bethany

2012-01-01

While FDA gathers vast amounts of data about prescription drugs prior to their marketing approval, important information about the relative effectiveness and long term safety of products is not required for approval, and often is never collected. Increased postmarket research on the safety and comparative effectiveness of products would improve medical decisionmaking and lead to better clinical outcomes. Fortunately, Congress has recognized the value of this information for healthcare professionals. In response to a congressional mandate in the FDA Amendments Act (FDAAA), FDA is developing the Sentinel Initiative, an active surveillance system for monitoring postmarket drug safety issues. FDAAA also authorized FDA to require a drug sponsor to conduct postmarket safety studies or clinical trials to address a specific safety concern. To increase the repository of comparative effectiveness information, Congress established the Patient-Centered Outcomes Research Institute (PCORI) in the Patient Protection and Affordable Care Act (PPACA), directing it to manage comparative effectiveness research (CER). This article discusses the need for better safety and comparative effectiveness information and outlines methods to efficiently conduct the research and communicate it effectively to healthcare professionals. Coordination between FDA and the PCORI in gathering and communicating postmarket information is recommended. Medical source data collected by the Sentinel Initiative should be used for CER in addition to postmarket safety surveillance, and FDA and the PCORI should adopt identical standards for the distribution and communication of CER. Coordination between the two entities is recommended to save costs, reduce duplication of efforts, and to generate and communicate more information on prescription drugs for medical decisionmakers.

Effect Sizes in Cluster-Randomized Designs

ERIC Educational Resources Information Center

Hedges, Larry V.

2007-01-01

Multisite research designs involving cluster randomization are becoming increasingly important in educational and behavioral research. Researchers would like to compute effect size indexes based on the standardized mean difference to compare the results of cluster-randomized studies (and corresponding quasi-experiments) with other studies and to…

Teaching Research to MSW Students: Effectiveness of the Team-Based Learning Pedagogy

ERIC Educational Resources Information Center

Macke, Caroline; Tapp, Karen

2012-01-01

Social work students often have been labeled as research-reluctant. Consequently, it is important to identify effective teaching strategies. One innovative strategy is team-based learning. The effectiveness of team-based learning has not yet been evaluated with a social work research class. As a result, the current study compared the effectiveness…

Outcomes of a pharmacotherapy/research rotation in a family medicine training program.

PubMed

Murphy, Julie A; Shrader, Sarah R; Montooth, Audrey K

2008-06-01

The effects of a required pharmacotherapy/research rotation in family medicine residency programs, precepted by a clinical pharmacist, have not been documented in the literature. This study evaluated the effects that a focused pharmacotherapy/research rotation had on family medicine residents' knowledge of pharmacotherapy and research topics. During the first year of a family medicine residency, 15 residents were required to complete 1 month in pharmacotherapy and research. They spent time observing a pharmacist-run clinic and discussing pharmacotherapy and research topics. Residents completed a 20-question pretest and a posttest consisting of 15 pharmacotherapy and five research questions while on the rotation. Higher scores on the tests indicated higher levels of knowledge. The differences in mean scores were evaluated using paired t tests. Overall, the mean score on the pretest was 10.13 compared to 14.67 on the posttest. Mean scores on the pharmacotherapy and research components for the pretests and posttests were 7.27 compared to 10.47 and 2.87 compared to 4.20, respectively. A focused pharmacotherapy/research rotation, precepted by a clinical pharmacist, increases family medicine residents' knowledge.

78 FR 22263 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... produce effectiveness and comparative effectiveness research. The Effective Health Care Program also... materials and translation products that are currently available are designed to help practicing clinicians... started developing some tools, such as faculty slide sets based on comparative effectiveness reviews of...

Attitudes toward comparative effectiveness research and patient engagement among reproductive health clinicians.

PubMed

Kohn, Julia; Unger, Zoe; Dolatshahi, Jennifer; Simons, Hannah; Rein, Alison

2017-06-01

To assess reproductive health clinicians' knowledge of and attitudes toward comparative effectiveness research (CER), patient-centered outcomes research (PCOR) and patient engagement in research. Web-based survey of reproductive health clinicians. Among 103 responding clinicians, familiarity with CER and PCOR was moderate (35 and 44%, respectively). Once definitions were provided, most respondents agreed with the potential positive impacts of CER and patient engagement (65-87%), the importance of PCOR (95-99%) and that their patients might be interested in engaging in research as more than subjects (93%). We found positive attitudes toward PCOR and CER, and a range of experiences with patient engagement in research. There may be untapped potential for PCOR and CER in the reproductive health field.

Treating Localized Prostate Cancer

MedlinePlus

... Prostate Cancer: Update of a 2008 Systematic Review . Comparative Effectiveness Review No. 146. (Prepared by the ECRI ... Prostate Cancer Research Protocol Archived March 29, 2013 Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer: ...

Rating the effectiveness of local tobacco policies for reducing youth smoking.

PubMed

Lipperman-Kreda, Sharon; Friend, Karen B; Grube, Joel W

2014-04-01

Important questions remain regarding the effectiveness of local tobacco policies for preventing and reducing youth tobacco use and the relative importance of these policies. The aims of this paper are to: (1) compare policy effectiveness ratings provided by researchers and tobacco prevention specialists for individual local tobacco policies, and (2) develop and describe a systematic approach to score communities for locally-implemented tobacco policies. We reviewed municipal codes of 50 California communities to identify local tobacco regulations in five sub-domains. We then developed an instrument to rate the effectiveness of these policies and administered it to an expert panel of 40 tobacco researchers and specialists. We compared mean policy effectiveness ratings obtained from researchers and prevention specialists and used it to score the 50 communities. High inter-rater reliabilities obtained for each sub-domain indicated substantial agreement among the raters about relative policy effectiveness. Results showed that, although researchers and prevention specialists differed on the mean levels of policy ratings, their relative rank ordering of the effectiveness of policy sub-domains were very similar. While both researchers and prevention specialists viewed local outdoor clean air policies as least effective in preventing and reducing youth cigarette smoking, they rated tobacco sales policies and advertising and promotion as more effective than the other policies. Moreover, we found high correlations between community scores generated from researchers' and prevention specialists' ratings. This approach can be used to inform research on local policies and prevention efforts and help bridge the gap between research and practice.

Study design elements for rigorous quasi-experimental comparative effectiveness research.

PubMed

Maciejewski, Matthew L; Curtis, Lesley H; Dowd, Bryan

2013-03-01

Quasi-experiments are likely to be the workhorse study design used to generate evidence about the comparative effectiveness of alternative treatments, because of their feasibility, timeliness, affordability and external validity compared with randomized trials. In this review, we outline potential sources of discordance in results between quasi-experiments and experiments, review study design choices that can improve the internal validity of quasi-experiments, and outline innovative data linkage strategies that may be particularly useful in quasi-experimental comparative effectiveness research. There is an urgent need to resolve the debate about the evidentiary value of quasi-experiments since equal consideration of rigorous quasi-experiments will broaden the base of evidence that can be brought to bear in clinical decision-making and governmental policy-making.

Comparative effectiveness research and big data: balancing potential with legal and ethical considerations.

PubMed

Gray, Elizabeth Alexandra; Thorpe, Jane Hyatt

2015-01-01

Big data holds big potential for comparative effectiveness research. The ability to quickly synthesize and use vast amounts of health data to compare medical interventions across settings of care, patient populations, payers and time will greatly inform efforts to improve quality, reduce costs and deliver more patient-centered care. However, the use of big data raises significant legal and ethical issues that may present barriers or limitations to the full potential of big data. This paper addresses the scope of some of these legal and ethical issues and how they may be managed effectively to fully realize the potential of big data.

Research on the Treatment of Couple Distress

ERIC Educational Resources Information Center

Lebow, Jay L.; Chambers, Anthony L.; Christensen, Andrew; Johnson, Susan M.

2012-01-01

This article reviews the research on couple therapy over the last decade. The research shows that couple therapy positively impacts 70% of couples receiving treatment. The effectiveness rates of couple therapy are comparable to the effectiveness rates of individual therapies and vastly superior to control groups not receiving treatment. The…

34 CFR 660.1 - What is the International Research and Studies Program?

Code of Federal Regulations, 2012 CFR

2012-07-01

... outcomes and effectiveness of supported programs; (f) Comparative studies of the effectiveness of... 34 Education 3 2012-07-01 2012-07-01 false What is the International Research and Studies Program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION THE INTERNATIONAL RESEARCH AND STUDIES PROGRAM...

34 CFR 660.1 - What is the International Research and Studies Program?

Code of Federal Regulations, 2013 CFR

2013-07-01

... outcomes and effectiveness of supported programs; (f) Comparative studies of the effectiveness of... 34 Education 3 2013-07-01 2013-07-01 false What is the International Research and Studies Program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION THE INTERNATIONAL RESEARCH AND STUDIES PROGRAM...

34 CFR 660.1 - What is the International Research and Studies Program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... outcomes and effectiveness of supported programs; (f) Comparative studies of the effectiveness of... 34 Education 3 2014-07-01 2014-07-01 false What is the International Research and Studies Program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION THE INTERNATIONAL RESEARCH AND STUDIES PROGRAM...

34 CFR 660.1 - What is the International Research and Studies Program?

Code of Federal Regulations, 2011 CFR

2011-07-01

... outcomes and effectiveness of supported programs; (f) Comparative studies of the effectiveness of... 34 Education 3 2011-07-01 2011-07-01 false What is the International Research and Studies Program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION THE INTERNATIONAL RESEARCH AND STUDIES PROGRAM...

34 CFR 660.1 - What is the International Research and Studies Program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... outcomes and effectiveness of supported programs; (f) Comparative studies of the effectiveness of... 34 Education 3 2010-07-01 2010-07-01 false What is the International Research and Studies Program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION THE INTERNATIONAL RESEARCH AND STUDIES PROGRAM...

Pre-study feasibility and identifying sensitivity analyses for protocol pre-specification in comparative effectiveness research.

PubMed

Girman, Cynthia J; Faries, Douglas; Ryan, Patrick; Rotelli, Matt; Belger, Mark; Binkowitz, Bruce; O'Neill, Robert

2014-05-01

The use of healthcare databases for comparative effectiveness research (CER) is increasing exponentially despite its challenges. Researchers must understand their data source and whether outcomes, exposures and confounding factors are captured sufficiently to address the research question. They must also assess whether bias and confounding can be adequately minimized. Many study design characteristics may impact on the results; however, minimal if any sensitivity analyses are typically conducted, and those performed are post hoc. We propose pre-study steps for CER feasibility assessment and to identify sensitivity analyses that might be most important to pre-specify to help ensure that CER produces valid interpretable results.

Higher motivation - greater control? The effect of arousal on judgement.

PubMed

Riemer, Hila; Viswanathan, Madhu

2013-01-01

This research examines control over the effect of arousal, a dimension of affect, on judgement. Past research shows that high processing motivation enhances control over the effects of affect on judgement. Isolating and studying arousal as opposed to valence, the other dimension of affect, and its effect on judgement, we identify boundary conditions for past findings. Drawing from the literature on processes by which arousal influences judgement, we demonstrate that the role of motivation is contingent upon the type of judgement task (i.e., memory- versus stimulus-based judgement). In stimulus-based judgement, individuals exert greater control over the effect of arousal on judgement under low compared to high motivation. In contrast, in memory-based judgement individuals exert greater control over the effect of arousal under high compared to low motivation. Theoretical implications and avenues for future research are discussed.

The COMET Sleep Research Platform.

PubMed

Nichols, Deborah A; DeSalvo, Steven; Miller, Richard A; Jónsson, Darrell; Griffin, Kara S; Hyde, Pamela R; Walsh, James K; Kushida, Clete A

2014-01-01

The Comparative Outcomes Management with Electronic Data Technology (COMET) platform is extensible and designed for facilitating multicenter electronic clinical research. Our research goals were the following: (1) to conduct a comparative effectiveness trial (CET) for two obstructive sleep apnea treatments-positive airway pressure versus oral appliance therapy; and (2) to establish a new electronic network infrastructure that would support this study and other clinical research studies. The COMET platform was created to satisfy the needs of CET with a focus on creating a platform that provides comprehensive toolsets, multisite collaboration, and end-to-end data management. The platform also provides medical researchers the ability to visualize and interpret data using business intelligence (BI) tools. COMET is a research platform that is scalable and extensible, and which, in a future version, can accommodate big data sets and enable efficient and effective research across multiple studies and medical specialties. The COMET platform components were designed for an eventual move to a cloud computing infrastructure that enhances sustainability, overall cost effectiveness, and return on investment.

The COMET Sleep Research Platform

PubMed Central

Nichols, Deborah A.; DeSalvo, Steven; Miller, Richard A.; Jónsson, Darrell; Griffin, Kara S.; Hyde, Pamela R.; Walsh, James K.; Kushida, Clete A.

2014-01-01

Introduction: The Comparative Outcomes Management with Electronic Data Technology (COMET) platform is extensible and designed for facilitating multicenter electronic clinical research. Background: Our research goals were the following: (1) to conduct a comparative effectiveness trial (CET) for two obstructive sleep apnea treatments—positive airway pressure versus oral appliance therapy; and (2) to establish a new electronic network infrastructure that would support this study and other clinical research studies. Discussion: The COMET platform was created to satisfy the needs of CET with a focus on creating a platform that provides comprehensive toolsets, multisite collaboration, and end-to-end data management. The platform also provides medical researchers the ability to visualize and interpret data using business intelligence (BI) tools. Conclusion: COMET is a research platform that is scalable and extensible, and which, in a future version, can accommodate big data sets and enable efficient and effective research across multiple studies and medical specialties. The COMET platform components were designed for an eventual move to a cloud computing infrastructure that enhances sustainability, overall cost effectiveness, and return on investment. PMID:25848590

Evaluating Differential Effects Using Regression Interactions and Regression Mixture Models

ERIC Educational Resources Information Center

Van Horn, M. Lee; Jaki, Thomas; Masyn, Katherine; Howe, George; Feaster, Daniel J.; Lamont, Andrea E.; George, Melissa R. W.; Kim, Minjung

2015-01-01

Research increasingly emphasizes understanding differential effects. This article focuses on understanding regression mixture models, which are relatively new statistical methods for assessing differential effects by comparing results to using an interactive term in linear regression. The research questions which each model answers, their…

Can we maximize both value and quality in gynecologic cancer care? A work in progress.

PubMed

Havrilesky, Laura J; Fountain, Cynthia

2014-01-01

Value is defined as desirable health outcomes achieved per monetary unit spent. Comparative effectiveness research and cost-effectiveness research are methods that have been developed to quantify effectiveness and value to inform management decisions. In this article we review the comparative and cost-effectiveness literature in the field of ovarian cancer treatment. Studies have shown that improved ovarian cancer survival is associated with complete primary surgical cytoreduction, with treatment at high volume facilities by subspecialist providers (gynecologic oncologists) and with National Comprehensive Cancer Network (NCCN) guideline-adherent care in both surgical staging and chemotherapy regimens. Intraperitoneal/intravenous chemotherapy (compared with intravenous alone) has been associated with improved survival and cost-effectiveness. Bevacizumab for primary and maintenance therapy has been found to not be cost-effective (even in selective subsets) despite a small progression-free survival (PFS) advantage. For platinum-sensitive recurrent ovarian cancer, secondary cytoreduction and platinum-based combinations are associated with improved overall survival (OS); several platinum-based combinations have also been found cost-effective. For platinum-resistant recurrence, single agent therapy and supportive care are cost-effective compared with combination therapies. Although little prospective clinical research has been done around end-of-life care, one study reported that for platinum-resistant ovarian cancer, palliative intervention would potentially reduce costs and increase quality adjusted life years compared with usual care (based on improvement in quality of life [QOL]). Overall, cost comparisons of individual chemotherapy regimens are highly dependent on market prices of novel therapeutic agents.

"Lies, damned lies ..." and observational studies in comparative effectiveness research.

PubMed

Albert, Richard K

2013-06-01

A new federal initiative has allocated $1.1 billion to comparative effectiveness research, and many have emphasized the importance of including observational studies in this effort. The rationale for using observational studies to assess comparative effectiveness is based on concerns that randomized controlled trials (RCTs) are not "real world" because they enroll homogeneous patient populations, measure study outcomes that are not important to patients, use protocols that are overly complex, are conducted in specialized centers, and use study treatments that are not consistent with usual care, and that RCTs are not always feasible because of a lack of equipoise, the need to assess delayed endpoints, and concerns that they take years to complete and are expensive. This essay questions the validity of each of these proposed limitations, summarizes concerns raised about the accuracy of results generated by observational studies, provides some examples of discrepancies between results of observational studies and RCTs that pertain to pulmonary and critical care, and suggests that using observational studies for comparative effectiveness research may increase rather than decrease the cost of health care and may harm patients.

Methods and impact of engagement in research, from theory to practice and back again: early findings from the Patient-Centered Outcomes Research Institute.

PubMed

Forsythe, Laura; Heckert, Andrea; Margolis, Mary Kay; Schrandt, Suzanne; Frank, Lori

2018-01-01

Since 2012, PCORI has been funding patient-centered comparative effectiveness research with a requirement for engaging patients and other stakeholders in the research, a requirement that is unique among the US funders of clinical research. This paper presents PCORI's evaluation framework for assessing the short- and long-term impacts of engagement; describes engagement in PCORI projects (types of stakeholders engaged, when in the research process they are engaged and how they are engaged, contributions of their engagement); and identifies the effects of engagement on study design, processes, and outcomes selection, as reported by both PCORI-funded investigators and patient and other stakeholder research partners. Detailed quantitative and qualitative information collected annually from investigators and their partners was analyzed via descriptive statistics and cross-sectional qualitative content and thematic analysis, and compared against the outcomes expected from the evaluation framework and its underlying conceptual model. The data support the role of engaged research partners in refinements to the research questions, selection of interventions to compare, choice of study outcomes and how they are measured, contributions to strategies for recruitment, and ensuring studies are patient-centered. The evaluation framework and the underlying conceptual model are supported by results to date. PCORI will continue to assess the effects of engagement as the funded projects progress toward completion, dissemination, and uptake into clinical decision making.

Causal Inference and the Comparative Interrupted Time Series Design: Findings from Within-Study Comparisons

ERIC Educational Resources Information Center

St. Clair, Travis; Hallberg, Kelly; Cook, Thomas D.

2014-01-01

Researchers are increasingly using comparative interrupted time series (CITS) designs to estimate the effects of programs and policies when randomized controlled trials are not feasible. In a simple interrupted time series design, researchers compare the pre-treatment values of a treatment group time series to post-treatment values in order to…

Using Bayesian Adaptive Trial Designs for Comparative Effectiveness Research: A Virtual Trial Execution.

PubMed

Luce, Bryan R; Connor, Jason T; Broglio, Kristine R; Mullins, C Daniel; Ishak, K Jack; Saunders, Elijah; Davis, Barry R

2016-09-20

Bayesian and adaptive clinical trial designs offer the potential for more efficient processes that result in lower sample sizes and shorter trial durations than traditional designs. To explore the use and potential benefits of Bayesian adaptive clinical trial designs in comparative effectiveness research. Virtual execution of ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) as if it had been done according to a Bayesian adaptive trial design. Comparative effectiveness trial of antihypertensive medications. Patient data sampled from the more than 42 000 patients enrolled in ALLHAT with publicly available data. Number of patients randomly assigned between groups, trial duration, observed numbers of events, and overall trial results and conclusions. The Bayesian adaptive approach and original design yielded similar overall trial conclusions. The Bayesian adaptive trial randomly assigned more patients to the better-performing group and would probably have ended slightly earlier. This virtual trial execution required limited resampling of ALLHAT patients for inclusion in RE-ADAPT (REsearch in ADAptive methods for Pragmatic Trials). Involvement of a data monitoring committee and other trial logistics were not considered. In a comparative effectiveness research trial, Bayesian adaptive trial designs are a feasible approach and potentially generate earlier results and allocate more patients to better-performing groups. National Heart, Lung, and Blood Institute.

It’s Your Game…Keep It Real: Can innovative public health prevention research thrive within a comparative effectiveness research framework?

PubMed Central

Shegog, Ross; Markham, Christine M.; Peskin, Melissa F.; Johnson, Kimberly; Cuccaro, Paula; Tortolero, Susan R.

2013-01-01

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It’s Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research. PMID:23344633

It's Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework?

PubMed

Shegog, Ross; Markham, Christine M; Peskin, Melissa F; Johnson, Kimberly; Cuccaro, Paula; Tortolero, Susan R

2013-04-01

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It's Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.

Inter-Method Reliability of School Effectiveness Measures: A Comparison of Value-Added and Regression Discontinuity Estimates

ERIC Educational Resources Information Center

Perry, Thomas

2017-01-01

Value-added (VA) measures are currently the predominant approach used to compare the effectiveness of schools. Recent educational effectiveness research, however, has developed alternative approaches including the regression discontinuity (RD) design, which also allows estimation of absolute school effects. Initial research suggests RD is a viable…

Observational methods in comparative effectiveness research.

PubMed

Concato, John; Lawler, Elizabeth V; Lew, Robert A; Gaziano, J Michael; Aslan, Mihaela; Huang, Grant D

2010-12-01

Comparative effectiveness research (CER) may be defined informally as an assessment of available options for treating specific medical conditions in selected groups of patients. In this context, the most prominent features of CER are the various patient populations, medical ailments, and treatment options involved in any particular project. Yet, each research investigation also has a corresponding study design or "architecture," and in patient-oriented research a common distinction used to describe such designs are randomized controlled trials (RCTs) versus observational studies. The purposes of this overview, with regard to CER, are to (1) understand how observational studies can provide accurate results, comparable to RCTs; (2) recognize strategies used in selected newer methods for conducting observational studies; (3) review selected observational studies from the Veterans Health Administration; and (4) appreciate the importance of fundamental methodological principles when conducting or evaluating individual studies. Published by Elsevier Inc.

Comparative effectiveness research and medical informatics.

PubMed

D'Avolio, Leonard W; Farwell, Wildon R; Fiore, Louis D

2010-12-01

As is the case for environmental, ecological, astronomical, and other sciences, medical practice and research finds itself in a tsunami of data. This data deluge, due primarily to the introduction of digitalization in routine medical care and medical research, affords the opportunity for improved patient care and scientific discovery. Medical informatics is the subdiscipline of medicine created to make greater use of information in order to improve healthcare. The 4 areas of medical informatics research (information access, structure, analysis, and interaction) are used as a framework to discuss the overlap in information needs of comparative effectiveness research and potential contributions of medical informatics. Examples of progress from the medical informatics literature and the Veterans Affairs Healthcare System are provided. Published by Elsevier Inc.

Lessons from comparative effectiveness research methods development projects funded under the Recovery Act.

PubMed

Zurovac, Jelena; Esposito, Dominick

2014-11-01

The American Recovery and Reinvestment Act of 2009 (ARRA) directed nearly US$29.2 million to comparative effectiveness research (CER) methods development. To help inform future CER methods investments, we describe the ARRA CER methods projects, identify barriers to this research and discuss the alignment of topics with published methods development priorities. We used several existing resources and held discussions with ARRA CER methods investigators. Although funded projects explored many identified priority topics, investigators noted that much work remains. For example, given the considerable investments in CER data infrastructure, the methods development field can benefit from additional efforts to educate researchers about the availability of new data sources and about how best to apply methods to match their research questions and data.

Comparative Effectiveness Research Through a Collaborative Electronic Reporting Consortium.

PubMed

Fiks, Alexander G; Grundmeier, Robert W; Steffes, Jennifer; Adams, William G; Kaelber, David C; Pace, Wilson D; Wasserman, Richard C

2015-07-01

The United States lacks a system to use routinely collected electronic health record (EHR) clinical data to conduct comparative effectiveness research (CER) on pediatric drug therapeutics and other child health topics. This Special Article describes the creation and details of a network of EHR networks devised to use clinical data in EHRs for conducting CER, led by the American Academy of Pediatrics Pediatric Research in Office Settings (PROS). To achieve this goal, PROS has linked data from its own EHR-based "ePROS" network with data from independent practices and health systems across the United States. Beginning with 4 of proof-of-concept retrospective CER studies on psychotropic and asthma medication use and side effects with a planned full-scale prospective CER study on treatment of pediatric hypertension, the Comparative Effectiveness Research Through Collaborative Electronic Reporting (CER(2)) collaborators are developing a platform to advance the methodology of pediatric pharmacoepidemiology. CER(2) will provide a resource for future CER studies in pediatric drug therapeutics and other child health topics. This article outlines the vision for and present composition of this network, governance, and challenges and opportunities for using the network to advance child health and health care. The goal of this network is to engage child health researchers from around the United States in participating in collaborative research using the CER(2) database. Copyright © 2015 by the American Academy of Pediatrics.

Comparative PV LCOE calculator | Photovoltaic Research | NREL

Science.gov Websites

Use the Comparative Photovoltaic Levelized Cost of Energy Calculator (Comparative PV LCOE Calculator) to calculate levelized cost of energy (LCOE) for photovoltaic (PV) systems based on cost effect on LCOE to determine whether a proposed technology is cost-effective, perform trade-off analysis

The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review.

PubMed

Topolovec-Vranic, Jane; Natarajan, Karthik

2016-11-07

Recruiting an adequate number of participants into medical research studies is challenging for many researchers. Over the past 10 years, the use of social media websites has increased in the general population. Consequently, social media websites are a new, powerful method for recruiting participants into such studies. The objective was to answer the following questions: (1) Is the use of social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods? Using the MEDLINE, PsycINFO, and EMBASE databases, all medical research studies that used social media and at least one other method for recruitment were identified. These studies were then categorized as either interventional studies or observational studies. For each study, the effectiveness of recruitment, demographic characteristics of the participants, and cost-effectiveness of recruitment using social media were evaluated and compared with that of the other methods used. The social media sites used in recruitment were identified, and if a study stated that the target population was "difficult to reach" as identified by the authors of the study, this was noted. Out of 30 studies, 12 found social media to be the most effective recruitment method, 15 did not, and 3 found social media to be equally effective as another recruitment method. Of the 12 studies that found social media to be the best recruitment method, 8 were observational studies while 4 were interventional studies. Of the 15 studies that did not find social media to be the best recruitment method, 7 were interventional studies while 8 were observational studies. In total, 8 studies stated that the target population was "hard-to-reach," and 6 of these studies found social media to be the most effective recruitment method. Out of 14 studies that reported demographic data for participants, 2 studies found that social media recruited a sample comparable to that recruited via traditional methods and 12 did not. Out of 13 studies that reported cost-effectiveness, 5 studies found social media to be the most cost-effective recruitment method, 7 did not, and 1 study found social media equally cost-effective as compared with other methods. Only 12 studies out of 30 found social media to be the most effective recruitment method. There is evidence that social media can be the best recruitment method for hard-to-reach populations and observational studies. With only 30 studies having compared recruitment through social media with other methods, more studies need to be done that report the effectiveness of recruitment for each strategy, demographics of participants recruited, and cost-effectiveness of each method. ©Jane Topolovec-Vranic, Karthik Natarajan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.11.2016.

Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

2012-01-01

Aims Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. Materials & methods The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. Results Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The ‘analytic-deliberative’ conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. Conclusion While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER. PMID:22707880

Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

2012-03-01

AIMS: Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. MATERIALS #ENTITYSTARTX00026; METHODS: The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. RESULTS: Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The 'analytic-deliberative' conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. CONCLUSION: While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER.

Does understanding relational terminology mediate effects of intervention on compare word problems?

PubMed

Schumacher, Robin F; Fuchs, Lynn S

2012-04-01

The purpose of this study was to assess whether understanding relational terminology (i.e., more, less, and fewer) mediates the effects of intervention on compare word problems. Second-grade classrooms (N=31) were randomly assigned to one of three conditions: researcher-designed word-problem intervention, researcher-designed calculation intervention, or business-as-usual (teacher-designed) control. Students in word-problem intervention classrooms received instruction on the compare problem type, which included a focus on understanding relational terminology within compare word problems. Analyses, which accounted for variance associated with classroom clustering, indicated that (a) compared with the calculation intervention and business-as-usual conditions, word-problem intervention significantly increased performance on all three subtypes of compare problems and on understanding relational terminology, and (b) the intervention effect was fully mediated by students' understanding of relational terminology for one subtype of compare problems and partially mediated by students' understanding of relational terminology for the other two subtypes. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

ERIC Educational Resources Information Center

Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

2014-01-01

While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

A CTSA Agenda to Advance Methods for Comparative Effectiveness Research

PubMed Central

Helfand, Mark; Tunis, Sean; Whitlock, Evelyn P.; Pauker, Stephen G.; Basu, Anirban; Chilingerian, Jon; Harrell Jr., Frank E.; Meltzer, David O.; Montori, Victor M.; Shepard, Donald S.; Kent, David M.

2011-01-01

Abstract Clinical research needs to be more useful to patients, clinicians, and other decision makers. To meet this need, more research should focus on patient‐centered outcomes, compare viable alternatives, and be responsive to individual patients’ preferences, needs, pathobiology, settings, and values. These features, which make comparative effectiveness research (CER) fundamentally patient‐centered, challenge researchers to adopt or develop methods that improve the timeliness, relevance, and practical application of clinical studies. In this paper, we describe 10 priority areas that address 3 critical needs for research on patient‐centered outcomes (PCOR): (1) developing and testing trustworthy methods to identify and prioritize important questions for research; (2) improving the design, conduct, and analysis of clinical research studies; and (3) linking the process and outcomes of actual practice to priorities for research on patient‐centered outcomes. We argue that the National Institutes of Health, through its clinical and translational research program, should accelerate the development and refinement of methods for CER by linking a program of methods research to the broader portfolio of large, prospective clinical and health system studies it supports. Insights generated by this work should be of enormous value to PCORI and to the broad range of organizations that will be funding and implementing CER. Clin Trans Sci 2011; Volume 4: 188–198 PMID:21707950

Increasing uptake of comparative effectiveness and patient-centered outcomes research among stakeholders: insights from conference discussion.

PubMed

Law, Ernest; Harrington, Rachel; Alexander, G Caleb; Saha, Soumi; Oehrlein, Elisabeth; Perfetto, Eleanor M

2018-02-01

The goal of comparative effectiveness research (CER) and patient-centered outcomes research (PCOR) is to improve health outcomes by providing stakeholders with evidence directly relevant to decision making. In January 2017, the Pharmaceutical Research and Manufacturers Association Foundation, alongside the Academy for Managed Care Pharmacy, organized a conference aimed at engaging experts and opinion leaders representing clinicians, patients and payers to identify and discuss barriers and strategies to enhancing uptake and use of CER/PCOR. This report summarizes the conference discussion in the following sections: preconference survey; summary of barriers and strategies to the uptake of CER/PCOR identified by conference attendees; and future perspectives on the field.

A translation table for patient-centered comparative effectiveness research: guidance to improve the value of research for clinical and health policy decision-making.

PubMed

Tunis, Sean R; Messner, Donna A; Mohr, Penny; Gliklich, Richard E; Dubois, Robert W

2012-05-01

This article provides background and context for a series of papers stemming from a collaborative effort by Outcome Sciences, Inc., the National Pharmaceutical Council and the Center for Medical Technology Policy to use a stakeholder-driven process to develop a decision tool to select appropriate methods for comparative effectiveness research. The perceived need and origins of the 'translation table' concept for method selection are described and the legislative history and role of the Patient-Centered Outcomes Research Institute are reviewed. The article concludes by stressing the significance of this effort for future health services and clinical research, and the importance of consulting end-users--patients, providers, payers and policy-makers--in the process of defining research questions and approaches to them.

Assessing the value of patient-generated data to comparative effectiveness research.

PubMed

Howie, Lynn; Hirsch, Bradford; Locklear, Tracie; Abernethy, Amy P

2014-07-01

The goal of comparative effectiveness research is to assess medical therapies and allow patients, health care providers, payers, and policy makers to make evidence-based decisions about the most appropriate therapies in routine clinical practice. To conduct this type of research and to inform health care delivery, data about the impact of interventions on patient outcomes are needed. Methods of generating evidence for comparative effectiveness research provide opportunities to engage patients and understand their experiences with illness and its treatment. In this article we assess the need for, uses of, and strengths and weaknesses of patient-generated data. We also review in brief federal and medical society efforts to create new streams of patient-generated data for clinical and research use. We observe that the key to high-quality patient-generated data is to have immediate and actionable data so that patients experience the importance of the data for their own care as well as research purposes. We conclude that leveraging the emerging wealth of "big data" being generated by patient-facing technologies such as systems to collect patient-reported outcomes data and patient-worn sensors is critical to developing the evidence base that informs decisions made by patients, providers, and policy makers in pursuit of high-value medical care. Project HOPE—The People-to-People Health Foundation, Inc.

The policy debate over public investment in comparative effectiveness research.

PubMed

Rich, Eugene C

2009-06-01

Policy makers across the political spectrum, as well as many clinicians and physician professional associations, have proposed that better information on comparative clinical effectiveness should be a key element of any solution to the US health-care cost crisis. This superficial consensus hides intense disagreements over critical issues essential to any new public effort to promote more comparative effectiveness research (CER). This article reviews the background for these disputes, summarizes the different perspectives represented by policy makers and advocates, and offers a framework to aid both practicing and academic internists in understanding the key elements of the emerging debate. Regarding the fundamental question of "what is CER," disagreements rage over whether value or cost effectiveness should be a consideration, and how specific patient perspectives should be reflected in the development and the use of such research. The question of how to pay for CER invokes controversies over the role of the market in producing such information and the private (e.g., insurers and employers) versus public responsibility for its production. The financing debate further highlights the high stakes of comparative effectiveness research, and the risks of stakeholder interests subverting any public process. Accordingly there are a range of proposals for the federal government's role in prioritization, development, and dissemination of CER. The internal medicine community, with its long history of commitment to scientific medical practice and its leadership in evidence-based medicine, should have a strong interest and play an active role in this debate.

A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network.

PubMed

Devine, Emily Beth; Alfonso-Cristancho, Rafael; Devlin, Allison; Edwards, Todd C; Farrokhi, Ellen T; Kessler, Larry; Lavallee, Danielle C; Patrick, Donald L; Sullivan, Sean D; Tarczy-Hornoch, Peter; Yanez, N David; Flum, David R

2013-08-01

To describe the inaugural comparative effectiveness research (CER) cohort study of Washington State's Comparative Effectiveness Research Translation Network (CERTAIN), which compares invasive with noninvasive treatments for peripheral artery disease, and to focus on the patient centeredness of this cohort study by describing it within the context of a newly published conceptual framework for patient-centered outcomes research (PCOR). The peripheral artery disease study was selected because of clinician-identified uncertainty in treatment selection and differences in desired outcomes between patients and clinicians. Patient centeredness is achieved through the "Patient Voices Project," a CERTAIN initiative through which patient-reported outcome (PRO) instruments are administered for research and clinical purposes, and a study-specific patient advisory group where patients are meaningfully engaged throughout the life cycle of the study. A clinician-led research advisory panel follows in parallel. Primary outcomes are PRO instruments that measure function, health-related quality of life, and symptoms, the latter developed with input from the patients. Input from the patient advisory group led to revised retention procedures, which now focus on short-term (3-6 months) follow-up. The research advisory panel is piloting a point-of-care, patient assessment checklist, thereby returning study results to practice. The cohort study is aligned with the tenets of one of the new conceptual frameworks for conducting PCOR. The CERTAIN's inaugural cohort study may serve as a useful model for conducting PCOR and creating a learning health care network. Copyright © 2013 Elsevier Inc. All rights reserved.

A Model for Incorporating Patient and Stakeholder Voices in a Learning Healthcare Network: Washington State’s Comparative Effectiveness Research Translation Network (CERTAIN)

PubMed Central

Devine, EB; Alfonso-Cristancho, R; Devlin, A; Edwards, TC; Farrokhi, ET; Kessler, L; Lavallee, DC; Patrick, DL; Sullivan, SD; Tarczy-Hornoch, P; Yanez, ND; Flum, DR

2014-01-01

Objective To describe the inaugural comparative effectiveness research (CER) cohort study of Washington State’s Comparative Effectiveness Research Translation Network (CERTAIN), which compares invasive to non-invasive treatments for peripheral artery disease; to focus on the patient-centeredness of this cohort study by describing it within the context of a newly published conceptual frameworks for patient-centered outcomes research (PCOR). Study Design and Setting The peripheral artery disease study was selected due to clinician-identified uncertainty in treatment selection and differences in desired outcomes between patients and clinicians. Patient-centeredness is achieved through the ‘Patient Voices Project’, a CERTAIN initiative through which patient-reported outcome (PRO) instruments are administered for research and clinical purposes, and a study-specific patient advisory group where patients are meaningfully engaged throughout the life cycle of the trial. A clinician-led research advisory panel follows in parallel. Results Primary outcomes are PRO instruments that measure function, health-related quality of life, and symptoms; the latter developed with input from patients. Input from the patient advisory group led to revised retention procedures, which now focus on short-term (3–6 months) follow-up. The research advisory panel is piloting a point-of-care, patient assessment checklist, there by returning study results to practice. The cohort study is aligned with the tenets of one of the new conceptual frameworks for conducting PCOR. Conclusion CERTAIN’s inaugural cohort study may serve as a useful model for conducting PCOR and creating a Learning Healthcare Network. PMID:23849146

Allergic Responses Induced by a Fungal Biopesticide Metarhizium anisopliae and House Dust Mite are Compared in a Mouse Model

EPA Science Inventory

Biopesticides can be effective in controlling their target pest. However, research regarding mammalian health impacts of these agents has focused on toxicity and pathogenicity, with limited research regarding allergenicity and asthma development. We compared the ability of funga...

Application of Hierarchical Linear Models/Linear Mixed-Effects Models in School Effectiveness Research

ERIC Educational Resources Information Center

Ker, H. W.

2014-01-01

Multilevel data are very common in educational research. Hierarchical linear models/linear mixed-effects models (HLMs/LMEs) are often utilized to analyze multilevel data nowadays. This paper discusses the problems of utilizing ordinary regressions for modeling multilevel educational data, compare the data analytic results from three regression…

Translating comparative effectiveness research into Medicaid payment policy: views from medical and pharmacy directors.

PubMed

Weissman, Joel S; Westrich, Kimberly; Hargraves, J Lee; Pearson, Steven D; Dubois, Robert; Emond, Sarah; Olufajo, Olubode A

2015-03-01

As the USA seeks to expand the conduct and dissemination of comparative effectiveness research (CER), views of key stakeholders will help guide the way. We surveyed 60 medical and pharmacy directors from 46 state Medicaid programs. Over 90% felt that CER would lead to better clinical decision-making and overall value within 5 years and were willing to consider cost-effectiveness in setting medical policy. However, perceived poor quality, inconclusive research, restrictive legislative mandates, lack of budget impact and coverage recommendations, and lack of an independent body to interpret study results were major barriers cited to using CER evidence. Given the significant resources being invested in CER, it is critical that these barriers are overcome to maximize its usefulness for stakeholders.

Leveraging EHR Data for Outcomes and Comparative Effectiveness Research in Oncology

PubMed Central

Harris, Marcelline R.; Buyuktur, Ayse G.; Clark, Patricia M.; An, Lawrence C.; Hanauer, David A.

2012-01-01

Along with the increasing adoption of electronic health records (EHRs) are expectations that data collected within EHRs will be readily available for outcomes and comparative effectiveness research. Yet the ability to effectively share and reuse data depends on implementing and configuring EHRs with these goals in mind from the beginning. Data sharing and integration must be planned both locally as well as nationally. The rich data transmission and semantic infrastructure developed by the National Cancer Institute (NCI) for research provides an excellent example of moving beyond paper-based paradigms and exploiting the power of semantically robust, network-based systems, and engaging both domain and informatics expertise. Similar efforts are required to address current challenges in sharing EHR data. PMID:22948276

Comparing Indirect Effects in SEM: A Sequential Model Fitting Method Using Covariance-Equivalent Specifications

ERIC Educational Resources Information Center

Chan, Wai

2007-01-01

In social science research, an indirect effect occurs when the influence of an antecedent variable on the effect variable is mediated by an intervening variable. To compare indirect effects within a sample or across different samples, structural equation modeling (SEM) can be used if the computer program supports model fitting with nonlinear…

Comparing three knowledge communication strategies - Diffusion, Dissemination and Translation - through randomized controlled studies.

PubMed

Lane, Joseph P; Stone, Vathsala I

2015-01-01

This paper describes a series of three randomized controlled case studies comparing the effectiveness of three strategies for communicating new research-based knowledge (Diffusion, Dissemination, Translation), to different Assistive Technology (AT) stakeholder groups. Pre and post intervention measures for level of knowledge use (unaware, aware, interested, using) via the LOKUS instrument, assessed the relative effectiveness of the three strategies. The latter two approaches were both more effective than diffusion but also equally effective. The results question the value added by tailoring research findings to specific audiences, and instead supports the critical yet neglected role for relevance in determining knowledge use by stakeholders.

Meta-analysis of the effectiveness of computer-based laboratory versus traditional hands-on laboratory in college and pre-college science instructions

NASA Astrophysics Data System (ADS)

Onuoha, Cajetan O.

The purpose of this research study was to determine the overall effectiveness of computer-based laboratory compared with the traditional hands-on laboratory for improving students' science academic achievement and attitudes towards science subjects at the college and pre-college levels of education in the United States. Meta-analysis was used to synthesis the findings from 38 primary research studies conducted and/or reported in the United States between 1996 and 2006 that compared the effectiveness of computer-based laboratory with the traditional hands-on laboratory on measures related to science academic achievements and attitudes towards science subjects. The 38 primary research studies, with total subjects of 3,824 generated a total of 67 weighted individual effect sizes that were used in this meta-analysis. The study found that computer-based laboratory had small positive effect sizes over the traditional hands-on laboratory (ES = +0.26) on measures related to students' science academic achievements and attitudes towards science subjects (ES = +0.22). It was also found that computer-based laboratory produced more significant effects on physical science subjects compared to biological sciences (ES = +0.34, +0.17).

Falsification Testing of Instrumental Variables Methods for Comparative Effectiveness Research.

PubMed

Pizer, Steven D

2016-04-01

To demonstrate how falsification tests can be used to evaluate instrumental variables methods applicable to a wide variety of comparative effectiveness research questions. Brief conceptual review of instrumental variables and falsification testing principles and techniques accompanied by an empirical application. Sample STATA code related to the empirical application is provided in the Appendix. Comparative long-term risks of sulfonylureas and thiazolidinediones for management of type 2 diabetes. Outcomes include mortality and hospitalization for an ambulatory care-sensitive condition. Prescribing pattern variations are used as instrumental variables. Falsification testing is an easily computed and powerful way to evaluate the validity of the key assumption underlying instrumental variables analysis. If falsification tests are used, instrumental variables techniques can help answer a multitude of important clinical questions. © Health Research and Educational Trust.

75 FR 13293 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

..., and initiatives. The agenda will include a progress report on Comparative Effectiveness Research (CER... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and...

The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review

PubMed Central

2016-01-01

Background Recruiting an adequate number of participants into medical research studies is challenging for many researchers. Over the past 10 years, the use of social media websites has increased in the general population. Consequently, social media websites are a new, powerful method for recruiting participants into such studies. Objective The objective was to answer the following questions: (1) Is the use of social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods? Methods Using the MEDLINE, PsycINFO, and EMBASE databases, all medical research studies that used social media and at least one other method for recruitment were identified. These studies were then categorized as either interventional studies or observational studies. For each study, the effectiveness of recruitment, demographic characteristics of the participants, and cost-effectiveness of recruitment using social media were evaluated and compared with that of the other methods used. The social media sites used in recruitment were identified, and if a study stated that the target population was “difficult to reach” as identified by the authors of the study, this was noted. Results Out of 30 studies, 12 found social media to be the most effective recruitment method, 15 did not, and 3 found social media to be equally effective as another recruitment method. Of the 12 studies that found social media to be the best recruitment method, 8 were observational studies while 4 were interventional studies. Of the 15 studies that did not find social media to be the best recruitment method, 7 were interventional studies while 8 were observational studies. In total, 8 studies stated that the target population was “hard-to-reach,” and 6 of these studies found social media to be the most effective recruitment method. Out of 14 studies that reported demographic data for participants, 2 studies found that social media recruited a sample comparable to that recruited via traditional methods and 12 did not. Out of 13 studies that reported cost-effectiveness, 5 studies found social media to be the most cost-effective recruitment method, 7 did not, and 1 study found social media equally cost-effective as compared with other methods. Conclusions Only 12 studies out of 30 found social media to be the most effective recruitment method. There is evidence that social media can be the best recruitment method for hard-to-reach populations and observational studies. With only 30 studies having compared recruitment through social media with other methods, more studies need to be done that report the effectiveness of recruitment for each strategy, demographics of participants recruited, and cost-effectiveness of each method. PMID:27821383

Applying comparative effectiveness research methods in bipolar disorders.

PubMed

McCombs, Jeffrey S; Ganapathy, Vaidyanathan; Zolfaghari, Sara

2011-04-01

Randomized clinical trials [RCT] are the Gold Standard of medical evidence. However, observational comparative effectiveness research [CER] based on real-world data is receiving national attention. This paper demonstrates how observational CER can fill important gaps in clinical knowledge left behind by RCT approaches. An example of CER in bipolar disorders is presented. Paid claims data from a large commercial insurer were used to identify episodes of drug therapy. Episodes were defined each time a patient initiated or restarted therapy using an antipsychotic, antidepressant or mood stabilizing medication. Episode definitions were based on calculations of continuous days of drug therapy using a 15 day gap definition. 105,440 episodes of drug therapy were included in the analysis. Most episodes were initiated using a mood stabilizing drug (40%) or an antidepressant (40%). Over 59% of all episodes were for augmentation therapy, followed by switching episodes (25%) and restart episodes (16%). Patient outcomes measured by either duration of uninterrupted therapy or one-year post-treatment cost varied significantly with patient treatment history, especially episode type. The comparative effectiveness of alternative therapies was sensitive to the extent to which treatment history is taken into account. Observational research can evaluate patient outcomes across a wide range of clinical presentations with regard to the patient's treatment history. Treatment history is a major determinant of patient compliance and future treatment costs. Failure to account for treatment history can introduce bias into comparative effectiveness results. Observational CER research can also uncover important questions that require future research. Copyright © 2010 Elsevier B.V. All rights reserved.

Public perceptions of comparative effectiveness research and use of evidence in healthcare decision-making.

PubMed

Cornwell, Derekh; Hu, Mindy; Esposito, Dominick

2014-11-01

This study elaborates on the public's understanding of comparative effectiveness research (CER) or patient-centered outcomes research (PCOR), attitudes toward CER/PCOR and use of evidence in healthcare decision-making. We conducted six focus groups with the general public - three with individuals actively engaged in healthcare decision-making and three with individuals more passive in their approach. The general public has little knowledge of CER/PCOR, and its perceptions of certain CER/PCOR concepts are inconsistent with those of researchers and policy-makers. Active healthcare consumers value information more than passive consumers and are likely to use evidence in decision-making. Providers are an important source for disseminating and communicating CER/PCOR evidence to active and passive consumers.

Optimizing health information technology's role in enabling comparative effectiveness research.

PubMed

Navathe, Amol S; Conway, Patrick H

2010-12-01

Health information technology (IT) is a key enabler of comparative effectiveness research (CER). Health IT standards for data sharing are essential to advancing the research data infrastructure, and health IT is critical to the next step of incorporating clinical data into data sources. Four key principles for advancement of CER are (1) utilization of data as a strategic asset, (2) leveraging public-private partnerships, (3) building robust, scalable technology platforms, and (4) coordination of activities across government agencies. To maximize the value of the resources, payers and providers must contribute data to initiatives, engage with government agencies on lessons learned, continue to develop new technologies that address key challenges, and utilize the data to improve patient outcomes and conduct research.

Effectiveness of project ACORDE materials: applied evaluative research in a preclinical technique course.

PubMed

Shugars, D A; Trent, P J; Heymann, H O

1979-08-01

Two instructional strategies, the traditional lecture method and a standardized self-instructional (ACORDE) format, were compared for efficiency and perceived usefulness in a preclinical restorative dentistry technique course through the use of a posttest-only control group research design. Control and experimental groups were compared on (a) technique grades, (b) didactic grades, (c) amount of time spent, (d) student and faculty perceptions, and (e) observation of social dynamics. The results of this study demonstrated the effectiveness of Project ACORDE materials in teaching dental students, provided an example of applied research designed to test contemplated instructional innovations prior to use and used a method which highlighted qualitative, as well as quantitative, techniques for data gathering in applied research.

IMPACCT Kids’ Care: a real-world example of stakeholder involvement in comparative effectiveness research

PubMed Central

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-01-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement. PMID:26274796

Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness.

PubMed

Cragun, Deborah; Pal, Tuya; Vadaparampil, Susan T; Baldwin, Julie; Hampel, Heather; DeBate, Rita D

2016-07-01

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research , this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.

Caveats for the Use of Operational Electronic Health Record Data in Comparative Effectiveness Research

PubMed Central

Hersh, William R.; Weiner, Mark G.; Embi, Peter J.; Logan, Judith R.; Payne, Philip R.O.; Bernstam, Elmer V.; Lehmann, Harold P.; Hripcsak, George; Hartzog, Timothy H.; Cimino, James J.; Saltz, Joel H.

2013-01-01

The growing amount of data in operational electronic health record (EHR) systems provides unprecedented opportunity for its re-use for many tasks, including comparative effectiveness research (CER). However, there are many caveats to the use of such data. EHR data from clinical settings may be inaccurate, incomplete, transformed in ways that undermine their meaning, unrecoverable for research, of unknown provenance, of insufficient granularity, and incompatible with research protocols. However, the quantity and real-world nature of these data provide impetus for their use, and we develop a list of caveats to inform would-be users of such data as well as provide an informatics roadmap that aims to insure this opportunity to augment CER can be best leveraged. PMID:23774517

IMPACCT Kids' Care: a real-world example of stakeholder involvement in comparative effectiveness research.

PubMed

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-08-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement.

Traumatic Brain Injury Rehabilitation Comparative Effectiveness Research: Introduction to the Traumatic Brain Injury-Practice Based Evidence Archives Supplement.

PubMed

Horn, Susan D; Corrigan, John D; Dijkers, Marcel P

2015-08-01

This supplement of the Archives of Physical Medicine and Rehabilitation is devoted to the Traumatic Brain Injury-Practice Based Evidence study, the first practice-based evidence study, to our knowledge, of traumatic brain injury rehabilitation. The purpose of this preface is to place this study in the broader context of comparative effectiveness research and introduce the articles in the supplement. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Effects of Student Involvement and College Environment on Students' Learning and Living Experience at World-Class Research Universities in China: A Comparative Case Study of the University of Hong Kong (HKU) and Shanghai Jiao Tong University (SJTU)

ERIC Educational Resources Information Center

Chan, Roy Yew-Hung

2011-01-01

This comparative research examined the effects of student involvement and college environment on students' learning and living experience delivered by two aspiring world-class universities in Hong Kong and Shanghai. Few studies have shown how the levels of student involvement and college environment can benefit students at world-class institution.…

Opportunities and Challenges in Using Studies without a Control Group in Comparative Effectiveness Reviews

ERIC Educational Resources Information Center

Paulus, Jessica K.; Dahabreh, Issa J.; Balk, Ethan M.; Avendano, Esther E.; Lau, Joseph; Ip, Stanley

2014-01-01

When examining the evidence on therapeutic interventions to answer a comparative effectiveness research question, one should consider all studies that are informative on the interventions' causal effects. "Single group studies" evaluate outcomes longitudinally in cohorts of subjects who are managed with a single treatment strategy.…

Comparing Effectiveness of Undergraduate Course Delivery: A Student Perspective

ERIC Educational Resources Information Center

Koenig, Robert J.

2009-01-01

Higher education students can and do take courses delivered in a variety of ways. But, to date, little research has been done on the effectiveness of different delivery modes. This study sought to fill that void by comparing the effectiveness of three undergraduate course delivery modes: classroom, online, and video conference at a technical…

Teachers' Perceptions of Effective Teaching: A Comparative Study of Elementary School Teachers from China and the USA

ERIC Educational Resources Information Center

Meng, Lingqi; Muñoz, Marco

2016-01-01

This international study investigated Chinese and American elementary school teachers' perceptions of effective teaching. The sample comprised Chinese (n = 108) and US (n = 110) participating teachers. The Effective Teaching Quality Survey (ETQS) was adopted for this comparative education research, an instrument that operationalized Stronge's…

Future Directions for Cardiovascular Disease Comparative Effectiveness Research

PubMed Central

Hlatky, Mark A; Douglas, Pamela S; Cook, Nakela L; Wells, Barbara; Benjamin, Emelia J; Dickersin, Kay; Goff, David C; Hirsch, Alan T; Hylek, Elaine M; Peterson, Eric; Roger, Véronique L; Selby, Joseph V; Udelson, James E; Lauer, Michael S

2012-01-01

Comparative effectiveness research (CER) aims to provide decision-makers the evidence needed to evaluate the benefits and harms of alternative clinical management strategies. CER has become a national priority, with considerable new research funding allocated. Cardiovascular disease is a priority area for CER. This workshop report provides an overview of CER methods, with an emphasis on practical clinical trials and observational treatment comparisons. The report also details recommendations to the National Heart Lung and Blood Institute for a new framework for evidence development to foster cardiovascular CER, and specific studies to address eight clinical issues identified by the Institute of Medicine as high priorities for cardiovascular CER. PMID:22796257

What can comparative effectiveness research, propensity score and registry study bring to Chinese medicine?

PubMed

Liao, Xing; Xie, Yan-ming

2014-10-01

The impact of evidence-based medicine and clinical epidemiology on clinical research has contributed to the development of Chinese medicine in modern times over the past two decades. Many concepts and methods of modern science and technology are emerging in Chinese medicine research, resulting in constant progress. Systematic reviews, randomized controlled trials and other advanced mathematic approaches and statistical analysis methods have brought reform to Chinese medicine. In this new era, Chinese medicine researchers have many opportunities and challenges. On the one hand, Chinese medicine researchers need to dedicate themselves to providing enough evidence to the world through rigorous studies, whilst on the other hand, they also need to keep up with the speed of modern medicine research. For example, recently, real world study, comparative effectiveness research, propensity score techniques and registry study have emerged. This article aims to inspire Chinese medicine researchers to explore new areas by introducing these new ideas and new techniques.

76 FR 70456 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

... in developing mechanisms for reviewing and disseminating Comparative Effectiveness Research (CER) and... through its Effective Healthcare Program (EHCP). CER directly compares the benefits, potential risks, and... augment AHRQ's existing CER dissemination efforts performed by the Eisenberg Center and other initiatives...

A Quantitative Comparative Study Measuring Consumer Satisfaction Based on Health Record Format

ERIC Educational Resources Information Center

Moore, Vivianne E.

2013-01-01

This research study used a quantitative comparative method to investigate the relationship between consumer satisfaction and communication based on the format of health record. The central problem investigated in this research study related to the format of health record used and consumer satisfaction with care provided and effect on communication…

The Effects of International Mobility on European Researchers: Comparing Intra-EU and U.S. Mobility

ERIC Educational Resources Information Center

Veugelers, Reinhilde; Van Bouwel, Linda

2015-01-01

Using econometric analysis on survey data from European-born and European-educated researchers who are internationally mobile after their PhD within Europe or to the United States, we find significant positive effects from international mobility on scientific productivity, as well as several other positive career development effects. European…

Effect Size in Single-Case Research: A Review of Nine Nonoverlap Techniques

ERIC Educational Resources Information Center

Parker, Richard I.; Vannest, Kimberly J.; Davis, John L.

2011-01-01

With rapid advances in the analysis of data from single-case research designs, the various behavior-change indices, that is, effect sizes, can be confusing. To reduce this confusion, nine effect-size indices are described and compared. Each of these indices examines data nonoverlap between phases. Similarities and differences, both conceptual and…

Developments in Post-marketing Comparative Effectiveness Research

PubMed Central

S, Schneeweiss

2010-01-01

Physicians and insurers need to weigh the effectiveness of new drugs against existing therapeutics in routine care to make decisions about treatment and formularies. Because Food and Drug Administration (FDA) approval of most new drugs requires demonstrating efficacy and safety against placebo, there is limited interest by manufacturers in conducting such head-to-head trials. Comparative effectiveness research seeks to provide head-to-head comparisons of treatment outcomes in routine care. Health-care utilization databases record drug use and selected health outcomes for large populations in a timely way and reflect routine care, and therefore may be the preferred data source for comparative effectiveness research. Confounding caused by selective prescribing based on indication, severity, and prognosis threatens the validity of non-randomized database studies that often have limited details on clinical information. Several recent developments may bring the field closer to acceptable validity, including approaches that exploit the concepts of proxy variables using high-dimensional propensity scores, within-patient variation of drug exposure using crossover designs, and between-provider variation in prescribing preference using instrumental variable (IV) analyses. PMID:17554243

Developments in post-marketing comparative effectiveness research.

PubMed

Schneeweiss, S

2007-08-01

Physicians and insurers need to weigh the effectiveness of new drugs against existing therapeutics in routine care to make decisions about treatment and formularies. Because Food and Drug Administration (FDA) approval of most new drugs requires demonstrating efficacy and safety against placebo, there is limited interest by manufacturers in conducting such head-to-head trials. Comparative effectiveness research seeks to provide head-to-head comparisons of treatment outcomes in routine care. Health-care utilization databases record drug use and selected health outcomes for large populations in a timely way and reflect routine care, and therefore may be the preferred data source for comparative effectiveness research. Confounding caused by selective prescribing based on indication, severity, and prognosis threatens the validity of non-randomized database studies that often have limited details on clinical information. Several recent developments may bring the field closer to acceptable validity, including approaches that exploit the concepts of proxy variables using high-dimensional propensity scores, within-patient variation of drug exposure using crossover designs, and between-provider variation in prescribing preference using instrumental variable (IV) analyses.

Comparative effectiveness research in the U.S.A.: when will there be an impact on healthcare decision-making?

PubMed

Westrich, Kimberly D; Wilhelm, Jess A; Schur, Claudia L

2016-03-01

Five annual surveys of healthcare decision-makers potentially affected by comparative effectiveness research (CER) indicate sustained recognition of its importance and potential impact. Initial expectations of immediate CER impact have over time turned to stakeholder assessments of little short-term impact. In successive surveys, they project a continuous horizon of 3-5 years for CER to have a moderate or substantial improvement in decision making. The prominence of Patient-Centered Outcomes Research Institute in CER is highlighted by stakeholders, but greater emphasis on translating and disseminating research findings is needed, a role in which Agency for Healthcare Research and Quality is expected to contribute. Stakeholders, including patients, must be engaged throughout to ensure that findings provide the flexibility for decision makers to apply them to their patient populations.

Comparative effectiveness: its role in the healthcare system.

PubMed

Brown, Melissa M; Luo, Betsy; Brown, Heidi C; Brown, Gary C

2009-05-01

To describe comparative effectiveness and assess its role in crafting new healthcare policy. Senate Bill S.3408 would establish a nongovernment-affiliated Healthcare Comparative Effectiveness Research Institute that would work with healthcare experts and stakeholders in healthcare to prioritize interventions and services to be studied. A value-based medicine system of standardized comparative effectiveness and cost-effectiveness data using utilities would allow physicians to assess the total value (improvement in quality of life and/or length of life) conferred by interventions. Standardized comparativeness and cost-effectiveness data will give physicians an information system to identify the interventions that confer the greatest value to patients, and thus deliver higher quality care than possible with evidence-based data alone while allowing the most cost-effective care.

The Effects of L1 and L2 e-Glosses on Incidental Vocabulary Learning of Junior High-School English Students

ERIC Educational Resources Information Center

Hu, Si-Min; Vongpumivitch, Viphavee; Chang, Jason S.; Liou, Hsien-Chin

2014-01-01

While researchers have examined the effectiveness of various online gloss types on incidental L2 vocabulary learning, little research on online gloss languages has been conducted. Previous attempts which compared the effects of L1 and L2 glosses have reported mixed results. To fill the gaps, this study examined the effectiveness of Chinese and…

Comparison of Measures of Organizational Effectiveness in U.K. Higher Education.

ERIC Educational Resources Information Center

Lysons, Art; Hatherly, David; Mitchell, David A.

1998-01-01

Research on the organizational effectiveness of higher education institutions in the United Kingdom and Australia is compared with research on United States higher education. Focus is on identification of and statistical discrimination between institution types, based on faculty and administrator perceptions and values. (MSE)

"Big" versus "little" science: comparative analysis of program projects and individual research grants.

PubMed

Baumeister, A A; Bacharach, V R; Baumeister, A A

1997-11-01

Controversy about the amount and nature of funding for mental retardation research has persisted since the creation of NICHD. An issue that has aroused considerable debate, within the mental retardation research community as well as beyond, is distribution of funds between large group research grants, such as the program project (PO1) and the individual grant (RO1). Currently within the Mental Retardation and Developmental Disabilities Branch, more money is allocated to the PO1 mechanism than the RO1. We compared the two types of grants, focusing on success rates, productivity, costs, impact, publication practices, and outcome and conducted a comparative analysis of biomedical and behavioral research. Other related issues were considered, including review processes and cost-effectiveness.

Choosing Assessment Instruments for Anxiety Practice and Outcome Research with School-Aged Youth

ERIC Educational Resources Information Center

Erford, Bradley T.; Lutz, Julie A.

2015-01-01

Using effect size results from our meta-analysis for the treatment of anxiety in school-aged youth, the practical and technical aspects of five commonly used anxiety instruments were analyzed, and effect size estimates compared to indicate the best choices for use in anxiety outcome research.

Effects of Example Variability and Prior Knowledge in How Students Learn to Solve Equations

ERIC Educational Resources Information Center

Guo, Jian-Peng; Yang, Ling-Yan; Ding, Yi

2014-01-01

Researchers have consistently demonstrated that multiple examples are better than one example in facilitating learning because the comparison evoked by multiple examples supports learning and transfer. However, research outcomes are unclear regarding the effects of example variability and prior knowledge on learning from comparing multiple…

Ethics and Regulatory Challenges and Opportunities in Patient-Centered Comparative Effectiveness Research.

PubMed

Sugarman, Jeremy

2016-04-01

The Affordable Care Act includes provisions for the conduct of large-scale, patient-centered comparative effectiveness research. Such efforts aim toward the laudable moral goal of having evidence to improve health care decision making. Nevertheless, these pragmatic clinical research efforts that typically pose minimal incremental risk and are enmeshed in routine care settings perhaps surprisingly encounter an array of ethics and regulatory challenges and opportunities for academic health centers. An emphasis on patient-centeredness forces an examination of the appropriateness of traditional methods used to protect the rights, interests, and welfare of participants. At the same time, meaningful collaboration with patients throughout the research process also necessitates ensuring that novel approaches to research (including recruitment and consent) entail necessary protections regarding such issues as privacy. As the scientific and logistical aspects of this research are being developed, substantial attention is being focused on the accompanying ethics and regulatory issues that have emerged, which should help to facilitate ethically appropriate research in a variety of contexts.

Approaches to answering critical CER questions.

PubMed

Kinnier, Christine V; Chung, Jeanette W; Bilimoria, Karl Y

2015-01-01

While randomized controlled trials (RCTs) are the gold standard for research, many research questions cannot be ethically and practically answered using an RCT. Comparative effectiveness research (CER) techniques are often better suited than RCTs to address the effects of an intervention under routine care conditions, an outcome otherwise known as effectiveness. CER research techniques covered in this section include: effectiveness-oriented experimental studies such as pragmatic trials and cluster randomized trials, treatment response heterogeneity, observational and database studies including adjustment techniques such as sensitivity analysis and propensity score analysis, systematic reviews and meta-analysis, decision analysis, and cost effectiveness analysis. Each section describes the technique and covers the strengths and weaknesses of the approach.

Cluster randomized trials in comparative effectiveness research: randomizing hospitals to test methods for prevention of healthcare-associated infections.

PubMed

Platt, Richard; Takvorian, Samuel U; Septimus, Edward; Hickok, Jason; Moody, Julia; Perlin, Jonathan; Jernigan, John A; Kleinman, Ken; Huang, Susan S

2010-06-01

The need for evidence about the effectiveness of therapeutics and other medical practices has triggered new interest in methods for comparative effectiveness research. Describe an approach to comparative effectiveness research involving cluster randomized trials in networks of hospitals, health plans, or medical practices with centralized administrative and informatics capabilities. We discuss the example of an ongoing cluster randomized trial to prevent methicillin-resistant Staphylococcus aureus (MRSA) infection in intensive care units (ICUs). The trial randomizes 45 hospitals to: (a) screening cultures of ICU admissions, followed by Contact Precautions if MRSA-positive, (b) screening cultures of ICU admissions followed by decolonization if MRSA-positive, or (c) universal decolonization of ICU admissions without screening. All admissions to adult ICUs. The primary outcome is MRSA-positive clinical cultures occurring >or=2 days following ICU admission. Secondary outcomes include blood and urine infection caused by MRSA (and, separately, all pathogens), as well as the development of resistance to decolonizing agents. Recruitment of hospitals is complete. Data collection will end in Summer 2011. This trial takes advantage of existing personnel, procedures, infrastructure, and information systems in a large integrated hospital network to conduct a low-cost evaluation of prevention strategies under usual practice conditions. This approach is applicable to many comparative effectiveness topics in both inpatient and ambulatory settings.

A Comparative Study on the Effectiveness of the Computer Assisted Method and the Interactionist Approach to Teaching Geometry Shapes to Young Children

ERIC Educational Resources Information Center

Zaranis, Nicholas; Synodi, Evanthia

2017-01-01

The purpose of this study is to compare and evaluate the effectiveness of computer assisted teaching of geometry shapes and an interactionist approach to teaching geometry in kindergarten versus other more traditional teaching methods. Our research compares the improvement of the children's geometrical competence using two teaching approaches. The…

High School Learning Environments: Hybrid versus Traditional Formats

ERIC Educational Resources Information Center

Clifton, Mary Beth

2017-01-01

This research study examined the effects of hybrid course format as compared to face-to-face instruction format in a high school setting. At this time, there is little research on hybrid courses in the secondary schools. The quantitative portion of this ex post facto study utilized causal comparative design. Student data was collected from teacher…

Effects of Honours Programme Participation in Higher Education: A Propensity Score Matching Approach

ERIC Educational Resources Information Center

Kool, Ada; Mainhard, Tim; Jaarsma, Debbie; van Beukelen, Peter; Brekelmans, Mieke

2017-01-01

Honours programmes have become part of higher education systems around the globe, and an increasing number of students are enrolled in such programmes. So far, effects of these programmes are largely under-researched. Two gaps in previous research on the effects of such programmes were addressed: (1) most studies lack a comparable control group of…

The Effects of Single-Sex Compared with Coeducational Schooling on Mathematics and Science Achievement: Data from Korea

ERIC Educational Resources Information Center

Pahlke, Erin; Hyde, Janet Shibley; Mertz, Janet E.

2013-01-01

Some U.S. school districts are experimenting with single-sex schooling, hoping that it will yield better academic outcomes for students. Empirical research on the effects of single-sex schooling, however, has been equivocal, with various studies finding benefits, disadvantages, or no effect. Most of this research is marred because families…

Patient, caregiver and clinician use of comparative effectiveness research findings in care decisions: results from a national study.

PubMed

Frank, Lori B; Forsythe, Laura P; Workman, Thomas A; Hilliard, Tandrea; Lavelle, Mary; Harwell, Daniel; Fayish, Lauren

2017-05-01

To assess awareness, use and attitudes concerning comparative effectiveness research (CER) findings. Online surveys of patients and caregivers managing rare (n = 560 patients, n = 609 caregivers) or chronic conditions (n = 762 patients, n = 776 caregivers), and practicing clinicians (n = 638). Less than half of patients and caregivers reported exposure to any type of CER findings in the past 12 months. Of those, over half identify healthcare professionals as the information source, yet only 10% of clinicians indicated they were 'very familiar' with CER. Clinicians were concerned about the time required to find relevant evidence and the appropriateness of comparisons in available health research. Clinicians, patients and caregivers indicate unmet need for incorporating CER research findings into clinical decision-making.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.

PubMed

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-09-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement.

An overview of methods for comparative effectiveness research.

PubMed

Meyer, Anne-Marie; Wheeler, Stephanie B; Weinberger, Morris; Chen, Ronald C; Carpenter, William R

2014-01-01

Comparative effectiveness research (CER) is a broad category of outcomes research encompassing many different methods employed by researchers and clinicians from numerous disciplines. The goal of cancer-focused CER is to generate new knowledge to assist cancer stakeholders in making informed decisions that will improve health care and outcomes of both individuals and populations. There are numerous CER methods that may be used to examine specific questions, including randomized controlled trials, observational studies, systematic literature reviews, and decision sciences modeling. Each has its strengths and weaknesses. To both inform and serve as a reference for readers of this issue of Seminars in Radiation Oncology as well as the broader oncology community, we describe CER and several of the more commonly used approaches and analytical methods. © 2013 Published by Elsevier Inc.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations

PubMed Central

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-01-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438

Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness

PubMed Central

Cragun, Deborah; Pal, Tuya; Vadaparampil, Susan T.; Baldwin, Julie; Hampel, Heather; DeBate, Rita D.

2015-01-01

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen. PMID:27429602

Ostracism Online: A social media ostracism paradigm.

PubMed

Wolf, Wouter; Levordashka, Ana; Ruff, Johanna R; Kraaijeveld, Steven; Lueckmann, Jan-Matthis; Williams, Kipling D

2015-06-01

We describe Ostracism Online, a novel, social media-based ostracism paradigm designed to (1) keep social interaction experimentally controlled, (2) provide researchers with the flexibility to manipulate the properties of the social situation to fit their research purposes, (3) be suitable for online data collection, (4) be convenient for studying subsequent within-group behavior, and (5) be ecologically valid. After collecting data online, we compared the Ostracism Online paradigm with the Cyberball paradigm (Williams & Jarvis Behavior Research Methods, 38, 174-180, 2006) on need-threat and mood questionnaire scores (van Beest & Williams Journal of Personality and Social Psychology 91, 918-928, 2006). We also examined whether ostracized targets of either paradigm would be more likely to conform to their group members than if they had been included. Using a Bayesian analysis of variance to examine the individual effects of the different paradigms and to compare these effects across paradigms, we found analogous effects on need-threat and mood. Perhaps because we examined conformity to the ostracizers (rather than neutral sources), neither paradigm showed effects of ostracism on conformity. We conclude that Ostracism Online is a cost-effective, easy to use, and ecologically valid research tool for studying the psychological and behavioral effects of ostracism.

A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogeneous clinical data

PubMed Central

Sittig, Dean F.; Hazlehurst, Brian L.; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B.

2012-01-01

Comparative Effectiveness Research (CER) has the potential to transform the current healthcare delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for inter-institutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast six, large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, socio-technical model of health information technology use to help guide our work. We identified six generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions. PMID:22692259

Language Research Center's Computerized Test System (LRC-CTS) - Video-formatted tasks for comparative primate research

NASA Technical Reports Server (NTRS)

Rumbaugh, Duane M.; Washburn, David A.; Savage-Rumbaugh, E. S.; Hopkins, William D.; Richardson, W. K.

1991-01-01

Automation of a computerized test system for comparative primate research is shown to improve the results of learning in standard paradigms. A mediational paradigm is used to determine the degree to which criterion in the learning-set testing reflects stimulus-response associative or mediational learning. Rhesus monkeys are shown to exhibit positive transfer as the criterion levels are shifted upwards, and the effectiveness of the computerized testing system is confirmed.

The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial.

PubMed

Frandsen, Mai; Thow, Megan; Ferguson, Stuart G

2016-08-10

Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-reach populations), cost effectiveness, and usability. However, to date, no studies have examined how participants recruited via social media progress through a study compared with those recruited using more traditional recruitment strategies. (1) Examine whether visiting the study website prior to being contacted by researchers creates self-screened participants who are more likely to progress through all study phases (eligible, enrolled, completed); (2) compare conversion percentages and cost effectiveness of each recruitment method at each study phase; and, (3) compare demographic and smoking characteristics of participants recruited through each strategy to determine if they attract similar samples. Participants recruited to a smoking cessation clinical trial were grouped by how they had become aware of the study: via social media (Facebook) or traditional media (eg, newspaper, flyers, radio, word of mouth). Groups were compared based on throughput data (conversion percentages and cost) as well as demographic and smoking characteristics. Visiting the study website did not result in individuals who were more likely to be eligible for (P=.24), enroll in (P=.20), or complete (P=.25) the study. While using social media was more cost effective than traditional methods when we examined earlier endpoints of the recruitment process (cost to obtain a screened respondent: AUD $22.73 vs $29.35; cost to obtain an eligible respondent: $37.56 vs $44.77), it was less cost effective in later endpoints (cost per enrolled participant: $56.34 vs $52.33; cost per completed participant: $103.66 vs $80.43). Participants recruited via social media were more likely to be younger (P=.001) and less confident in their quit attempts (P=.004) compared to those recruited via traditional methods. Our study suggests that while social media advertising may be effective in generating interest from potential participants, this strategy's ability to attract conscientious recruits is more questionable. Researchers considering using online resources (eg, social media advertising, matrix codes) should consider including prescreening questions to promote conversion percentages. Ultimately, researchers seeking to maximize their recruitment budget should consider using a combination of advertising strategies. Australian New Zealand Clinical Trials Registry ACTRN 12614000329662; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365947l (Archived by WebCite at http://www.webcitation.org/6jc6zXWZI).

Does involvement in a cohort study improve health and affect health inequalities? A natural experiment.

PubMed

Quick, Annie; Böhnke, Jan R; Wright, John; Pickett, Kate E

2017-01-25

Evidence suggests that the process of taking part in health research can improve participants' health, independent of any intended intervention. However, no research has yet explored whether these effects differ across socioeconomic groups. If the effect of mere participation in health research also has a social gradient this could increase health inequalities and bias research results. This study used the Born in Bradford family cohort (BIB) to explore whether simply taking part in BIB had improved participants' health and, if so, whether this effect was mediated by socioeconomic status. Survey data on self-reported health behaviours were collected between 2007 and 2010 as part of BIB. These were augmented by clinical data on birth weight. Pregnant women on their second pregnancy, joining BIB for the first time formed the control group. Their health was compared to women on their second pregnancy who had both pregnancies within the study, who formed the exposed group. In order to limit the inherent bias in a non-randomised study, propensity score analysis was used, matching on age, ethnicity, education and date of questionnaire. The results were then compared according to mothers' education. Of six outcomes tested, only alcohol consumption showed a statistically significant reduction with exposure to BIB (OR: 0.35, 95% CIs 0.13, 0.92). Although effect estimates were larger for women with higher education compared to lower education, these effects were not statistically significant. Despite one significant finding, these results overall are insufficient to conclude that simply taking part in BIB affected participants' health. We recommend that socioeconomic status is considered in future studies testing effects of research participation, and that randomised studies with larger sample sizes are conducted.

77 FR 5255 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... Education activities. AHRQ is the lead agency charged with supporting research designed to improve the... results from comparative effectiveness research studies. The planned assessment approaches will promote... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Agency...

Preference option randomized design (PORD) for comparative effectiveness research: Statistical power for testing comparative effect, preference effect, selection effect, intent-to-treat effect, and overall effect.

PubMed

Heo, Moonseong; Meissner, Paul; Litwin, Alain H; Arnsten, Julia H; McKee, M Diane; Karasz, Alison; McKinley, Paula; Rehm, Colin D; Chambers, Earle C; Yeh, Ming-Chin; Wylie-Rosett, Judith

2017-01-01

Comparative effectiveness research trials in real-world settings may require participants to choose between preferred intervention options. A randomized clinical trial with parallel experimental and control arms is straightforward and regarded as a gold standard design, but by design it forces and anticipates the participants to comply with a randomly assigned intervention regardless of their preference. Therefore, the randomized clinical trial may impose impractical limitations when planning comparative effectiveness research trials. To accommodate participants' preference if they are expressed, and to maintain randomization, we propose an alternative design that allows participants' preference after randomization, which we call a "preference option randomized design (PORD)". In contrast to other preference designs, which ask whether or not participants consent to the assigned intervention after randomization, the crucial feature of preference option randomized design is its unique informed consent process before randomization. Specifically, the preference option randomized design consent process informs participants that they can opt out and switch to the other intervention only if after randomization they actively express the desire to do so. Participants who do not independently express explicit alternate preference or assent to the randomly assigned intervention are considered to not have an alternate preference. In sum, preference option randomized design intends to maximize retention, minimize possibility of forced assignment for any participants, and to maintain randomization by allowing participants with no or equal preference to represent random assignments. This design scheme enables to define five effects that are interconnected with each other through common design parameters-comparative, preference, selection, intent-to-treat, and overall/as-treated-to collectively guide decision making between interventions. Statistical power functions for testing all these effects are derived, and simulations verified the validity of the power functions under normal and binomial distributions.

An official American Thoracic Society research statement: comparative effectiveness research in pulmonary, critical care, and sleep medicine.

PubMed

Carson, Shannon S; Goss, Christopher H; Patel, Sanjay R; Anzueto, Antonio; Au, David H; Elborn, Stuart; Gerald, Joe K; Gerald, Lynn B; Kahn, Jeremy M; Malhotra, Atul; Mularski, Richard A; Riekert, Kristin A; Rubenfeld, Gordon D; Weaver, Terri E; Krishnan, Jerry A

2013-11-15

Comparative effectiveness research (CER) is intended to inform decision making in clinical practice, and is central to patient-centered outcomes research (PCOR). To summarize key aspects of CER definitions and provide examples highlighting the complementary nature of efficacy and CER studies in pulmonary, critical care, and sleep medicine. An ad hoc working group of the American Thoracic Society with experience in clinical trials, health services research, quality improvement, and behavioral sciences in pulmonary, critical care, and sleep medicine was convened. The group used an iterative consensus process, including a review by American Thoracic Society committees and assemblies. The traditional efficacy paradigm relies on clinical trials with high internal validity to evaluate interventions in narrowly defined populations and in research settings. Efficacy studies address the question, "Can it work in optimal conditions?" The CER paradigm employs a wide range of study designs to understand the effects of interventions in clinical settings. CER studies address the question, "Does it work in practice?" The results of efficacy and CER studies may or may not agree. CER incorporates many attributes of outcomes research and health services research, while placing greater emphasis on meeting the expressed needs of nonresearcher stakeholders (e.g., patients, clinicians, and others). CER complements traditional efficacy research by placing greater emphasis on the effects of interventions in practice, and developing evidence to address the needs of the many stakeholders involved in health care decisions. Stakeholder engagement is an important component of CER.

Example-Based Learning: Effects of Different Types of Examples on Student Performance, Cognitive Load and Self-Efficacy in a Statistical Learning Task

ERIC Educational Resources Information Center

Huang, Xiaoxia

2017-01-01

Previous research has indicated the disconnect between example-based research focusing on worked examples (WEs) and that focusing on modeling examples. The purpose of this study was to examine and compare the effect of four different types of examples from the two separate lines of research, including standard WEs, erroneous WEs, expert (masterly)…

Information services for comparative analysis of biorhythm research

NASA Technical Reports Server (NTRS)

1972-01-01

References and full text documents are presented in support of continuing research and research planning for the NASA behavioral physiology program. Areas covered include: (1) desynchronosis and performance; (2) effects of alcohol, common colds, drugs, and toxic hazards on performance; (3) effects of stress on rhythm of plasma steroids; (4) data processing of biological rhythms; (5) pharmacology and biological rhythms; (6) mechanisms of biological rhythms; and (7) development of biological rhythms.

Analysis of the effect of specific vocabulary instruction on high school chemistry students' knowledge and understanding

NASA Astrophysics Data System (ADS)

Labrosse, Peggy

The purpose of this study was to analyze the effects of specific vocabulary instruction on high school chemistry students' knowledge and understanding. Students might be able to formally recite a definition for a term without actually having understood the meaning of the term and its connection to other terms or to related concepts. Researchers (Cassels & Johnstone, 1983; Gabel, 1999; Johnstone, 1991) have been studying the difficulty students have in learning science, particularly chemistry. Gabel (1999) suggests that, "while research into misconceptions (also known as alternative conceptions) and problem-solving has dominated the field for the past 25 years, we are no closer to a solution that would improve the teaching and learning of chemistry" (P. 549). Gabel (1999) relates the difficulty in learning chemistry to use of language. She refers to student difficulty both with words that have more than one meaning in English and with words that are used to mean one idea in chemistry and another idea in every day language. The Frayer Model, a research-based teaching strategy, is a graphic organizer which students use to create meaningful definitions for terms in context (Frayer, Frederick, & Klausmeier, 1969). It was used as the treatment---the specific vocabulary instruction---in this research study. The researcher collected and analyzed data to answer three research questions that focused on the effect of using the Frayer model (a graphic organizer) on high school students' knowledge and understanding of academic language used in chemistry. The research took place in a New England high school. Four intact chemistry classes provided the student participants; two classes were assigned to the treatment group (TG) and two classes were assigned to the control group (CG). The TG received vocabulary instruction on 14 chosen terms using the Frayer Model. The CG received traditional vocabulary instruction with no special attention to the 14 terms selected for this study. The vocabulary knowledge was examined by means of multiple-choice pre- and post-tests which were administered to all student participants. The choices included a scientific synonym, an everyday synonym, and a synonym based on a common misconception related to the term. Student understanding of the chemistry content was examined using chemistry content understanding pre- and post-tests comprised of four probes based on the National Science Education Standards (National Research Council, 1996) and linked to common student misconceptions which were administered to all student participants. Vocabulary knowledge effect scores were compared between the TG and CG using a t-test. Only a slight gain in vocabulary knowledge mean effect scores was found in the TG compared to the CG; however, it was not statistically significant. Chemistry content understanding effect scores were compared between the TG and CG using Chi-square analysis. The results of the chemistry content understanding effect scores in the TG compared to the CG showed that the student participants in the CG did significantly better. Chemistry content understanding effect scores and vocabulary knowledge effect scores were compared using a t-test. Chapter V provides explanations for the results which do not corroborate those found by other researchers. The researcher contends that the use of the Frayer model for specific terms in content across the curriculum is worth further study.

Study protocol for the dabigatran, apixaban, rivaroxaban, edoxaban, warfarin comparative effectiveness research study.

PubMed

Krumme, Alexis A; Pawar, Ajinkya; Schneeweiss, Sebastian; Glynn, Robert J; Choudhry, Niteesh K; Kulldorff, Martin; Ortiz, Adrian Santiago; Avorn, Jerome; Gagne, Joshua J

2018-01-01

Since 2010, four oral anticoagulants have been approved for marketing in addition to warfarin for treatment of thromboembolic disease. Limited head-to-head data exist comparing these treatments, leaving patients and clinicians with little guidance for selecting a strategy that balances recurrence reduction with bleeding risk. In the dabigatran, apixaban, rivaroxban, edoxaban and warfarin comparative effectiveness research study, we compare all five currently available oral anticoagulant agents for the extended treatment of deep venous thrombosis and pulmonary embolism, as well as no extended treatment, and evaluate whether results differ in specific sub-populations. As our population includes Medicare novel anticoagulant users and large numbers of commercially insured and Medicaid patients, our results will likely be transportable to the majority of US patients experiencing a DVT or pulmonary embolism. NCT03271450.

Comparing the Effectiveness of Self-Paced and Collaborative Frame-of-Reference Training on Rater Accuracy in a Large-Scale Writing Assessment

ERIC Educational Resources Information Center

Raczynski, Kevin R.; Cohen, Allan S.; Engelhard, George, Jr.; Lu, Zhenqiu

2015-01-01

There is a large body of research on the effectiveness of rater training methods in the industrial and organizational psychology literature. Less has been reported in the measurement literature on large-scale writing assessments. This study compared the effectiveness of two widely used rater training methods--self-paced and collaborative…

Faculty Satisfaction with Distance Education: A Comparative Analysis on Effectiveness of Undergraduate Course Delivery Modes

ERIC Educational Resources Information Center

Koenig, Robert J.

2010-01-01

Higher education faculty can and do teach courses delivered in a variety of ways. But, to date, little research has been done on the effectiveness of different delivery modes. This study sought to fill that void by comparing the effectiveness of three undergraduate course delivery modes: classroom, online, and video conference at a technical…

Measurement in Comparative Effectiveness Research

PubMed Central

Chubak, Jessica; Rutter, Carolyn M.; Kamineni, Aruna; Johnson, Eric A.; Stout, Natasha K.; Weiss, Noel S.; Doria-Rose, V. Paul; Doubeni, Chyke A.; Buist, Diana S.M.

2013-01-01

Comparative effectiveness research (CER) on preventive services can shape policy and help patients, their providers, and public health practitioners select regimens and programs for disease prevention. Patients and providers need information about the relative effectiveness of various regimens they may choose. Decision makers need information about the relative effectiveness of various programs to offer or recommend. The goal of this paper is to define and differentiate measures of relative effectiveness of regimens and programs for disease prevention. Cancer screening is used to demonstrate how these measures differ in an example of two hypothetic screening regimens and programs. Conceptually and algebraically defined measures of relative regimen and program effectiveness are also presented. The measures evaluate preventive services that range from individual tests through organized, population-wide prevention programs. Examples illustrate how effective screening regimens may not result in effective screening programs and how measures can vary across subgroups and settings. Both regimen and program relative effectiveness measures assess benefits of prevention services in real-world settings, but each addresses different scientific and policy questions. As the body of CER grows, a common lexicon for various measures of relative effectiveness becomes increasingly important to facilitate communication and shared understanding among researchers, healthcare providers, patients, and policymakers. PMID:23597816

The Effect of Computer Games on Students' Critical Thinking Disposition and Educational Achievement

ERIC Educational Resources Information Center

Seifi, Mohammad; Derikvandi, Zahra; Moosavipour, Saeed; Khodabandelou, Rouhollah

2015-01-01

The main aim of this research was to investigate the effect of computer games on student' critical thinking disposition and educational achievement. The research method was descriptive, and its type was casual-comparative. The sample included 270 female high school students in Andimeshk town selected by multistage cluster method. Ricketts…

An Exploratory Study of Video Browsing User Interface Designs and Research Methodologies: Effectiveness in Information Seeking Tasks.

ERIC Educational Resources Information Center

Tse, Tony; Vegh, Sandor; Shneiderman, Ben; Marchionini, Gary

1999-01-01

The purpose of this exploratory study was to develop research methods to compare the effectiveness of two video browsing interface designs, or surrogates--one static (storyboard) and one dynamic (slide show)--on two distinct information seeking tasks (gist determination and object recognition). (AEF)

Generic Behavioural Criteria of Managerial Effectiveness: An Empirical and Comparative Case Study of UK Local Government

ERIC Educational Resources Information Center

Hamlin, Robert G.; Serventi, Susan A.

2008-01-01

Purpose: The purpose of this paper is to present the findings of a "partnership-research" study of effective and ineffective managerial behaviour within the "local government" setting of the Wolverhampton City Council Social Care Department, and to describe how the research supports and challenges the organisation's existing…

A Meta-Analysis of Effectiveness Studies on Computer Technology-Supported Language Learning

ERIC Educational Resources Information Center

Grgurovic, Maja; Chapelle, Carol A.; Shelley, Mack C.

2013-01-01

With the aim of summarizing years of research comparing pedagogies for second/foreign language teaching supported with computer technology and pedagogy not-supported by computer technology, a meta-analysis was conducted of empirical research investigating language outcomes. Thirty-seven studies yielding 52 effect sizes were included, following a…

Useful Effect Size Interpretations for Single Case Research

ERIC Educational Resources Information Center

Parker, Richard I.; Hagan-Burke, Shanna

2007-01-01

An obstacle to broader acceptability of effect sizes in single case research is their lack of intuitive and useful interpretations. Interpreting Cohen's d as "standard deviation units difference" and R[superscript 2] as "percent of variance accounted for" do not resound with most visual analysts. In fact, the only comparative analysis widely…

Outcome Benchmarks for Adaptations of Research-Supported Treatments for Adult Traumatic Stress

ERIC Educational Resources Information Center

Rubin, Allen; Parrish, Danielle E.; Washburn, Micki

2016-01-01

This article provides benchmark data on within-group effect sizes from published randomized controlled trials (RCTs) that evaluated the efficacy of research-supported treatments (RSTs) for adult traumatic stress. Agencies can compare these benchmarks to their treatment group effect size to inform their decisions as to whether the way they are…

School Composition and Peer Effects in Distinctive Organizational Settings

ERIC Educational Resources Information Center

Marks, Helen M.

2002-01-01

This chapter reviews the research on school composition and peer effects from three comparative perspectives--Catholic and public schools, single-sex and coeducational schools, and small and large schools. Most of the research is sociological, focuses on high schools, and draws on national samples. The chapter seeks to discern cumulative trends in…

Comparative effectiveness research and its utility in In-clinic practice

PubMed Central

Dang, Amit; Kaur, Kirandeep

2016-01-01

One of the important components of patient-centered healthcare is comparative effectiveness research (CER), which aims at generating evidence from the real-life setting. The primary purpose of CER is to provide comparative information to the healthcare providers, patients, and policy makers about the standard of care available. This involves research on clinical questions unanswered by the explanatory trials during the regulatory approval process. Main methods of CER involve randomized controlled trials and observational methods. The limitations of these two methods have been overcome with the help of new statistical methods. After the evidence generation, it is equally important to communicate the results to all the interested organizations. CER is beginning to have its impact in the clinical practice as its results become part of the clinical practice guidelines. CER will have far-reaching scientific and financial impact. CER will make both the treating physician and the patient equally responsible for the treatment offered. PMID:26955571

Practical guide to understanding Comparative Effectiveness Research (CER).

PubMed

Neely, J Gail; Sharon, Jeffrey D; Graboyes, Evan M; Paniello, Randal C; Nussenbaum, Brian; Grindler, David J; Dassopoulos, Themistocles

2013-12-01

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

Observation for clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion.

PubMed

Wan, Ying

2018-05-01

Aim of the study was to observe and analyze the clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion. The research objects were 600 cases of phlebitis caused by infusion, all of which were treated in our hospital from June 2013 to June 2016. All patients were entitled to the right to know. They were randomly divided into the research group and the control group. Patients in the control group were treated with magnesium sulfate solution wet compress, while patients in the research group were treated with phellodendron wet compress. The effects in these two groups were observed and compared. Compared with the control group, the research group has better overall treatment efficiency, p<0.05; shorter average onset of action, p<0.05; less time in relieving red swelling and pain, p<0.05. Phellodendron wet compress shows a beneficial effect in treating the phlebitis caused by infusion. It can not only obviously shorten the onset of action, but also level up the overall treatment efficiency that helps patients to recover.

The Role of Schools in Bridging Within-School Achievement Gaps Based on Socioeconomic Status: A Cross-National Comparative Study

ERIC Educational Resources Information Center

Huang, Haigen; Sebastian, James

2015-01-01

Since the publication of the Coleman report in 1966, research on the role of schools in influencing student achievement relative to the role of family background has generated considerable interest and controversy. A large volume of international and comparative research has also been devoted to studying school effects on student achievement.…

Performance of Fourth-Grade Students with Learning Disabilities on Multiplication Facts Comparing Teacher-Mediated and Technology-Mediated Interventions: A Preliminary Investigation

ERIC Educational Resources Information Center

Bryant, Brian R.; Ok, Minwook; Kang, Eun Young; Kim, Min Kyung; Lang, Russell; Bryant, Diane Pedrotty; Pfannestiel, Kathleen

2015-01-01

Instructional applications (apps) are educational software programs that can be accessed via mobile technologies (e.g., iPad, smartphone) and used to help students acquire various academic skills, including mathematics. Although research suggests that app-based instruction (AI) can be effective, there is a paucity of research comparing AI, to…

Clinical evidence inputs to comparative effectiveness research could impact the development of novel treatments.

PubMed

Eber, Michael R; Goldman, Dana P; Lakdawalla, Darius N; Philipson, Tomas J; Pritchard, Daryl; Huesch, Marco; Summers, Nicholas; Linthicum, Mark T; Sullivan, Jeff; Dubois, Robert W

2015-05-07

This study aims to analyze the impacts of a range of clinical evidence generation scenarios associated with comparative effectiveness research (CER) on pharmaceutical innovation. We used the Global Pharmaceutical Policy Model to project the effect of changes in pharmaceutical producer costs, revenues and timings on drug innovation and health for the age 55+ populations in the USA and Europe through year 2060 using three clinical scenarios. Changes in producer incentives from widespread CER evidence generation and use had varied but often large predicted impacts on simulated outcomes in 2060. Effect on the number of new drug introductions ranged from a 81.1% reduction to a 45.5% increase, and the effect on population-level life expectancy ranged from a 15.6% reduction to a 11.4% increase compared to baseline estimates. The uncertainty surrounding the consequences of increased clinical evidence generation and use on innovation calls for a carefully measured approach to CER implementation, balancing near-term benefits to spending and health with long-term implications for innovation.

Why does primary angioplasty not work in registries? Quantifying the susceptibility of real-world comparative effectiveness data to allocation bias.

PubMed

Sen, Sayan; Davies, Justin E; Malik, Iqbal S; Foale, Rodney A; Mikhail, Ghada W; Hadjiloizou, Nearchos; Hughes, Alun; Mayet, Jamil; Francis, Darrel P

2012-11-01

Meta-analysis of registries (comparative effectiveness research) shows that primary angioplasty and fibrinolysis have equivalent real-world survival. Yet, randomized, controlled trials consistently find primary angioplasty superior. Can unequal allocation of higher-risk patients in registries have masked primary angioplasty benefit? First, we constructed a model to demonstrate the potential effect of allocation bias. We then analyzed published registries (55022 patients) for allocation of higher-risk patients (Killip class ≥1) to determine whether the choice of reperfusion therapy was affected by the risk level of the patient. Meta-regression was used to examine the relationship between differences in allocation of high-risk patient to primary angioplasty or fibrinolysis and mortality. Initial modeling suggested that registry outcomes are sensitive to allocation bias of high-risk patients. Across the registries, the therapy receiving excess high-risk patients had worse mortality. Unequal distribution of high-risk status accounted for most of the between-registry variance (adjusted R(2)(meta)=83.1%). Accounting for differential allocation of higher-risk patients, primary angioplasty gave 22% lower mortality (odds ratio, 0.78; 95% confidence interval, 0.64-0.97; P=0.029). We derive a formula, called the number needed to abolish, highlighting situations in which comparative effectiveness studies are particularly vulnerable to this bias. In ST-segment elevation myocardial infarction, clinicians' preference for management of a few high-risk patients can shift mortality substantially. Comparative effectiveness research in any disease is vulnerable to this, especially diseases with an immediately identifiable high-risk subgroup that clinicians prefer to allocate to 1 therapy. For this reason, preliminary indications from registry-based comparative effectiveness research should be definitively tested by randomized, controlled trials.

Binge Eating Disorder

MedlinePlus

... C., Fang, A., Chosak, A., et al. (2011). Comparative Prevalence, Correlates of Impairment, and Service Utilization for ... 2015). Management and Outcomes of Binge-Eating Disorder . Comparative Effectiveness Reviews, No. 160 . Agency for Healthcare Research ...

Research on Internet-Supported Learning: A Review

ERIC Educational Resources Information Center

Bekele, Teklu Abate; Menchaca, Michael Paul

2008-01-01

How did the Internet affect learning in higher education? What methodological and theoretical issues characterized research on Internet-Supported Learning (ISL)? What implications existed for future research? A constant comparative, qualitative analysis of 29 studies indicated grade achievement was the prime measure of effectiveness in ISL…

Improving the relevance and consistency of outcomes in comparative effectiveness research.

PubMed

Tunis, Sean R; Clarke, Mike; Gorst, Sarah L; Gargon, Elizabeth; Blazeby, Jane M; Altman, Douglas G; Williamson, Paula R

2016-03-01

Policy makers have clearly indicated--through heavy investment in the Patient Centered Outcomes Research Institute--that reporting outcomes that are meaningful to patients is crucial for improvement in healthcare delivery and cost reduction. Better interpretation and generalizability of clinical research results that incorporate patient-centered outcomes research can be achieved by accelerating the development and uptake of core outcome sets (COS). COS provide a standardized minimum set of the outcomes that should be measured and reported in all clinical trials of a specific condition. The level of activity around COS has increased significantly over the past decade, with substantial progress in several clinical domains. However, there are many important clinical conditions for which high-quality COS have not been developed and there are limited resources and capacity with which to develop them. We believe that meaningful progress toward the goals behind the significant investments in patient-centered outcomes research and comparative effectiveness research will depend on a serious effort to address these issues.

Improving the relevance and consistency of outcomes in comparative effectiveness research

PubMed Central

Tunis, Sean R; Clarke, Mike; Gorst, Sarah L; Gargon, Elizabeth; Blazeby, Jane M; Altman, Douglas G; Williamson, Paula R

2016-01-01

Policy makers have clearly indicated – through heavy investment in the Patient Centered Outcomes Research Institute – that reporting outcomes that are meaningful to patients is crucial for improvement in healthcare delivery and cost reduction. Better interpretation and generalizability of clinical research results that incorporate patient-centered outcomes research can be achieved by accelerating the development and uptake of core outcome sets (COS). COS provide a standardized minimum set of the outcomes that should be measured and reported in all clinical trials of a specific condition. The level of activity around COS has increased significantly over the past decade, with substantial progress in several clinical domains. However, there are many important clinical conditions for which high-quality COS have not been developed and there are limited resources and capacity with which to develop them. We believe that meaningful progress toward the goals behind the significant investments in patient-centered outcomes research and comparative effectiveness research will depend on a serious effort to address these issues. PMID:26930385

The impact of comparative effectiveness research on health and health care spending☆, ☆☆

PubMed Central

Basu, Anirban; Jena, Anupam B.; Philipson, Tomas J.

2011-01-01

Comparative effectiveness research (CER) is thought to identify what works and does not work in health care. We interpret CER as infusing evidence on product quality into markets, shifting the relative demand for products in CER studies. We analyze how shifts in demand affect health and health care spending and demonstrate that CER may raise or lower overall health when treatments have heterogeneous effects, but payers respond with product-specific coverage policies. Among patients with schizophrenia, we calibrate that subsidy policies based on the clinical trial CATIE may have reduced overall health by inducing some patients to switch away from schizophrenia treatments that were effective for them towards winners of the CER. PMID:21696840

The Drawbacks of Project Funding for Epistemic Innovation: Comparing Institutional Affordances and Constraints of Different Types of Research Funding.

PubMed

Franssen, Thomas; Scholten, Wout; Hessels, Laurens K; de Rijcke, Sarah

2018-01-01

Over the past decades, science funding shows a shift from recurrent block funding towards project funding mechanisms. However, our knowledge of how project funding arrangements influence the organizational and epistemic properties of research is limited. To study this relation, a bridge between science policy studies and science studies is necessary. Recent studies have analyzed the relation between the affordances and constraints of project grants and the epistemic properties of research. However, the potentially very different affordances and constraints of funding arrangements such as awards, prizes and fellowships, have not yet been taken into account. Drawing on eight case studies of funding arrangements in high performing Dutch research groups, this study compares the institutional affordances and constraints of prizes with those of project grants and their effects on organizational and epistemic properties of research. We argue that the prize case studies diverge from project-funded research in three ways: 1) a more flexible use, and adaptation of use, of funds during the research process compared to project grants; 2) investments in the larger organization which have effects beyond the research project itself; and 3), closely related, greater deviation from epistemic and organizational standards. The increasing dominance of project funding arrangements in Western science systems is therefore argued to be problematic in light of epistemic and organizational innovation. Funding arrangements that offer funding without scholars having to submit a project-proposal remain crucial to support researchers and research groups to deviate from epistemic and organizational standards.

Mental imagery interventions reduce subsequent food intake only when self-regulatory resources are available.

PubMed

Missbach, Benjamin; Florack, Arnd; Weissmann, Lukas; König, Jürgen

2014-01-01

Research has shown that imagining food consumption leads to food-specific habituation effects. In the present research, we replicated these effects and further examined whether the depletion of self-regulatory resources would reduce the habituation effects of imagined food consumption. Since self-regulatory resources have been shown to reduce habituation effects during the perception of emotional stimuli, we expected a reduction in habituation effects from imagined food consumption when self-regulatory resources were depleted. In Study 1, we replicated habituation effects as a response to imagining gummy bear consumption with a high (36) and medium number (18) of repetitions in a camouflaged taste test. Participants imagining gummy bear intake showed decreased food intake compared with participants who imagined putting a coin into a laundry machine. The number of repetitions did not significantly moderate the observed habituation effect. In Study 2, we investigated whether self-regulatory depletion would impede habituation effects evoked by the imagination of walnut consumption. Participants in a depleted state did not show a reduction in food intake after imagining walnut intake compared with participants in a non-depleted state. We discuss directions for future research and processes that might underlie the observed moderating effect of self-regulatory resources.

The Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans: Toward Comparative Effectiveness in the Pediatric Rheumatic Diseases.

PubMed

Ringold, Sarah; Nigrovic, Peter A; Feldman, Brian M; Tomlinson, George A; von Scheven, Emily; Wallace, Carol A; Huber, Adam M; Schanberg, Laura E; Li, Suzanne C; Weiss, Pamela F; Fuhlbrigge, Robert C; Morgan, Esi M; Kimura, Yukiko

2018-05-01

The pediatric rheumatic diseases are a heterogeneous group of rare diseases, posing a number of challenges for the use of traditional clinical and translational research methods. Innovative comparative effectiveness approaches are needed to efficiently study treatment strategies and disease outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed the consensus treatment plan (CTP) approach as a comparative effectiveness tool for research in pediatric rheumatology. CTPs are treatment strategies, developed by consensus methods among CARRA members, intended to reduce variation in treatment approaches, standardize outcome measurements, and allow for comparison of the effectiveness of different approaches with the goal of improving disease outcomes. To date, CTPs have been published for 8 different diseases and disease manifestations. The approach has been successfully piloted for juvenile localized scleroderma, systemic juvenile idiopathic arthritis (JIA), polyarticular JIA, dermatomyositis, and lupus nephritis. Large-scale studies are underway for systemic JIA and polyarticular JIA, with the CARRA patient registry serving as the data collection platform. These studies have been designed with stakeholder involvement, including active input from CARRA providers, patients, and parents, with the goal of increasing feasibility and ensuring the relevance of the outcomes. These studies include ancillary biologic specimen collection intended to support additional translational and mechanistic studies. Data from these ongoing CTP studies will provide more information on the ability of this approach to identify effective treatment strategies and improve outcomes in the pediatric rheumatic diseases. © 2018, American College of Rheumatology.

Assessing the Expected Value of Research Studies in Reducing Uncertainty and Improving Implementation Dynamics.

PubMed

Grimm, Sabine E; Dixon, Simon; Stevens, John W

2017-07-01

With low implementation of cost-effective health technologies being a problem in many health systems, it is worth considering the potential effects of research on implementation at the time of health technology assessment. Meaningful and realistic implementation estimates must be of dynamic nature. To extend existing methods for assessing the value of research studies in terms of both reduction of uncertainty and improvement in implementation by considering diffusion based on expert beliefs with and without further research conditional on the strength of evidence. We use expected value of sample information and expected value of specific implementation measure concepts accounting for the effects of specific research studies on implementation and the reduction of uncertainty. Diffusion theory and elicitation of expert beliefs about the shape of diffusion curves inform implementation dynamics. We illustrate use of the resulting dynamic expected value of research in a preterm birth screening technology and results are compared with those from a static analysis. Allowing for diffusion based on expert beliefs had a significant impact on the expected value of research in the case study, suggesting that mistakes are made where static implementation levels are assumed. Incorporating the effects of research on implementation resulted in an increase in the expected value of research compared to the expected value of sample information alone. Assessing the expected value of research in reducing uncertainty and improving implementation dynamics has the potential to complement currently used analyses in health technology assessments, especially in recommendations for further research. The combination of expected value of research, diffusion theory, and elicitation described in this article is an important addition to the existing methods of health technology assessment.

AHRQ series paper 1: comparing medical interventions: AHRQ and the effective health-care program.

PubMed

Slutsky, Jean; Atkins, David; Chang, Stephanie; Sharp, Beth A Collins

2010-05-01

In 2005, the Agency for Healthcare Research and Quality established the Effective Health Care (EHC) Program. The EHC Program aims to provide understandable and actionable information for patients, clinicians, and policy makers. The Evidence-based Practice Centers are one of the cornerstones of the EHC Program. Three key elements guide the EHC Program and thus, the conduct of Comparative Effectiveness Reviews by the EPC Program. Comparative Effectiveness Reviews introduce several specific challenges in addition to the familiar issues raised in a systematic review or meta-analysis of a single intervention. The articles in this series together form the current Methods Guide for Comparative Effectiveness Reviews of the EHC Program.

The incident user design in comparative effectiveness research.

PubMed

Johnson, Eric S; Bartman, Barbara A; Briesacher, Becky A; Fleming, Neil S; Gerhard, Tobias; Kornegay, Cynthia J; Nourjah, Parivash; Sauer, Brian; Schumock, Glen T; Sedrakyan, Art; Stürmer, Til; West, Suzanne L; Schneeweiss, Sebastian

2013-01-01

Comparative effectiveness research includes cohort studies and registries of interventions. When investigators design such studies, how important is it to follow patients from the day they initiated treatment with the study interventions? Our article considers this question and related issues to start a dialogue on the value of the incident user design in comparative effectiveness research. By incident user design, we mean a study that sets the cohort's inception date according to patients' new use of an intervention. In contrast, most epidemiologic studies enroll patients who were currently or recently using an intervention when follow-up began. We take the incident user design as a reasonable default strategy because it reduces biases that can impact non-randomized studies, especially when investigators use healthcare databases. We review case studies where investigators have explored the consequences of designing a cohort study by restricting to incident users, but most of the discussion has been informed by expert opinion, not by systematic evidence. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

Free-Form Comparative Education

ERIC Educational Resources Information Center

Lawson, Robert F.

1975-01-01

The question of a central focus in comparative education was discussed, brief examples of research requirements considered, and kinds of selective association implied which could provide for more effective networking, thus connecting sectors of work within the Comparative and International Society to other organizations. (Author/RK)

Research, Training, and Practice: The Normative Model and Beyond.

ERIC Educational Resources Information Center

Evertson, Carolyn M.

Four specific purposes were addressed in this study: (1) to identify models of classroom management and instructional management used by effective and less effective teachers; (2) to compare and contrast these models; (3) to compare and contrast a normative model of classroom management used in management training workshops with the models…

Comparative Effectiveness of Context-Based and Traditional Approaches in Teaching Genetics: Student Views and Achievement

ERIC Educational Resources Information Center

Kazeni, Monde; Onwu, Gilbert

2013-01-01

The study aimed to determine the comparative effectiveness of context-based and traditional teaching approaches in enhancing student achievement in genetics, problem-solving, science inquiry and decision-making skills, and attitude towards the study of life sciences. A mixed method but essentially quantitative research approach involving a…

The Effects of Differentiated Instruction Support Inclusion Services on Fifth Grade Reading/Language Arts Achievement

ERIC Educational Resources Information Center

Wendt, Stephanie L.

2012-01-01

Using a causal-comparative research design, this study investigated the effectiveness of Differentiated Instruction Support Inclusion Services on fifth grade regular education and gifted students' Reading/Language Arts achievement. The study analyzed and compared the achievement of the regular education students who received no inclusion support…

Setting high-impact clinical research priorities for the Society for Vascular Surgery.

PubMed

Kraiss, Larry W; Conte, Michael S; Geary, Randolph L; Kibbe, Melina; Ozaki, C Keith

2013-02-01

With the overall goal of enhancing the effectiveness and efficiency of vascular care, the Society for Vascular Surgery (SVS) recently completed a process by which it identified its top clinical research priorities to address critical gaps in knowledge guiding practitioners in prevention and treatment of vascular disease. After a survey of the SVS membership, a panel of SVS committee members and opinion leaders considered 53 distinct research questions through a structured process that resulted in identification of nine clinical issues that were felt to merit immediate attention by vascular investigators and external funding agencies. These are, in order of priority: (1) define optimal management of asymptomatic carotid stenosis, (2) compare the effectiveness of medical vs invasive treatment (open or endovascular) of vasculogenic claudication, (3) compare effectiveness of open vs endovascular infrainguinal revascularization as initial treatment of critical limb ischemia, (4) develop and compare the effectiveness of clinical strategies to reduce cardiovascular and other perioperative complications (eg, wound) after vascular intervention, (5) compare the effectiveness of strategies to enhance arteriovenous fistula maturation and durability, (6) develop best practices for management of chronic venous ulcer, (7) define optimal adjunctive medical therapy to enhance the success of lower extremity revascularization, (8) identify and evaluate medical therapy to prevent abdominal aortic aneurysm growth, and (9) evaluate ultrasound vs computed tomographic angiography surveillance after endovascular aneurysm repair. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Using the LOINC Semantic Structure to Integrate Community-based Survey Items into a Concept-based Enterprise Data Dictionary to Support Comparative Effectiveness Research.

PubMed

Co, Manuel C; Boden-Albala, Bernadette; Quarles, Leigh; Wilcox, Adam; Bakken, Suzanne

2012-01-01

In designing informatics infrastructure to support comparative effectiveness research (CER), it is necessary to implement approaches for integrating heterogeneous data sources such as clinical data typically stored in clinical data warehouses and those that are normally stored in separate research databases. One strategy to support this integration is the use of a concept-oriented data dictionary with a set of semantic terminology models. The aim of this paper is to illustrate the use of the semantic structure of Clinical LOINC (Logical Observation Identifiers, Names, and Codes) in integrating community-based survey items into the Medical Entities Dictionary (MED) to support the integration of survey data with clinical data for CER studies.

Clinically localized prostate cancer in 2017: A review of comparative effectiveness.

PubMed

Lavery, Hugh J; Cooperberg, Matthew R

2017-02-01

Introducing the topic of comparative effectiveness for prostate cancer treatments with a reminder of the disease's heterogeneity risks tautology. However, the profound variation both in this cancer's biology and its clinical course is increasingly widely recognized, while management alternatives for clinically localized prostate cancer have exploded. Available options now include active surveillance, multiple surgical approaches to prostatectomy, various forms of external-beam and interstitial radiation, and a growing list of energy ablative technologies. Each treatment option has its own efficacy rate as well as its own set of complications, side effects and financial costs. Difficulties comparing these options, together with the high prevalence of the disease, led the Institute of Medicine to include localized prostate cancer among the top 25 priority conditions for future comparative effectiveness research. The sheer volume of possible treatment options, with their individual risks and benefits, can be confusing for patients and clinicians to research, understand and explain. To help clinicians navigate these treatment options, we have assembled this Urologic Oncology Seminar on the comparative effectiveness of treatments for clinically localized prostate cancer. The articles focus on high quality evidence-based medicine and most have included useful tables summarizing seminal trials and available resources. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of long-term preservation on amphibian body conditions: implications for historical morphological research

PubMed Central

Shu, Guocheng; Gong, Yuzhou; Xie, Feng; Wu, Nicholas C.

2017-01-01

Measurements of historical specimens are widely applied in studies of taxonomy, systematics, and ecology, but biologists often assume that the effects of preservative chemicals on the morphology of amphibian specimens are minimal in their analyses. We compared the body length and body mass of 182 samples of 13 live and preserved (up to 10 years) anuran species and found that the body length and body mass of preserved specimens significantly decreased by 6.1% and 24.8%, respectively, compared to those measurements of their live counterparts. The changes in body length and mass also exhibited highly significant variations between species. Similarly, there were significant differences in shrinkage of body length and body mass between sexes, where males showed greater shrinkage in body length and body mass compared to females. Preservation distorted the magnitude of the interspecific differences in body length observed in the fresh specimens. Overall, the reduction in body length or mass was greater in longer or heavier individuals. Due to the effects of preservation on amphibian morphology, we propose two parsimonious conversion equations to back-calculate the original body length and body mass of studied anurans for researchers working with historical data, since morphological data from preserved specimens may lead to incorrect biological interpretations when comparing to fresh specimens. Therefore, researchers should correct for errors due to preservation effects that may lead to the misinterpretation of results. PMID:28929024

Medical and pharmacy coverage decision making at the population level.

PubMed

Mohr, Penny E; Tunis, Sean R

2014-06-01

Medicare is one of the largest health care payers in the United States. As a result, its decisions about coverage have profound implications for patient access to care. In this commentary, the authors describe how Medicare used evidence on heterogeneity of treatment effects to make population-based decisions on health care coverage for implantable cardiac defibrillators. This case is discussed in the context of the rapidly expanding availability of comparative effectiveness research. While there is a potential tension between population-based and patient-centered decision making, the expanded diversity of populations and settings included in comparative effectiveness research can provide useful information for making more discerning and informed policy and clinical decisions.

Can CER be an effective tool for change in the development and assessment of new drugs and technologies?

PubMed

Brixner, Diana I; Watkins, John B

2012-06-01

Comparative effectiveness research (CER) has been proposed in the United States as a way to compare new drugs and technologies with established alternatives and determine not just whether a therapy works, but how well it works compared to other options. To define the current use of CER in the development of new drugs and technologies and explore what is needed for this research approach to reduce or stabilize health care costs in the United States. In 2010, the Patient-Centered Outcomes Research Institute (PCORI) was established by the Patient Protection and Affordable Care Act (PPACA) to coordinate federally funded CER and recommend research priorities. Hochman and McCormick's (2010) evaluation of 328 randomized trials, observational studies, and meta-analyses involving medications published between June 2008 and September 2009 in 6 key journals showed that most published research did not fulfill the criteria of CER (defined as comparison to active treatment) and that most study design is driven by FDA requirements rather than the need to develop evidence to facilitates election of the most effective therapy. Since PPACA provides alternative funding for CER, it could encourage funding more studies to help determine which treatment delivers the best value per unit of investment from clinical, humanistic, and economic perspectives. Manufacturers may avoid CER because it increases product development costs, but a drug proven more effective is more likely to be accepted by formulary committees, increasing the drug's market share, whereas payers may reject or limit use of a new drug that performs less effectively in comparative studies. CER may not directly reduce expenditures for drugs and medical technologies. The results may vary widely from case to case; however, despite often significantly higher prices for new drugs, it is important to look beyond product costs to the overall impact on health care costs, including medical cost offsets that may occur through improved health or decreased morbidity. To truly decrease cost and improve quality, cost-effectiveness will have to be integrated into CER with the objective of prioritizing efficient therapies in the real-world health care system. If the methods and output of CER improve, the resulting cost-effectiveness ratios will also be more useful to the payer. CER should ultimately, therefore, be a useful tool to help patients, providers, and decision makers provide the most effective and most cost-effective interventions.

Use of comparative effectiveness research in drug coverage and pricing decisions: a six-country comparison.

PubMed

Sorenson, Corinna

2010-07-01

Comparative effectiveness research (CER) has assumed an increasing role in drug coverage and, in some cases, pricing decisions in Europe, as decision-makers seek to obtain better value for money. 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. Investing in CER can help address the current gap in publicly available, credible, up-to-date, and scientifically based comparative information on the effectiveness of drugs and other health interventions. This information can be used to base coverage and pricing decisions on evidence of value, thereby facilitating access to and public and private investment in the most beneficial new drugs and technologies. In turn, use of CER creates incentives for more efficient, high-quality health care and encourages development of innovative products that offer measurable value to patients.

EPA LABORATORIES IMPLEMENT EMS PROGRAM

EPA Science Inventory

This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

Recycling Research. Tracking Trash.

ERIC Educational Resources Information Center

DeLago, Louise Furia

1991-01-01

An activity in which students research the effectiveness of recycling is presented. Students compare the types and amount of litter both before and after recycling is implemented. Directions for the activity and a sample data sheet are included. (KR)

Full Flip, Half Flip and No Flip: Evaluation of Flipping an Introductory Programming Course

ERIC Educational Resources Information Center

Fryling, Meg; Yoder, Robert; Breimer, Eric

2016-01-01

While some research has suggested that video lectures are just as effective as in-person lectures to convey basic information to students, not everyone agrees that the flipped classroom model is an effective way of educating students. This research explores traditional, semi-flipped and fully-flipped classroom models by comparing three sections of…

Comparing Two Web/Mail Mixed-Mode Contact Protocols to a Unimode Mail Survey

ERIC Educational Resources Information Center

Newberry, Milton G., III; Israel, Glenn D.

2017-01-01

Recent research has shown mixed-mode surveys are advantageous for organizations to use in collecting data. Previous research explored web/mail mode effects for four-contact waves. This study explores the effect of web/mail mixed-mode systems over a series of contacts on the customer satisfaction data from the Florida Cooperative Extension Service…

Possible new treatment for Kaposi sarcoma | Center for Cancer Research

Cancer.gov

A collaborative effort by researchers at the National Cancer Institute (NCI) and Celgene Corporation, a global biopharmaceutical company, has yielded a possible new treatment for Kaposi sarcoma (KS), a cancer caused by a human gammaherpesvirus. The drug, called pomalidomide, is highly effective against KS and has fewer side effects compared with chemotherapy, suggesting that

Comparison of Nonoverlap Methods for Identifying Treatment Effect in Single-Subject Experimental Research

ERIC Educational Resources Information Center

Rakap, Salih; Snyder, Patricia; Pasia, Cathleen

2014-01-01

Debate is occurring about which result interpretation aides focused on examining the experimental effect should be used in single-subject experimental research. In this study, we examined seven nonoverlap methods and compared results using each method to judgments of two visual analysts. The data sources for the present study were 36 studies…

Effects of Arts Education on Participation in the Arts. Research Division Report 36.

ERIC Educational Resources Information Center

Bergonzi, Louis; Smith, Julia

Using data from the 1992 Survey of Public Participation in the Arts (SPPA92), research focused on the question: "Does arts education make arts participation more accessible to Americans?" The effects of both school-based arts education and community-based arts education were considered and compared. Art forms considered in this…

A Comparison of Two Methods of Teaching Research to Master of Social Work Students

ERIC Educational Resources Information Center

Walsh, Christine Ann; Hewson, Jennifer

2012-01-01

While various curriculum strategies have been presented for teaching research, little is known about the effectiveness of different teaching approaches. This study compared two models for teaching research to MSW students: a mentorship model (TM1) and a more structured, didactic model (TM2). Students (n = 23) self-completed the Research Self…

Prospective observational studies to assess comparative effectiveness: the ISPOR good research practices task force report.

PubMed

Berger, Marc L; Dreyer, Nancy; Anderson, Fred; Towse, Adrian; Sedrakyan, Art; Normand, Sharon-Lise

2012-01-01

In both the United States and Europe there has been an increased interest in using comparative effectiveness research of interventions to inform health policy decisions. Prospective observational studies will undoubtedly be conducted with increased frequency to assess the comparative effectiveness of different treatments, including as a tool for "coverage with evidence development," "risk-sharing contracting," or key element in a "learning health-care system." The principle alternatives for comparative effectiveness research include retrospective observational studies, prospective observational studies, randomized clinical trials, and naturalistic ("pragmatic") randomized clinical trials. This report details the recommendations of a Good Research Practice Task Force on Prospective Observational Studies for comparative effectiveness research. Key issues discussed include how to decide when to do a prospective observational study in light of its advantages and disadvantages with respect to alternatives, and the report summarizes the challenges and approaches to the appropriate design, analysis, and execution of prospective observational studies to make them most valuable and relevant to health-care decision makers. The task force emphasizes the need for precision and clarity in specifying the key policy questions to be addressed and that studies should be designed with a goal of drawing causal inferences whenever possible. If a study is being performed to support a policy decision, then it should be designed as hypothesis testing-this requires drafting a protocol as if subjects were to be randomized and that investigators clearly state the purpose or main hypotheses, define the treatment groups and outcomes, identify all measured and unmeasured confounders, and specify the primary analyses and required sample size. Separate from analytic and statistical approaches, study design choices may strengthen the ability to address potential biases and confounding in prospective observational studies. The use of inception cohorts, new user designs, multiple comparator groups, matching designs, and assessment of outcomes thought not to be impacted by the therapies being compared are several strategies that should be given strong consideration recognizing that there may be feasibility constraints. The reasoning behind all study design and analytic choices should be transparent and explained in study protocol. Execution of prospective observational studies is as important as their design and analysis in ensuring that results are valuable and relevant, especially capturing the target population of interest, having reasonably complete and nondifferential follow-up. Similar to the concept of the importance of declaring a prespecified hypothesis, we believe that the credibility of many prospective observational studies would be enhanced by their registration on appropriate publicly accessible sites (e.g., clinicaltrials.gov and encepp.eu) in advance of their execution. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

How Big Data, Comparative Effectiveness Research, and Rapid-Learning Health-Care Systems Can Transform Patient Care in Radiation Oncology.

PubMed

Sanders, Jason C; Showalter, Timothy N

2018-01-01

Big data and comparative effectiveness research methodologies can be applied within the framework of a rapid-learning health-care system (RLHCS) to accelerate discovery and to help turn the dream of fully personalized medicine into a reality. We synthesize recent advances in genomics with trends in big data to provide a forward-looking perspective on the potential of new advances to usher in an era of personalized radiation therapy, with emphases on the power of RLHCS to accelerate discovery and the future of individualized radiation treatment planning.

75 FR 33626 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... Comparative Effectiveness Research in Clinical Hypertension Management. Date: June 24, 2010. Time: 12 p.m. to... Institute Special Emphasis Panel. Ruth L. Kirschstein NRSA Institutional Research Training Grants. Date... Domestic Assistance Program Nos. 93.233, National Center for Sleep Disorders Research; 93.837, Heart and...

Using Facebook as a LMS?

ERIC Educational Resources Information Center

Arabacioglu, Taner; Akar-Vural, Ruken

2014-01-01

The main purpose of this research was to compare the communication media according to effective teaching. For this purpose, in the research, the mixed method, including quantitative and qualitative data collecting techniques, was applied. For the quantitative part of the research, the static group comparison design was implemented as one of the…

An Evaluative and Prescriptive Look at Graphics Research.

ERIC Educational Resources Information Center

Soderston, Candace

Graphics research history shows that some topics have been studied heavily while others have been almost entirely neglected. Furthermore, researchers have used many different methods of defining and measuring effects such as legibility and comprehension, and this, together with vagueness in reporting, makes it difficult to compare studies and draw…

An Analysis of Teacher Selection Tools in Pennsylvania

ERIC Educational Resources Information Center

Vitale, Tracy L.

2009-01-01

The purpose of this study was to examine teacher screening and selection tools currently being utilized by public school districts in Pennsylvania and to compare these tools to the research on qualities of effective teachers. The researcher developed four research questions that guided her study. The Pennsylvania Association of School Personnel…

Web-based Comparative Patient-reported Outcome Feedback to Support Quality Improvement and Comparative Effectiveness Research in Total Joint Replacement.

PubMed

Zheng, Hua; Li, Wenjun; Harrold, Leslie; Ayers, David C; Franklin, Patricia D

2014-01-01

Patient-reported outcomes (PROs) are rarely included in quality monitoring systems, surgeon comparative feedback reports, or registries. We present the design and implementation of a secure website in a federally funded research program-Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR)-to return comparative PRO reports to participating surgeons, in addition to including traditional quality measures, in order to monitor and improve quality and health outcomes. The surgeon-specific comparative PRO reports were designed and structured based on user input for content, data elements, integration, and display. Three questions are addressed regarding the knee and hip joint symptom profiles of patients before TJR, as well as outcomes of surgery. The website is organized with a hierarchical structure to display data at national, practice, and individual surgeon levels, and provides a comprehensive site-level executive summary and surgeon-level data reports that can be downloaded. As of September 2014, over 22,000 patients were enrolled from more than 130 surgeons in 22 states. The reporting website was launched in September 2012 and has been updated quarterly for all surgeons to review their site- and individual-specific outcomes data compared to national benchmarks. In this novel system, quarterly comparative surgeon feedback extends beyond traditional measures of complication rates to include PROs of pain relief and functional gain. We anticipate that this enhanced data will facilitate patient-centered quality improvement (QI) and outcomes research from the registry. As the Centers for Medicare & Medicaid Services (CMS) and other insurers consider future implementation of PROs, surgeons will increasingly need comparative data by which to self-monitor their practice outcomes.

"Design characteristics of the CORRONA CERTAIN study: a comparative effectiveness study of biologic agents for rheumatoid arthritis patients".

PubMed

Pappas, Dimitrios A; Kremer, Joel M; Reed, George; Greenberg, Jeffrey D; Curtis, Jeffrey R

2014-04-01

Comparative effectiveness research has recently attracted considerable attention. The Comparative Effectiveness Registry to study Therapies for Arthritis and Inflammatory Conditions (CERTAIN) is an ongoing prospective cohort study of adult patients with Rheumatoid Arthritis (RA). CERTAIN uses the existing Consortium of Rheumatology Researchers of North America (CORRONA) network of participating private and academic sites in order to recruit patients fulfilling the 1987 ACR criteria that have at least moderate disease activity. Patients starting or switching biologic agents either anti-TNF therapy or a non anti-TNF biologic are eligible for enrollment, depending on the treatment selected by their physician. Enrollment is expected to be completed by March of 2014, and 2711 patients will participate in the study. As of October 7th 2013, 2234 patients have been enrolled. Patient visits and laboratory blood work are mandated every three months for one year. Safety data is collected through one year and beyond. The primary comparative effectiveness endpoint is attainment of low RA disease activity at one year among patients who have been exposed to at least one prior TNF-α inhibitor agent prior to enrollment. Multiple secondary effectiveness and safety endpoints will be addressed by investigating the entire population enrolled (naïve and biologic experienced). The unique design features of CERTAIN will inform comparative effectiveness and safety questions for choosing biologic agents for the management of RA.

Re-Orientation of Clinical Research in Traumatic Brain Injury: Report of an International Workshop on Comparative Effectiveness Research

PubMed Central

Menon, David K.; Lingsma, Hester F.; Pineda, Jose A.; Sandel, M. Elizabeth; Manley, Geoffrey T.

2012-01-01

Abstract During the National Neurotrauma Symposium 2010, the DG Research of the European Commission and the National Institutes of Health/National Institute of Neurological Disorders and Stroke (NIH/NINDS) organized a workshop on comparative effectiveness research (CER) in traumatic brain injury (TBI). This workshop reviewed existing approaches to improve outcomes of TBI patients. It had two main outcomes: First, it initiated a process of re-orientation of clinical research in TBI. Second, it provided ideas for a potential collaboration between the European Commission and the NIH/NINDS to stimulate research in TBI. Advances in provision of care for TBI patients have resulted from observational studies, guideline development, and meta-analyses of individual patient data. In contrast, randomized controlled trials have not led to any identifiable major advances. Rigorous protocols and tightly selected populations constrain generalizability. The workshop addressed additional research approaches, summarized the greatest unmet needs, and highlighted priorities for future research. The collection of high-quality clinical databases, associated with systems biology and CER, offers substantial opportunities. Systems biology aims to identify multiple factors contributing to a disease and addresses complex interactions. Effectiveness research aims to measure benefits and risks of systems of care and interventions in ordinary settings and broader populations. These approaches have great potential for TBI research. Although not new, they still need to be introduced to and accepted by TBI researchers as instruments for clinical research. As with therapeutic targets in individual patient management, so it is with research tools: one size does not fit all. PMID:21545277

Variation in adherence to medications across the healthcare system in two comparative effectiveness research cohorts.

PubMed

Franklin, Jessica M; Donneyong, Macarius M; Desai, Rishi J; Markson, Leona; Girman, Cynthia J; McKay, Caroline; Patel, Mehul D; Mavros, Panagiotis; Schneeweiss, Sebastian

2017-10-01

To assess heterogeneity in adherence to medications in two example comparative effectiveness research studies. We analyzed data from commercially insured patients initiating a statin or anticoagulant during 2005-2012. We calculated the cross-validated R 2 from a series of hierarchical linear models to assess variation in 1-year adherence. There was less heterogeneity in adherence in the statin cohort compared with the anticoagulant cohort, where patient characteristics explained 7.2% of variation in adherence, and adding therapy and provider characteristics increased the proportion of variation explained to 8.0 and 8.5%, cumulatively. Random effects provided essentially no explanatory power, even in the statin cohort with large numbers of patients clustered within each pharmacy, prescriber and provider. The dependence of adherence on the healthcare system was stronger when the healthcare system influenced treatment choice and patient access to medication and when indications for treatment were strong.

Building the Evidence Base for Decision-making in Cancer Genomic Medicine Using Comparative Effectiveness Research

PubMed Central

Goddard, Katrina A.B.; Knaus, William A.; Whitlock, Evelyn; Lyman, Gary H.; Feigelson, Heather Spencer; Schully, Sheri D.; Ramsey, Scott; Tunis, Sean; Freedman, Andrew N.; Khoury, Muin J.; Veenstra, David L.

2013-01-01

Background The clinical utility is uncertain for many cancer genomic applications. Comparative effectiveness research (CER) can provide evidence to clarify this uncertainty. Objectives To identify approaches to help stakeholders make evidence-based decisions, and to describe potential challenges and opportunities using CER to produce evidence-based guidance. Methods We identified general CER approaches for genomic applications through literature review, the authors’ experiences, and lessons learned from a recent, seven-site CER initiative in cancer genomic medicine. Case studies illustrate the use of CER approaches. Results Evidence generation and synthesis approaches include comparative observational and randomized trials, patient reported outcomes, decision modeling, and economic analysis. We identified significant challenges to conducting CER in cancer genomics: the rapid pace of innovation, the lack of regulation, the limited evidence for clinical utility, and the beliefs that genomic tests could have personal utility without having clinical utility. Opportunities to capitalize on CER methods in cancer genomics include improvements in the conduct of evidence synthesis, stakeholder engagement, increasing the number of comparative studies, and developing approaches to inform clinical guidelines and research prioritization. Conclusions CER offers a variety of methodological approaches to address stakeholders’ needs. Innovative approaches are needed to ensure an effective translation of genomic discoveries. PMID:22516979

The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial

PubMed Central

Thow, Megan; Ferguson, Stuart G

2016-01-01

Background Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-reach populations), cost effectiveness, and usability. However, to date, no studies have examined how participants recruited via social media progress through a study compared with those recruited using more traditional recruitment strategies. Objectives (1) Examine whether visiting the study website prior to being contacted by researchers creates self-screened participants who are more likely to progress through all study phases (eligible, enrolled, completed); (2) compare conversion percentages and cost effectiveness of each recruitment method at each study phase; and, (3) compare demographic and smoking characteristics of participants recruited through each strategy to determine if they attract similar samples. Methods Participants recruited to a smoking cessation clinical trial were grouped by how they had become aware of the study: via social media (Facebook) or traditional media (eg, newspaper, flyers, radio, word of mouth). Groups were compared based on throughput data (conversion percentages and cost) as well as demographic and smoking characteristics. Results Visiting the study website did not result in individuals who were more likely to be eligible for (P=.24), enroll in (P=.20), or complete (P=.25) the study. While using social media was more cost effective than traditional methods when we examined earlier endpoints of the recruitment process (cost to obtain a screened respondent: AUD $22.73 vs $29.35; cost to obtain an eligible respondent: $37.56 vs $44.77), it was less cost effective in later endpoints (cost per enrolled participant: $56.34 vs $52.33; cost per completed participant: $103.66 vs $80.43). Participants recruited via social media were more likely to be younger (P=.001) and less confident in their quit attempts (P=.004) compared to those recruited via traditional methods. Conclusions Our study suggests that while social media advertising may be effective in generating interest from potential participants, this strategy’s ability to attract conscientious recruits is more questionable. Researchers considering using online resources (eg, social media advertising, matrix codes) should consider including prescreening questions to promote conversion percentages. Ultimately, researchers seeking to maximize their recruitment budget should consider using a combination of advertising strategies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN 12614000329662; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365947l (Archived by WebCite at http://www.webcitation.org/6jc6zXWZI) PMID:27511829

Can statistical linkage of missing variables reduce bias in treatment effect estimates in comparative effectiveness research studies?

PubMed

Crown, William; Chang, Jessica; Olson, Melvin; Kahler, Kristijan; Swindle, Jason; Buzinec, Paul; Shah, Nilay; Borah, Bijan

2015-09-01

Missing data, particularly missing variables, can create serious analytic challenges in observational comparative effectiveness research studies. Statistical linkage of datasets is a potential method for incorporating missing variables. Prior studies have focused upon the bias introduced by imperfect linkage. This analysis uses a case study of hepatitis C patients to estimate the net effect of statistical linkage on bias, also accounting for the potential reduction in missing variable bias. The results show that statistical linkage can reduce bias while also enabling parameter estimates to be obtained for the formerly missing variables. The usefulness of statistical linkage will vary depending upon the strength of the correlations of the missing variables with the treatment variable, as well as the outcome variable of interest.

Evaluation of the Treatment of Diabetic Retinopathy A Research Project

ERIC Educational Resources Information Center

Kupfer, Carl

1973-01-01

Evaluated is the treatment of diabetic retinopathy (blindness due to ruptured vessels of the retina as a side effect of diabetes), and described is a research project comparing two types of photocoagulation treatment. (DB)

Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network.

PubMed

Ali, Joseph; Califf, Robert; Sugarman, Jeremy

2016-01-01

PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward.

"Medical effectiveness" in Canadian and U.S. health policy: the comparative politics of inferential ambiguity.

PubMed Central

Tanenbaum, S J

1996-01-01

OBJECTIVE: To compare Canadian and U.S. policymaking to determine how different health care systems may use health services research differently in responding to the common problem of ineffective medical care. DATA SOURCES/STUDY DESIGN/DATA COLLECTION: Not applicable. PRINCIPAL FINDINGS: The United States and Canada are making surprisingly divergent responses to the problem of medical ineffectiveness: reinforcement of the solidarity principle and deprivatization in Canada, and reinforcement of market competition and privatization in the United States. In doing so, Canadian policymakers overstate the societal applicability and U.S. policymakers the individual applicability of outcomes research findings. CONCLUSIONS: Probabilistic findings of medical effectiveness are fundamentally ambiguous as they relate to action. They therefore invite divergent policy responses from different policy regimes. Health services researchers must not imagine that research findings are sufficient to determine the course of health policy. PMID:8943988

Assessing the comparative effectiveness of newly marketed medications: methodological challenges and implications for drug development.

PubMed

Schneeweiss, S; Gagne, J J; Glynn, R J; Ruhl, M; Rassen, J A

2011-12-01

Comparative-effectiveness research (CER) aims to produce actionable evidence regarding the effectiveness and safety of medical products and interventions as they are used outside of controlled research settings. Although CER evidence regarding medications is particularly needed shortly after market approval, key methodological challenges include (i) potential bias due to channeling of patients to the newly marketed medication because of various patient-, physician-, and system-related factors; (ii) rapid changes in the characteristics of the user population during the early phase of marketing; and (iii) lack of timely data and the often small number of users in the first few months of marketing. We propose a mix of approaches to generate comparative-effectiveness data in the early marketing period, including sequential cohort monitoring with secondary health-care data and propensity score (PS) balancing, as well as extended follow-up of phase III and phase IV trials, indirect comparisons of placebo-controlled trials, and modeling and simulation of virtual trials.

Teaching reading comprehension to learners with autism spectrum disorder: Discrepancies between teacher and research-recommended practices.

PubMed

Accardo, Amy L; Finnegan, Elizabeth G

2017-11-01

Students with autism spectrum disorder have been found to experience difficulty with reading comprehension despite intact decoding and word recognition. This identified need for targeted reading comprehension remediation results in a need for teachers to utilize research-based practices and to individualize instruction for students with autism spectrum disorder; however, teachers report a lack of access to such practices. This study utilized survey methodology to gather perceptions and experiences of teachers and to compare teacher preparedness to use effective instructional practices emerging from the extant research to teacher-reported effective practices in the classroom. Study findings, based on 112 participants, reveal a discrepancy between teacher-reported effective practices, and the practices identified as effective through research, indicating a research to practice gap. Implications for practice include professional development recommendations, and the need for increased communication between researchers and teachers.

The role of randomized cluster crossover trials for comparative effectiveness testing in anesthesia: design of the Benzodiazepine-Free Cardiac Anesthesia for Reduction in Postoperative Delirium (B-Free) trial.

PubMed

Spence, Jessica; Belley-Côté, Emilie; Lee, Shun Fu; Bangdiwala, Shrikant; Whitlock, Richard; LeManach, Yannick; Syed, Summer; Lamy, Andre; Jacobsohn, Eric; MacIsaac, Sarah; Devereaux, P J; Connolly, Stuart

2018-07-01

Increasingly, clinicians and researchers recognize that studies of interventions need to evaluate not only their therapeutic efficacy (i.e., the effect on an outcome in ideal, controlled settings) but also their real-world effectiveness in broad, unselected patient groups. Effectiveness trials inform clinical practice by comparing variations in therapeutic approaches that fall within the standard of care. In this article, we discuss the need for studies of comparative effectiveness in anesthesia and the limitations of individual patient randomized-controlled trials in determining comparative effectiveness. We introduce the concept of randomized cluster crossover trials as a means of answering questions of comparative effectiveness in anesthesia, using the design of the Benzodiazepine-Free Cardiac Anesthesia for Reduction in Postoperative Delirium (B-Free) trial (Clinicaltrials.gov identifier NCT03053869).

Ability and Use of Comparative Effectiveness Research by P&T Committee Members and Support Staff: A 1-Year Follow-up.

PubMed

Augustine, Jill; Warholak, Terri L; Hines, Lisa E; Sun, Diana; Brown, Mary; Hurwitz, Jason; Taylor, Ann M; Brixner, Diana; Cobaugh, Daniel J; Schlaifer, Marissa; Malone, Daniel C

2016-06-01

In recent years, comparative effectiveness tools and methods have evolved to assist health care decision makers in identifying optimal therapies. In-person training programs on comparative effectiveness research may be helpful in understanding and applying this information. To provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program, in which participants were taught about CER designs and how to access available CER resources through the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program. A retrospective, cross-sectional questionnaire was developed and mailed to 2 groups of individuals: CER workshop attendees and interested nonattendees (expressing an interest in attending a workshop but did not attend for unknown reasons). The questionnaire asked respondents to indicate personal and organizational use of CER in the decision-making process. Participants were asked to indicate whether their knowledge, ability, and use of CER studies increased since participating in the program. Data were analyzed using nonparametric tests to compare the responses of attendees and nonattendees, as well as overall reliability of the instrument. A total of 164 respondents completed the questionnaire (63 attendees and 101 nonattendees; overall response rate = 44%). The majority of respondents were pharmacists (n = 157, 95.7%) and were affiliated with a hospital (n = 106, 64.6%). Proportions of attendees and nonattendees differed significantly in the use of EHC research reviews/reports (45% and 28%, respectively; P = 0.02) and EHC executive summaries of research reviews/reports (48% and 29%, respectively; P = 0.01). At 1-year follow-up, the majority of attendees reported an increase ("somewhat" or "very much") in knowledge of CER (91.5%), ability to use CER (83.0%), and use of CER studies (58.7%). Health professionals attending a continuing education CER program reported higher use of EHC CER materials compared with nonattendees. Additionally, attendees reported increased use of CER in clinical decision making. A continuing education program such as this may provide an effective avenue for introducing CER methods and resources to the P&T committee and clinical decision-making processes. This project was supported by grant number R18HS019220 from the Agency of Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency of Healthcare Research and Quality. Augustine has stock in Pfizer. The authors declared no other potential conflicts of interest associated with this study. Study concept and design were primarily contributed by Malone, along with Warholak, Hines, Brown, Hurwitz, and Taylor. Warholak, Hines, Brown, Hurwitz, and Taylor collected the data, assisted by Malone, Brixner, Cobaugh, and Schlaifer. Data interpretation was performed by Malone and Augustine, with assistance from the other authors. The manuscript was written primarily by Augustine, with assistance from Malone, Sun, Warholak, Hines, Brown, Hurwitz, and Taylor. Malone revised the manuscript, assisted by Warholak, Hines, Brown, Hurwitz, Taylor, Brixner, Cobaugh, and Schlaifer.

Conspicuous by Their Absence: Studies Comparing and Combining Risperidone and Applied Behavior Analysis to Reduce Challenging Behavior in Children with Autism

ERIC Educational Resources Information Center

Weeden, Marc; Ehrhardt, Kristal; Poling, Alan

2009-01-01

Both risperidone, an atypical antipsychotic drug, and function-based behavior-analytic interventions are popular and empirically validated treatments for reducing challenging behavior in children with autism. The kind of research that supports their effectiveness differs, however, and no published study has directly compared their effects or…

The Effects of an Academic Alternative High School on Academically At-Risk Students

ERIC Educational Resources Information Center

Winningham, Mark L.

2012-01-01

In a causal-comparative research design, this study investigated the effectiveness of an academic alternative school in improving at-risk student outcomes in a selected county school system in the Upper Cumberland region of Tennessee. The academic alternative high school was compared to a traditional high school serving at-risk populations.…

Measurement in comparative effectiveness research.

PubMed

Chubak, Jessica; Rutter, Carolyn M; Kamineni, Aruna; Johnson, Eric A; Stout, Natasha K; Weiss, Noel S; Doria-Rose, V Paul; Doubeni, Chyke A; Buist, Diana S M

2013-05-01

Comparative effectiveness research (CER) on preventive services can shape policy and help patients, their providers, and public health practitioners select regimens and programs for disease prevention. Patients and providers need information about the relative effectiveness of various regimens they may choose. Decision makers need information about the relative effectiveness of various programs to offer or recommend. The goal of this paper is to define and differentiate measures of relative effectiveness of regimens and programs for disease prevention. Cancer screening is used to demonstrate how these measures differ in an example of two hypothetical screening regimens and programs. Conceptually and algebraically defined measures of relative regimen and program effectiveness also are presented. The measures evaluate preventive services that range from individual tests through organized, population-wide prevention programs. Examples illustrate how effective screening regimens may not result in effective screening programs and how measures can vary across subgroups and settings. Both regimen and program relative effectiveness measures assess benefits of prevention services in real-world settings, but each addresses different scientific and policy questions. As the body of CER grows, a common lexicon for various measures of relative effectiveness becomes increasingly important to facilitate communication and shared understanding among researchers, healthcare providers, patients, and policymakers. Copyright © 2013 American Journal of Preventive Medicine. All rights reserved.

An Investigation of the Relationship between Culture (As Defined by the Correlates of Effective Schools) and Achievement in Two Demographically Comparable Urban High Schools

ERIC Educational Resources Information Center

Krizan, Margaret M. Best

2012-01-01

Research investigating the level of student achievement in two demographically comparable urban high schools was examined as to the presence of or the absence of the Correlates of Effective Schools. The purpose of the study was to determine: Do the Correlates of an Effective School as identified by Lezotte distinguish a higher achieving high…

The Effects of Cover, Copy, and Compare, Performance Feedback and Rewards on the Mathematical Calculation Skills of Students Identified with Math Difficulty

ERIC Educational Resources Information Center

Benson, Geetal

2013-01-01

This study examined the isolated effects of Cover, Copy and Compare (CCC) and the effects of CCC paired with performance feedback (CCC + PF) and rewards (CCC + RW) on the mathematical calculation skills of first grade students identified with math difficulty. Four research questions were addressed in this study. 1. Does Cover, Copy, and Compare…

Smoking abstinence and reinstatement effects in adolescent cigarette smokers.

PubMed

Colby, Suzanne M; Leventhal, Adam M; Brazil, Linda; Lewis-Esquerre, Johanna; Stein, L A R; Rohsenow, Damaris J; Monti, Peter M; Niaura, Raymond S

2010-01-01

The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Adolescents (aged 14-17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1-3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15-17 hr tobacco abstinence preceding Session 2. During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents.

Smoking abstinence and reinstatement effects in adolescent cigarette smokers

PubMed Central

Leventhal, Adam M.; Brazil, Linda; Lewis-Esquerre, Johanna; Stein, L. A. R.; Rohsenow, Damaris J.; Monti, Peter M.; Niaura, Raymond S.

2010-01-01

Introduction The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Methods Adolescents (aged 14–17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1–3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15–17 hr tobacco abstinence preceding Session 2. Results During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Discussion Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents. PMID:19933776

The Effectiveness of Educational Technology Applications for Enhancing Mathematics Achievement in K-12 Classrooms: A Meta-Analysis. Educator's Summary

ERIC Educational Resources Information Center

Center for Research and Reform in Education, 2012

2012-01-01

This review summarizes research on the effects of technology use on mathematics achievement in K-12 classrooms. The main research questions included: (1) Do education technology applications improve mathematics achievement in K-12 classrooms as compared to traditional teaching methods without education technology?; and (2) What study and research…

School Choice in Indianapolis: Effects of Charter, Magnet, Private, and Traditional Public Schools

ERIC Educational Resources Information Center

Berends, Mark; Waddington, R. Joseph

2018-01-01

School choice researchers are often limited to comparing one type of choice with another (e.g., charter schools vs. traditional public schools). One area researchers have not examined is the effects of different school types within the same urban region. We fill this gap by analyzing longitudinal data for students (grades 3-8) in Indianapolis,…

Examining the Effects of Independent MALL on Vocabulary Recall and Listening Comprehension: An Exploratory Case Study of Preschool Children

ERIC Educational Resources Information Center

Terantino, Joe

2016-01-01

In recent years scholars have explored the use of mobile devices as potential sources for language learning and teaching. Mobile phones and tablets, especially, have been researched with a focus on effectively building vocabulary primarily among university-level students. Comparable research in other age groups has not been as widespread. This…

What is the role of combination drug therapy in the treatment of overactive bladder? ICI-RS 2014.

PubMed

Visco, Anthony G; Fraser, Matthew O; Newgreen, Donald; Oelke, Matthias; Cardozo, Linda

2016-02-01

The role of combination therapy using oral antimuscarinic medications for the treatment of overactive bladder was proposed at the 2014 International Consultation on Incontinence-Research Society in Bristol, UK to identify key factors to consider when making clinical decisions and to guide future research design. Combination therapy is justified if monotherapy is associated with suboptimal efficacy or bothersome side effects. Combination therapy has the potential to improve efficacy with fewer side effects than monotherapy. Two Phase 2 studies comparing combination therapy that included an antimuscarinic demonstrated improvement in mean voided volume, the primary outcome chosen, with some combinations showing improved micturition frequency and quality of life. The two studies found no evidence of an increased safety risk with combination therapy compared to monotherapy. Future studies should use clinically meaningful or patient reported outcomes such as incontinence episodes when comparing efficacy. If surrogate measures are used, a clear justification should be provided. Cost analyses should be planned for clinical research trials evaluating combination drug therapy. Combination therapy is reasonable when monotherapy has suboptimal efficacy or bothersome side effects. Future research studies evaluating combination therapy for urgency urinary incontinence should ideally(1) be performed as part of a randomized clinical trial,(2) evaluate non-responders to monotherapy,(3) evaluate combination therapy using medications with different mechanisms of action,(4) include clinically meaningful and patient reported outcomes when evaluating efficacy, and(5) include cost-effectiveness analyses to justify any increased cost by showing improvement in efficacy or reduction in side effects. © 2016 Wiley Periodicals, Inc.

Health services and policy research in hepatology.

PubMed

Talwalkar, Jayant A

2014-05-01

This article examines recent health services and policy research studies in hepatology and liver transplantation. Critical issues include access to medical care, timeliness of referral and consultation, resource utilization in clinical practice, comparative effectiveness research, and the evaluation of care delivery models. Despite policymaking efforts, there continues to be unwarranted variation in access to subspecialty care and liver transplantation services based on race and geographic location. Variations in primary care and specialist awareness of practice guidelines for liver disease contribute to disparities in appropriateness and timeliness of treatments. Defining the cost-effectiveness of increased resource utilization for novel antiviral therapies and liver transplantation continues to stimulate controversy. Few comparative effectiveness studies in hepatology exist to date, yet a growing number of analyses using national datasets will help inform policy in this arena. Identifying care delivery models that demonstrate high value for populations with chronic liver disease is critical in the context of recent healthcare reform efforts. Health services and policy research is a growing field of investigation in hepatology and liver transplantation. Further emphasis on research training and workforce development in this area will be critical for understanding and improving patient-centered outcomes for this population.

Young adult and parent stakeholder perspectives on participation in patient-centered comparative effectiveness research.

PubMed

Saunders, Tully; Mackie, Thomas I; Shah, Supriya; Gooding, Holly; de Ferranti, Sarah D; Leslie, Laurel K

2016-08-01

Explore perspectives of adolescent and young adult (AYA) and parent stakeholders regarding their engagement in comparative effectiveness research (CER) evaluating cholesterol screening and treatment strategies for 17-21 year olds. All nine AYAs and parent stakeholders participating in a 20-member panel of AYAs, parents and professionals (i.e., clinicians, researchers, policy makers, payers), completed a quantitative survey and a semistructured interview at the completion of the core CER study. AYAs and parents stakeholders emphasized the role of power differentials regarding shared knowledge, relationships and trust, and logistics. To mitigate power differentials, stakeholders recommended more materials, clearer definition of roles and in-person meetings. Perceived positive outcomes included diversity of perspectives provided, better understanding their own health and decision-making and improving CER.

Using the LOINC Semantic Structure to Integrate Community-based Survey Items into a Concept-based Enterprise Data Dictionary to Support Comparative Effectiveness Research

PubMed Central

Co, Manuel C.; Boden-Albala, Bernadette; Quarles, Leigh; Wilcox, Adam; Bakken, Suzanne

2012-01-01

In designing informatics infrastructure to support comparative effectiveness research (CER), it is necessary to implement approaches for integrating heterogeneous data sources such as clinical data typically stored in clinical data warehouses and those that are normally stored in separate research databases. One strategy to support this integration is the use of a concept-oriented data dictionary with a set of semantic terminology models. The aim of this paper is to illustrate the use of the semantic structure of Clinical LOINC (Logical Observation Identifiers, Names, and Codes) in integrating community-based survey items into the Medical Entities Dictionary (MED) to support the integration of survey data with clinical data for CER studies. PMID:24199059

Status and Prospects for Developing Electromagnetic Methods and Facilities for Engineer Reconnaissance in Russia

NASA Astrophysics Data System (ADS)

Potekaev, A. I.; Donchenko, V. A.; Zambalov, S. D.; Parvatov, G. N.; Smirnov, I. M.; Svetlichnyi, V. A.; Yakubov, V. P.; Yakovlev, I. A.

2018-03-01

An analysis of the most effective methods, techniques and scientific-research developments of induction mine detectors is performed, their comparative tactical-technical characteristics are reported, and priority avenues for further research are outlined.

Effect Size as the Essential Statistic in Developing Methods for mTBI Diagnosis.

PubMed

Gibson, Douglas Brandt

2015-01-01

The descriptive statistic known as "effect size" measures the distinguishability of two sets of data. Distingishability is at the core of diagnosis. This article is intended to point out the importance of effect size in the development of effective diagnostics for mild traumatic brain injury and to point out the applicability of the effect size statistic in comparing diagnostic efficiency across the main proposed TBI diagnostic methods: psychological, physiological, biochemical, and radiologic. Comparing diagnostic approaches is difficult because different researcher in different fields have different approaches to measuring efficacy. Converting diverse measures to effect sizes, as is done in meta-analysis, is a relatively easy way to make studies comparable.

Applications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go?

PubMed

Borah, Bijan J; Moriarty, James P; Crown, William H; Doshi, Jalpa A

2014-01-01

Propensity score (PS) methods have proliferated in recent years in observational studies in general and in observational comparative effectiveness research (CER) in particular. PS methods are an important set of tools for estimating treatment effects in observational studies, enabling adjustment for measured confounders in an easy-to-understand and transparent way. This article demonstrates how PS methods have been used to address specific CER questions from 2001 through to 2012 by identifying six impactful studies from this period. This article also discusses areas for improvement, including data infrastructure, and a unified set of guidelines in terms of PS implementation and reporting, which will boost confidence in evidence generated through observational CER using PS methods.

75 FR 35820 - National Institute of Biomedical Imaging and Bioengineering; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... Imaging and Bioengineering Special Emphasis Panel Decision Support Systems and Comparative Effectiveness Research (ARRA). Date: July 23, 2010. Time: 12 p.m. to 5 p.m. Agenda: To review and evaluate grant... Assistance Program Nos. 93.701, ARRA Related Biomedical Research and Research Support Awards, National...

Improving Critical Thinking "via" Authenticity: The CASPiE Research Experience in a Military Academy Chemistry Course

ERIC Educational Resources Information Center

Chase, A. M.; Clancy, H. A.; Lachance, R. P.; Mathison, B. M.; Chiu, M. M.; Weaver, G. C.

2017-01-01

Course-based undergraduate research experiences (CUREs) can introduce many students to authentic research activities in a cost-effective manner. Past studies have shown that students who participated in CUREs report greater interest in chemistry, better data collection and analysis skills, and enhanced scientific reasoning compared to traditional…

Comparative Costs of Home Care and Residential Care

ERIC Educational Resources Information Center

Chappell, Neena L.; Havens, Betty; Honorary, Dlitt; Hollander, Marcus J.; Miller, Jo Ann; McWilliam, Carol

2004-01-01

Purpose: This paper reports on Canadian research that examined the cost effectiveness of home care for seniors as a substitute for long-term institutional services. Design and Methods: Two Canadian cities were included in the research: Victoria, British Columbia, and Winnipeg, Manitoba. The research computes the costs of formal care and informal…

Commentary: Will academia embrace comparative effectiveness research?

PubMed

Lauer, Michael S

2011-06-01

In recent medical history, a number of therapies that were widely adopted based on observational data or pathophysiological constructs turned out to be useless or even harmful when tested in randomized comparative effectiveness trials. These therapies not only harmed patients but also did a disservice to the practical education of medical students, residents, and fellows. These trainees effectively learned that it is acceptable to implement practices even in the absence of high-quality evidence, and so they may not have learned how to analyze the quality of evidence. In this issue of Academic Medicine, seven groups address critical aspects of the intersection between comparative effectiveness research (CER) and academic medicine. Their topics include the need at academic health centers for cultural shifts, for addressing conflicts of interest, for exploiting academic talent and electronic information resources, for interacting well with policy makers, for incorporating economic evaluations, for incorporating tests of educational methods, for developing multidisciplinary models, and for integrating CER into "predictive health." This commentary argues that academia must embrace CER by insisting on the highest levels of evidence, by viewing all clinical interactions as opportunities for scientific advancement, by setting an example for policy makers and colleagues working in nonacademic settings, and by engaging all physicians in the clinical research enterprise.

Carrots, tomatoes and cocoa: Research on dietary antioxidants in Düsseldorf.

PubMed

Stahl, Wilhelm

2016-04-01

Dietary antioxidants, their biological effects and underlying mechanisms of action are key topics of research at the Institute of Biochemistry and Molecular Biology I at the Heinrich-Heine University in Düsseldorf where Helmut Sies is active now since more than 35 years. In the present article his research activity on carotenoids is summarized including studies on their bioavailability, antioxidant properties, cellular signaling and dermatological effects. Additionally, comparable studies on cocoa polyphenols are described. Copyright © 2015 Elsevier Inc. All rights reserved.

Methodological recommendations for comparative research on the treatment of chronic wounds.

PubMed

Sonnad, S S; Goldsack, J C; Mohr, P; Tunis, S

2013-09-01

To provide specific recommendations to product developers and clinical researchers on the design of comparative effectiveness studies for the treatment of chronic wounds, specifically those pertaining to arterial and venous-disease related ulcers, diabetic foot ulcers, pressure ulcers and burn wounds. The recommendations were developed based on a process defined by the Center for Medical Technology Policy (CMTP). After selecting the subject area, semi-structured phone interviews were conducted by one of the authors (SSS) with representatives of payers, manufacturers, clinicians, clinician/researchers and patient advocates. Next, a broad range of stakeholders participated in a meeting convened by CMTP to determine their needs. A technical working group comprising key stakeholders then participated in clarifying recommendations developed by CMTP staff and adding important considerations for their implementation. The resulting draft document was finalised based on public and solicited comment from individual manufacturers; a consortium of product developers and manufacturers; and an alliance of physicians, providers, manufacturers and patient organisations. This article is a summary of the full effectiveness guidance document. To address the needs of patients, clinicians, guideline developers, payers and other post-regulatory decision makers, this work makes ten recommendations to guide comparative effectiveness research for chronic wound care. These recommendations fall into four categories: study design, population, comparators and outcomes. This paper suggests that using the recommendations outlined to conduct comparative effectiveness research on treatments for chronic wound therapies would facilitate trials that provide patients, clinicians, and payers with the information they need to make optimal treatment decisions. These recommendations focus on design changes that would have the largest impact in improving the usability of the results by decision makers and provide specific guidance on the design of prospective studies intended to inform decision making by patients, clinicians and payers. There were no external sources of funding for these recommendations. The Value Institute and the Center for Medical Technology Policy (CMTP) are both private, non-profit organisations. The authors have no financial, commercial or social conflicts of interest to declare with respect to the article or its content.

Disaggregated Effects of Device on Score Comparability

ERIC Educational Resources Information Center

Davis, Laurie; Morrison, Kristin; Kong, Xiaojing; McBride, Yuanyuan

2017-01-01

The use of tablets for large-scale testing programs has transitioned from concept to reality for many state testing programs. This study extended previous research on score comparability between tablets and computers with high school students to compare score distributions across devices for reading, math, and science and to evaluate device…

The economics of comparative effectiveness studies: societal and private perspectives and their implications for prioritizing public investments in comparative effectiveness research.

PubMed

Meltzer, David; Basu, Anirban; Conti, Rena

2010-01-01

Comparative effectiveness research (CER) can provide valuable information for patients, providers and payers. These stakeholders differ in their incentives to invest in CER. To maximize benefits from public investments in CER, it is important to understand the value of CER from the perspectives of these stakeholders and how that affects their incentives to invest in CER. This article provides a conceptual framework for valuing CER, and illustrates the potential benefits of such studies from a number of perspectives using several case studies. We examine cases in which CER provides value by identifying when one treatment is consistently better than others, when different treatments are preferred for different subgroups, and when differences are small enough that decisions can be made based on price. We illustrate these findings using value-of-information techniques to assess the value of research, and by examining changes in pharmaceutical prices following publication of a comparative effectiveness study. Our results suggest that CER may have high societal value but limited private return to providers or payers. This suggests the importance of public efforts to promote the production of CER. We also conclude that value-of-information tools may help inform policy decisions about how much public funds to invest in CER and how to prioritize the use of available public funds for CER, in particular targeting public CER spending to areas where private incentives are low relative to social benefits.

The Comparative Effects of Prediction/Discussion-Based Learning Cycle, Conceptual Change Text, and Traditional Instructions on Student Understanding of Genetics

ERIC Educational Resources Information Center

Yilmaz, Diba; Tekkaya, Ceren; Sungur, Semra

2011-01-01

The present study examined the comparative effects of a prediction/discussion-based learning cycle, conceptual change text (CCT), and traditional instructions on students' understanding of genetics concepts. A quasi-experimental research design of the pre-test-post-test non-equivalent control group was adopted. The three intact classes, taught by…

National Trauma Institute: A National Coordinating Center for Trauma Research Funding

DTIC Science & Technology

2016-12-01

comparing the effectiveness of modern ventilator modalities upon patients with ARDS/ALI does not exist. Low-tidal volume ventilation (ARDSNet...associated with better oxygenation , less sedative usage, and less ventilator -associated pneumonia compared with other ventilator modes. However, questions...hypercoagulable at baseline, and that further investigations into the effects of platelet activation and obesity, time-to-enoxaparin administration, and

The Design of Pre-Service Inclusive Education Courses and Their Effects on Self-Efficacy: A Comparative Study

ERIC Educational Resources Information Center

Lancaster, Julie; Bain, Alan

2010-01-01

This study compared two versions of a 13-week mandatory undergraduate inclusive education course to determine their effects on the self-efficacy of pre-service elementary education teachers. For the purposes of the research, the self-efficacy construct was applied specifically to working with students who have inclusive educational needs. The…

A Comparative Study on the Effects of Negative Evidence and Enriched Input on Learning of Verb-Noun Collocations

ERIC Educational Resources Information Center

Okyar, Hatice; Yangin Eksi, Gonca

2017-01-01

This study compared the effectiveness of negative evidence and enriched input on learning the verb-noun collocations. There were 52 English as Foreign Language (EFL) learners in this research study and they were randomly assigned to the negative evidence or enriched input groups. While the negative evidence group (n = 27) was provided with…

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research.

PubMed

Phillips, Kathryn A; Deverka, Patricia A; Sox, Harold C; Khoury, Muin J; Sandy, Lewis G; Ginsburg, Geoffrey S; Tunis, Sean R; Orlando, Lori A; Douglas, Michael P

2017-10-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address.Genet Med advance online publication 13 April 2017.

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research

PubMed Central

Phillips, Kathryn A.; Deverka, Patricia A.; Sox, Harold C.; Khoury, Muin J.; Sandy, Lewis G.; Ginsburg, Geoffrey S.; Tunis, Sean R.; Orlando, Lori A.; Douglas, Michael P.

2017-01-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address. Genet Med advance online publication 13 April 2017 PMID:28406488

Meta-Analysis of Single-Case Research Design Studies on Instructional Pacing.

PubMed

Tincani, Matt; De Mers, Marilyn

2016-11-01

More than four decades of research on instructional pacing has yielded varying and, in some cases, conflicting findings. The purpose of this meta-analysis was to synthesize single-case research design (SCRD) studies on instructional pacing to determine the relative benefits of brisker or slower pacing. Participants were children and youth with and without disabilities in educational settings, excluding higher education. Tau-U, a non-parametric statistic for analyzing data in SCRD studies, was used to determine effect size estimates. The article extraction yielded 13 instructional pacing studies meeting contemporary standards for high quality SCRD research. Eleven of the 13 studies reported small to large magnitude effects when two or more pacing parameters were compared, suggesting that instructional pacing is a robust instructional variable. Brisker instructional pacing with brief inter-trial interval (ITI) produced small increases in correct responding and medium to large reductions in challenging behavior compared with extended ITI. Slower instructional pacing with extended wait-time produced small increases in correct responding, but also produced small increases in challenging behavior compared with brief wait-time. Neither brief ITI nor extended wait-time meets recently established thresholds for evidence-based practice, highlighting the need for further instructional pacing research. © The Author(s) 2016.

Cookstove Research Update - Health effects

EPA Science Inventory

The topic by Jan Dye will focus on acute pulmonary and innate immunity health effects in mice inhaling cookstove emissions from natural draft or forced draft advanced stoves compared to a rudimentary three-stone fire.

A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

PubMed

Concannon, Thomas W; Fuster, Melissa; Saunders, Tully; Patel, Kamal; Wong, John B; Leslie, Laurel K; Lau, Joseph

2014-12-01

We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.

When to Perform Antenna Measurements in a Near-Field Range or a Short Tapered Chamber

DTIC Science & Technology

2017-03-01

study was undertaken to quantify and compare electromagnetic device (i.e., antenna) measurements using the US Army Research Laboratory’s (ARL’s) near...results for future antennas under test in the most cost-effective manner (man-hours, custom mount, etc.) 15. SUBJECT TERMS electromagnetic , chamber...study was undertaken to quantify and compare electromagnetic (EM) device (i.e., antenna) measurements using the US Army Research Laboratory’s (ARL

Begin with the End in Mind: Measuring the Effectiveness of Remediation on Student Performance on the Test of Essential Academic Skills (TEAS-V)

ERIC Educational Resources Information Center

Cumberbatch-Sullivan, Karen J.

2013-01-01

This quantitative, causal-comparative research study investigated the effectiveness of a strategy to address concerns in nursing education about the high attrition rates and poor retention rates of pre-licensure nursing students, particularly in the first semester of nursing school. Two research questions guided this study and focused on the…

The Effect of 5E-Learning Model Supported with Webquest Media on Students' Achievement and Satisfaction

ERIC Educational Resources Information Center

Sahin, Semsettin M. S.; Baturay, Meltem Huri

2016-01-01

The purpose of this research study is to investigate the effect of the 5E-learning model supported with WebQuest media on the achievement and satisfaction of students. Therefore, two groups of students were compared in an experimental research design model. The experimental group was exposed to the 5E-learning model supported with WebQuest media;…

The Effect of Electric Current Teaching Based upon the 5E Model on Academic Achievement and Attitudes of Students

ERIC Educational Resources Information Center

Guzel, Hattice

2017-01-01

In this research, the purpose was to examine and compare the effect of teaching Electric Current, which is a topic of grade 11 physics lesson, on student achievement and attitude according to the 5E model belonging to the constructivist learning theory and the traditional teaching method. The research was conducted in the spring semester of…

The Effect of Three Levels of Inquiry on the Improvement of Science Concept Understanding of Elementary School Teacher Candidates

ERIC Educational Resources Information Center

Artayasa, I. Putu; Susilo, Herawati; Lestari, Umie; Indriwati, Sri Endah

2018-01-01

This research aims to compare the effect of the implementation of three levels of inquiry: level 2 (structured inquiry), level 3 (guided inquiry), and level 4 (open inquiry) toward science concept understanding of elementary school teacher candidates. This is a quasi experiment research with pre-test post-test nonequivalent control group design.…

Annual Research Progress Report Letterman Army Institute of Research

DTIC Science & Technology

1974-06-30

Nutritional studies have been conducted compariig the efficacy of 3 different diets (Study No. 2) Studies to establish precise Oj consumption and caloric ...Muscle Metabolism as Related to Exercise, Serum Electrolytes, Diet , and Steriods in Normal Man and Disease 81 065 The Effects of Nutrition and...Factors Influencing Physiological Functioning 105 168 The Effects of Diet Upon Respiration Metabolism 111 169 Comparative Pathology of Animals Maintained

Effects of Finite Element Resolution in the Simulation of Magnetospheric Particle Motion

NASA Technical Reports Server (NTRS)

Hansen, Richard

2006-01-01

This document describes research done in conjunction with a degree program. The purpose of the research was to compare particle trajectories in a specified set of global electric and magnetic fields; to study the effect of mesh spacing, resulting in an evaluation of adequate spacing resolution; and to study time-dependent fields in the context of substorm dipolarizations of the magnetospheric tail.

Possible new treatment for Kaposi sarcoma | Center for Cancer Research

Cancer.gov

A collaborative effort by researchers at the National Cancer Institute (NCI) and Celgene Corporation, a global biopharmaceutical company, has yielded a possible new treatment for Kaposi sarcoma (KS), a cancer caused by a human gammaherpesvirus. The drug, called pomalidomide, is highly effective against KS and has fewer side effects compared with chemotherapy, suggesting that it may be a useful alternative to traditional therapies. Read more...

To Compare the Effects of Computer Based Learning and the Laboratory Based Learning on Students' Achievement Regarding Electric Circuits

ERIC Educational Resources Information Center

Bayrak, Bekir; Kanli, Uygar; Kandil Ingeç, Sebnem

2007-01-01

In this study, the research problem was: "Is the computer based physics instruction as effective as laboratory intensive physics instruction with regards to academic success on electric circuits 9th grade students?" For this research of experimental quality the design of pre-test and post-test are applied with an experiment and a control…

The Effect of Mobility on Texas Assessment of Knowledge and Skills Test Scores

ERIC Educational Resources Information Center

Alvarez, Ray

2006-01-01

This research studies the effects of mobility on the high-stakes test scores of a Title I South Central Texas school district. The study involved 10, 5th-grade elementary feeder school populations graduating to the 6th grade in 3 middle schools. The researcher compared the 1st administration scores of the Texas Assessment of Knowledge and Skills…

“Design characteristics of the CORRONA CERTAIN study: a comparative effectiveness study of biologic agents for rheumatoid arthritis patients”

PubMed Central

2014-01-01

Background Comparative effectiveness research has recently attracted considerable attention. The Comparative Effectiveness Registry to study Therapies for Arthritis and Inflammatory Conditions (CERTAIN) is an ongoing prospective cohort study of adult patients with Rheumatoid Arthritis (RA). Methods/Design CERTAIN uses the existing Consortium of Rheumatology Researchers of North America (CORRONA) network of participating private and academic sites in order to recruit patients fulfilling the 1987 ACR criteria that have at least moderate disease activity. Patients starting or switching biologic agents either anti-TNF therapy or a non anti-TNF biologic are eligible for enrollment, depending on the treatment selected by their physician. Enrollment is expected to be completed by March of 2014, and 2711 patients will participate in the study. As of October 7th 2013, 2234 patients have been enrolled. Patient visits and laboratory blood work are mandated every three months for one year. Safety data is collected through one year and beyond. The primary comparative effectiveness endpoint is attainment of low RA disease activity at one year among patients who have been exposed to at least one prior TNF-α inhibitor agent prior to enrollment. Multiple secondary effectiveness and safety endpoints will be addressed by investigating the entire population enrolled (naïve and biologic experienced). Discussion The unique design features of CERTAIN will inform comparative effectiveness and safety questions for choosing biologic agents for the management of RA. PMID:24690143

Methodological standards and patient-centeredness in comparative effectiveness research: the PCORI perspective.

PubMed

2012-04-18

Rigorous methodological standards help to ensure that medical research produces information that is valid and generalizable, and are essential in patient-centered outcomes research (PCOR). Patient-centeredness refers to the extent to which the preferences, decision-making needs, and characteristics of patients are addressed, and is the key characteristic differentiating PCOR from comparative effectiveness research. The Patient Protection and Affordable Care Act signed into law in 2010 created the Patient-Centered Outcomes Research Institute (PCORI), which includes an independent, federally appointed Methodology Committee. The Methodology Committee is charged to develop methodological standards for PCOR. The 4 general areas identified by the committee in which standards will be developed are (1) prioritizing research questions, (2) using appropriate study designs and analyses, (3) incorporating patient perspectives throughout the research continuum, and (4) fostering efficient dissemination and implementation of results. A Congressionally mandated PCORI methodology report (to be issued in its first iteration in May 2012) will begin to provide standards in each of these areas, and will inform future PCORI funding announcements and review criteria. The work of the Methodology Committee is intended to enable generation of information that is relevant and trustworthy for patients, and to enable decisions that improve patient-centered outcomes.

Comparisons among Health Behavior Surveys: Implications for the Design of Informatics Infrastructures That Support Comparative Effectiveness Research.

PubMed

Yoon, Sunmoo; Wilcox, Adam B; Bakken, Suzanne

2013-01-01

To address the electronic health data fragmentation that is a methodological limitation of comparative effectiveness research (CER), the Washington Heights Inwood Informatics Infrastructure for Comparative Effectiveness Research (WICER) project is creating a patient-centered research data warehouse (RDW) by linking electronic clinical data (ECD) from New York Presbyterian Hospital's clinical data warehouse with ECD from ambulatory care, long-term care, and home health settings and the WICER community health survey (CHS). The purposes of the research were to identify areas of overlap between the WICER CHS and two other surveys that include health behavior data (the Behavioral Risk Factor Surveillance System (BRFSS) Survey and the New York City Community Health Survey (NYC CHS)) and to identify gaps in the current WICER RDW that have the potential to affect patient-centered CER. We compared items across the three surveys at the item and conceptual levels. We also compared WICER RDW (ECD and WICER CHS), BRFSS, and NYC CHS to the County Health Ranking framework. We found that 22 percent of WICER items were exact matches with BRFSS and that there were no exact matches between WICER CHS and NYC CHS items not also contained in BRFSS. The results suggest that BRFSS and, to a lesser extent, NYC CHS have the potential to serve as population comparisons for WICER CHS for some health behavior-related data and thus may be particularly useful for considering the generalizability of CER study findings. Except for one measure related to health behavior (motor vehicle crash deaths), the WICER RDW's comprehensive coverage supports the mortality, morbidity, and clinical care measures specified in the County Health Ranking framework but is deficient in terms of some socioeconomic factors and descriptions of the physical environment as captured in BRFSS. Linkage of these data in the WICER RDW through geocoding can potentially facilitate patient-centered CER that integrates important socioeconomic and physical environment influences on health outcomes. The research methods and findings may be relevant to others interested in either integrating health behavior data into RDWs to support patient-centered CER or conducting population-level comparisons.

Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

PubMed

Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

2014-11-01

Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The role of observational investigations in comparative effectiveness research.

PubMed

Marko, Nicholas F; Weil, Robert J

2010-12-01

Comparative effectiveness research (CER) seeks to inform clinical decisions between alternate treatment strategies using data that reflects real patient populations and real-world clinical scenarios for the purpose of improving patient outcomes. There are multiple clinical situations where the unique characteristics of observational investigations can inform medical decision-making within the CER paradigm. Accordingly, it is critical for clinicians to appreciate the strengths and limitations of observational research, particularly as they apply to CER. This review focuses on the role of observational research in CER. We discuss the concept of evidence hierarchies as they relate to observational research and CER, review the scope and nature of observational research, present the rationale for its inclusion in CER investigations, discuss potential sources of bias in observational investigations as well as strategies used to compensate for these biases, and discuss a framework to implement observational research in CER. The CER paradigm recognizes the limitations of hierarchical models of evidence and favors application of a strength-of-evidence model. In this model, observational research fills gaps in randomized clinical trial data and is particularly valuable to investigate effectiveness, harms, prognosis, and infrequent outcomes as well as in circumstances where randomization is not possible and in studies of many surgical populations. Observational investigations must be designed with careful consideration of potential sources of bias and must incorporate strategies to control such bias prospectively, and their results must be reported in a uniform and transparent fashion. When these conditions can be achieved, observational research represents a valuable and critical component of modern CER. © 2010, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Practice-based evidence study design for comparative effectiveness research.

PubMed

Horn, Susan D; Gassaway, Julie

2007-10-01

To describe a new, rigorous, comprehensive practice-based evidence for clinical practice improvement (PBE-CPI) study methodology, and compare its features, advantages, and disadvantages to those of randomized controlled trials and sophisticated statistical methods for comparative effectiveness research. PBE-CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It uses the knowledge of front-line caregivers, who develop study questions and define variables as part of a transdisciplinary team. Its comprehensive measurement framework provides a basis for analyses of significant bivariate and multivariate associations between treatments and outcomes, controlling for patient differences, such as severity of illness. PBE-CPI studies can uncover better practices more quickly than randomized controlled trials or sophisticated statistical methods, while achieving many of the same advantages. We present examples of actionable findings from PBE-CPI studies in postacute care settings related to comparative effectiveness of medications, nutritional support approaches, incontinence products, physical therapy activities, and other services. Outcomes improved when practices associated with better outcomes in PBE-CPI analyses were adopted in practice.

An Approach to Assess Generalizability in Comparative Effectiveness Research: A Case Study of the Whole Systems Demonstrator Cluster Randomized Trial Comparing Telehealth with Usual Care for Patients with Chronic Health Conditions.

PubMed

Steventon, Adam; Grieve, Richard; Bardsley, Martin

2015-11-01

Policy makers require estimates of comparative effectiveness that apply to the population of interest, but there has been little research on quantitative approaches to assess and extend the generalizability of randomized controlled trial (RCT)-based evaluations. We illustrate an approach using observational data. Our example is the Whole Systems Demonstrator (WSD) trial, in which 3230 adults with chronic conditions were assigned to receive telehealth or usual care. First, we used novel placebo tests to assess whether outcomes were similar between the RCT control group and a matched subset of nonparticipants who received usual care. We matched on 65 baseline variables obtained from the electronic medical record. Second, we conducted sensitivity analysis to consider whether the estimates of treatment effectiveness were robust to alternative assumptions about whether "usual care" is defined by the RCT control group or nonparticipants. Thus, we provided alternative estimates of comparative effectiveness by contrasting the outcomes of the RCT telehealth group and matched nonparticipants. For some endpoints, such as the number of outpatient attendances, the placebo tests passed, and the effectiveness estimates were robust to the choice of comparison group. However, for other endpoints, such as emergency admissions, the placebo tests failed and the estimates of treatment effect differed markedly according to whether telehealth patients were compared with RCT controls or matched nonparticipants. The proposed placebo tests indicate those cases when estimates from RCTs do not generalize to routine clinical practice and motivate complementary estimates of comparative effectiveness that use observational data. Future RCTs are recommended to incorporate these placebo tests and the accompanying sensitivity analyses to enhance their relevance to policy making. © The Author(s) 2015.

How Generalizable Is Your Experiment? An Index for Comparing Samples and Populations

ERIC Educational Resources Information Center

Tipton, Elizabeth

2013-01-01

Recent research on the design of social experiments has highlighted the effects of different design choices on research findings. Since experiments rarely collect their samples using random selection, in order to address these external validity problems and design choices, recent research has focused on two areas. The first area is on methods for…

A Review of the Research Literature on the Infusion of Technology into the School Curriculum

ERIC Educational Resources Information Center

Morrison, Gary R.; Morrison, Jennifer R.; Ross, Steven M.

2016-01-01

For many years, researchers attempted to prove that the use of technology would improve student achievement (Morrison, 1994). Many of these assertions prompted researchers to "test" the effectiveness of these various technologies by comparing a technology such as television or computers to a teacher teaching. While a number of…

An Action Research Study on the Effect of Interactive Technology and Active Learning on Student Performance

ERIC Educational Resources Information Center

Bear, Teresa J.

2013-01-01

This quantitative action science research study utilized a causal-comparative experimental research design in order to determine if the use of student response systems (clickers), as an active learning strategy in a community college course, improved student performance in the course. Students in the experimental group (n = 26) used clickers to…

DEVELOPMENT, APPLICATION AND VALIDATION OF A SHEEPSHEAD MINNOW ESTROGEN-RESPONSIVE CDNA MACROARRAY

EPA Science Inventory

This presentation provides an overview of research conducted by the Gulf Ecology Division investigating the effects of endocrine disrupting chemicals on estuarine fish species. A series of research studies were initiated to examine the comparative dose-response characteristics an...

Comparative-effectiveness research to aid population decision making by relating clinical outcomes and quality-adjusted life years.

PubMed

Campbell, Jonathan D; Zerzan, Judy; Garrison, Louis P; Libby, Anne M

2013-04-01

Comparative-effectiveness research (CER) at the population level is missing standardized approaches to quantify and weigh interventions in terms of their clinical risks, benefits, and uncertainty. We proposed an adapted CER framework for population decision making, provided example displays of the outputs, and discussed the implications for population decision makers. Building on decision-analytical modeling but excluding cost, we proposed a 2-step approach to CER that explicitly compared interventions in terms of clinical risks and benefits and linked this evidence to the quality-adjusted life year (QALY). The first step was a traditional intervention-specific evidence synthesis of risks and benefits. The second step was a decision-analytical model to simulate intervention-specific progression of disease over an appropriate time. The output was the ability to compare and quantitatively link clinical outcomes with QALYs. The outputs from these CER models include clinical risks, benefits, and QALYs over flexible and relevant time horizons. This approach yields an explicit, structured, and consistent quantitative framework to weigh all relevant clinical measures. Population decision makers can use this modeling framework and QALYs to aid in their judgment of the individual and collective risks and benefits of the alternatives over time. Future research should study effective communication of these domains for stakeholders. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Comparing the Effectiveness of Error-Correction Strategies in Discrete Trial Training

ERIC Educational Resources Information Center

Turan, Michelle K.; Moroz, Lianne; Croteau, Natalie Paquet

2012-01-01

Error-correction strategies are essential considerations for behavior analysts implementing discrete trial training with children with autism. The research literature, however, is still lacking in the number of studies that compare and evaluate error-correction procedures. The purpose of this study was to compare two error-correction strategies:…

Parametric Investigation of a High-Lift Airfoil at High Reynolds Numbers

NASA Technical Reports Server (NTRS)

Lin, John C.; Dominik, Chet J.

1997-01-01

A new two-dimensional, three-element, advanced high-lift research airfoil has been tested in the NASA Langley Research Center s Low-Turbulence Pressure Tunnel at a chord Reynolds number up to 1.6 x 107. The components of this high-lift airfoil have been designed using a incompressible computational code (INS2D). The design was to provide high maximum-lift values while maintaining attached flow on the single-segment flap at landing conditions. The performance of the new NASA research airfoil is compared to a similar reference high-lift airfoil. On the new high-lift airfoil the effects of Reynolds number on slat and flap rigging have been studied experimentally, as well as the Mach number effects. The performance trend of the high-lift design is comparable to that predicted by INS2D over much of the angle-of-attack range. However, the code did not accurately predict the airfoil performance or the configuration-based trends near maximum lift where the compressibility effect could play a major role.

Future directions for cardiovascular disease comparative effectiveness research: report of a workshop sponsored by the National Heart, Lung, and Blood Institute.

PubMed

Hlatky, Mark A; Douglas, Pamela S; Cook, Nakela L; Wells, Barbara; Benjamin, Emelia J; Dickersin, Kay; Goff, David C; Hirsch, Alan T; Hylek, Elaine M; Peterson, Eric D; Roger, Véronique L; Selby, Joseph V; Udelson, James E; Lauer, Michael S

2012-08-14

Comparative effectiveness research (CER) aims to provide decision makers with the evidence needed to evaluate the benefits and harms of alternative clinical management strategies. CER has become a national priority, with considerable new research funding allocated. Cardiovascular disease is a priority area for CER. This workshop report provides an overview of CER methods, with an emphasis on practical clinical trials and observational treatment comparisons. The report also details recommendations to the National Heart, Lung, and Blood Institute for a new framework for evidence development to foster cardiovascular CER, and specific studies to address 8 clinical issues identified by the Institute of Medicine as high priorities for cardiovascular CER. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Creating the Total Quality Effective School.

ERIC Educational Resources Information Center

Lezotte, Lawrence W.

This book shows how Deming's Total Quality Management (TQM) theory for organizational management can be integrated with the effective-schools literature. Part 1 compares the 14 principles of TQM with the tenets of effective-schools research. The second part develops a blueprint for creating the total quality effective school. The conceptual…

CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials.

PubMed

Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

2011-03-01

Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of knowledge about patients' lifestyle behaviors that may affect cancer's progression and recurrence, and limited ability to compile and interpret the wide range of variables that must be considered in the cancer treatment. This lack of data integration limits the potential for patients and clinicians to engage in fully informed decision-making regarding cancer prevention, treatment, and survivorship care, and the translation of research results into mainstream medical care. Particularly important, as noted in a 2009 report on CER to the President and Congress, the limited focus on health behavior-change interventions was a major hindrance in this research landscape (DHHS 2009). This paper describes an initiative to improve CER for cancer by addressing several of these limitations. The Cyberinfrastructure for Comparative Effectiveness Research (CYCORE) project, informed by the National Science Foundation's 2007 report "Cyberinfrastructure Vision for 21(st) Century Discovery" has, as its central aim, the creation of a prototype for a user-friendly, open-source cyberinfrastructure (CI) that supports acquisition, storage, visualization, analysis, and sharing of data important for cancer-related CER. Although still under development, the process of gathering requirements for CYCORE has revealed new ways in which CI design can significantly improve the collection and analysis of a wide variety of data types, and has resulted in new and important partnerships among cancer researchers engaged in advancing health-related CI.

Comparative effectiveness research (CER): a summary of AHRQ's CER on therapies for rheumatoid arthritis.

PubMed

Oderda, Gary M; Balfe, Lisa M

2011-01-01

In recent years, the U.S. government has designated funding of several large-scale initiatives for comparative effectiveness research (CER) in health care. The American Recovery and Reinvestment Act (ARRA) of 2009 apportioned more than $1 billion to support CER programs administered by the Department of Health and Human Services (DHHS), the National Institutes of Health (NIH), and the Agency for Healthcare Research and Quality (AHRQ). CER is generally defined as the undertaking of original research or systematic reviews of published literature in order to compare the benefits and risks of different approaches to preventing, diagnosing, or treating diseases. These approaches may include diagnostic tests, medications, medical devices, and surgeries. The overall goals of CER are to support informed health care decisions by patients, clinicians, payers, and policy makers and to apply its evidence to ultimately improve the quality, effectiveness, and efficiency of health care. To (a) provide managed care professionals with general definitions of CER, specifically as it is administered by AHRQ; (b) discuss the importance of CER to clinical and managed care pharmacists; and (c) summarize key methods and findings from AHRQ's 2007 comparative effectiveness review on therapies for rheumatoid arthritis (RA). As supported by AHRQ, CER is conducted in order to synthesize comprehensive evidence on the comparative benefits and harms of treatment interventions. The findings from comparative effectiveness reviews can thus contribute to informing therapeutic strategies and treatment decisions. In 2007, a multitude of RA treatment options and studies motivated AHRQ to commission a systematic comparative effectiveness review. Conducted by investigators at the RTI-University of North Carolina Evidence-Based Practice Center, the review included comparisons of synthetic disease-modifying antirheumatic drugs (DMARDs), biologic agents, synthetic DMARDs versus biologic agents, and various combination therapies. Head-to-head comparisons of synthetic DMARDs generally revealed no significant differences in long-term clinical and radiographic outcomes, or in functional capacity or health-related quality of life. Two nonrandomized prospective cohort studies and 1 open-label effectiveness trial reported no differences in ACR20 and ACR50 response rates in patients treated with the tissue necrosis factor (TNF)-alpha inhibitors etanercept and infliximab. Comparisons of TNF-alpha inhibitors generally indicated no significant differences in rates of adverse events, including serious infections, and no increases in rates over time. In comparisons of a biologic agent combined with methotrexate versus a biologic agent alone, combination therapies were generally associated with better clinical response rates and better outcomes of functional capacity and quality of life. The most common adverse events observed in studies on biologic agents were diarrhea, headache, nausea, rhinitis, injection site reactions, and upper respiratory tract infections.

Variability in the Results of Meta-Analysis as a Function of Comparing Effect Sizes Based on Scores from Noncomparable Measures: A Simulation Study

ERIC Educational Resources Information Center

Nugent, William R.

2017-01-01

Meta-analysis is a significant methodological advance that is increasingly important in research synthesis. Fundamental to meta-analysis is the presumption that effect sizes, such as the standardized mean difference (SMD), based on scores from different measures are comparable. It has been argued that population observed score SMDs based on scores…

Creatine and Caffeine: Considerations for Concurrent Supplementation.

PubMed

Trexler, Eric T; Smith-Ryan, Abbie E

2015-12-01

Nutritional supplementation is a common practice among athletes, with creatine and caffeine among the most commonly used ergogenic aids. Hundreds of studies have investigated the ergogenic potential of creatine supplementation, with consistent improvements in strength and power reported for exercise bouts of short duration (≤ 30 s) and high intensity. Caffeine has been shown to improve endurance exercise performance, but results are mixed in the context of strength and sprint performance. Further, there is conflicting evidence from studies comparing the ergogenic effects of coffee and caffeine anhydrous supplementation. Previous research has identified independent mechanisms by which creatine and caffeine may improve strength and sprint performance, leading to the formulation of multi-ingredient supplements containing both ingredients. Although scarce, research has suggested that caffeine ingestion may blunt the ergogenic effect of creatine. While a pharmacokinetic interaction is unlikely, authors have suggested that this effect may be explained by opposing effects on muscle relaxation time or gastrointestinal side effects from simultaneous consumption. The current review aims to evaluate the ergogenic potential of creatine and caffeine in the context of high-intensity exercise. Research directly comparing coffee and caffeine anhydrous is discussed, along with previous studies evaluating the concurrent supplementation of creatine and caffeine.

The Spacing Effect and Metacognitive Control

ERIC Educational Resources Information Center

Mulligan, Neil W.; Peterson, Daniel J.

2014-01-01

Research suggests that spaced learning, compared with massed learning, results in superior long-term retention (the spacing effect). Son (2010) identified a potentially important moderator of the spacing effect: metacognitive control. Specifically, when participants chose massed restudy but were instead forced to space the restudy, the spacing…

Cost-Effectiveness of Four Educational Interventions.

ERIC Educational Resources Information Center

Levin, Henry M.; And Others

This study employs meta-analysis and cost-effectiveness instruments to evaluate and compare cross-age tutoring, computer assistance, class size reductions, and instructional time increases for their utility in improving elementary school reading and math scores. Using intervention effect studies as replication models, researchers first estimate…

Using primary care electronic health record data for comparative effectiveness research: experience of data quality assessment and preprocessing in The Netherlands.

PubMed

Huang, Yunyu; Voorham, Jaco; Haaijer-Ruskamp, Flora M

2016-07-01

Details of data quality and how quality issues were solved have not been reported in published comparative effectiveness studies using electronic health record data. We developed a conceptual framework of data quality assessment and preprocessing and apply it to a study comparing angiotensin-converting enzyme inhibitors with angiotensin receptor blockerss on renal function decline in diabetes patients. The framework establishes a line of thought to identify and act on data issues. The core concept is to evaluate whether data are fit-for-use for research tasks. Possible quality problems are listed through specific signal detections, and verified whether they are true problems. Optimal solutions are selected for the identified problems. This framework can be used in observational studies to improve validity of results.

Workload-Matched Adaptive Automation Support of Air Traffic Controller Information Processing Stages

NASA Technical Reports Server (NTRS)

Kaber, David B.; Prinzel, Lawrence J., III; Wright, Melanie C.; Clamann, Michael P.

2002-01-01

Adaptive automation (AA) has been explored as a solution to the problems associated with human-automation interaction in supervisory control environments. However, research has focused on the performance effects of dynamic control allocations of early stage sensory and information acquisition functions. The present research compares the effects of AA to the entire range of information processing stages of human operators, such as air traffic controllers. The results provide evidence that the effectiveness of AA is dependent on the stage of task performance (human-machine system information processing) that is flexibly automated. The results suggest that humans are better able to adapt to AA when applied to lower-level sensory and psychomotor functions, such as information acquisition and action implementation, as compared to AA applied to cognitive (analysis and decision-making) tasks. The results also provide support for the use of AA, as compared to completely manual control. These results are discussed in terms of implications for AA design for aviation.

The Effect of Brightness of Lamps Teaching Based on the 5E Model on Students' Academic Achievement and Attitudes

ERIC Educational Resources Information Center

Guzel, Hatice

2016-01-01

The purpose of this research was to examine and compare the effect of teaching the brightness of lamps, which is a topic for grade 11 physics lesson, on student achievement and attitude according to the 5E model belonging to the constructivist learning theory and the traditional teaching method. The research was conducted on 62 11th grade students…

The Long-Term Effectiveness of Reading Recovery and the Cost-Efficiency of Reading Recovery Relative to the Learning Disabled Classification Rate

ERIC Educational Resources Information Center

Galluzzo, Charles A.

2010-01-01

There is a great deal of research supporting Reading Recovery as a successful reading intervention program that assists below level first graders readers in closing the gap in reading at the same level of their average peers. There is a lack of research that analyses the cost-effectiveness of the Reading Recovery program compared to the cost in…

75 FR 15893 - Tire Fuel Efficiency Consumer Information Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... comparative performance information to inform consumers about the effect of their choices among replacement... Displays, 70 FR 18136 (April 8, 2005). \\4\\ Transportation Research Board Special Report 286, Tires and Passenger Vehicle Fuel Economy, National Research Council of the National Academies, 5 (2006) (hereinafter...

A COMPARATIVE ANALYSIS OF THE RESEARCH UTILIZATION PROCESS.

ERIC Educational Resources Information Center

LIPPITT, RONALD; AND OTHERS

A SUGGESTED MODEL FOR ADEQUATE DISSEMINATION OF RESEARCH FINDINGS CONSIDERS FOUR PRIMARY BARRIERS TO EFFECTIVE COMMUNICATION--(1) DIVISION OF PERSONNEL LABOR INTO TASK ROLES, (2) INSTITUTIONAL DISTINCTIONS, (3) DEVELOPMENT OF PROFESSIONAL REFERENCE GROUPS, AND (4) GEOGRAPHICAL DIVISIONS. SUGGESTED SOLUTIONS INCLUDE LINKING SYSTEMS AND ROLES,…

Comparing Three Methods for Teaching Newton's Third Law

ERIC Educational Resources Information Center

Smith, Trevor I.; Wittman, Michael C.

2007-01-01

Although guided-inquiry methods for teaching introductory physics have been individually shown to be more effective at improving conceptual understanding than traditional lecture-style instruction, researchers in physics education have not studied differences among reform-based curricula in much detail. Several researchers have developed…

Comparative effectiveness research in DARTNet primary care practices: point of care data collection on hypoglycemia and over-the-counter and herbal use among patients diagnosed with diabetes.

PubMed

Libby, Anne M; Pace, Wilson; Bryan, Cathy; Anderson, Heather Orton; Ellis, Samuel L; Allen, Richard Read; Brandt, Elias; Huebschmann, Amy G; West, David; Valuck, Robert J

2010-06-01

The Distributed Ambulatory Research in Therapeutics Network (DARTNet) is a federated network of electronic health record (EHR) data, designed as a platform for next-generation comparative effectiveness research in real-world settings. DARTNet links information from nonintegrated primary care clinics that use EHRs to deliver ambulatory care to overcome limitations with traditional observational research. Test the ability to conduct a remote, electronic point of care study in DARTNet practices by prompting clinic staff to obtain specific information during a patient encounter. Prospective survey of patients identified through queries of clinical data repositories in federated network organizations. On patient visit, survey is triggered and data are relinked to the EHR, de-identified, and copied for evaluation. Adult patients diagnosed with diabetes mellitus that scheduled a clinic visit for any reason in a 2-week period in DARTNet primary care practices. Survey on hypoglycemic events (past month) and over-the-counter and herbal supplement use. DARTNet facilitated point of care data collection triggered by an electronic prompt for additional information at a patient visit. More than one-third of respondents (33% response rate) reported either mild (45%) or severe hypoglycemic events (5%) in the month before the survey; only 3 of those were also coded using the ICD-9 (a significant difference in detection rates 37% vs. 1%). Nearly one-quarter of patients reported taking an OTC/herbal, 4% specifically for the treatment of symptoms of diabetes. Prospective data collection is feasible in DARTNet and can enable comparative effectiveness and safety research.

Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.

PubMed

Brody, Howard; Croisant, Sharon A; Crowder, Jerome W; Banda, Jonathan P

2015-02-01

Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group (A) or a higher income White group (B). Participants were presented with a variety of background reading and study materials. Meetings were held 2 hr per week for 6 weeks. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups. Group B addressed more topics than Group A and in some instances explored additional policy nuances. Members of Group A appeared more cognizant of issues of social justice that affect vulnerable populations and appeared leery of approaches that suggested possible disrespect for their own personal experiences. Future plans call for both repeating the dialogue with additional, diverse community groups and repeating community bioethics dialogues on new topics with the same groups. © The Author(s) 2015.

Employing open/hidden administration in psychotherapy research: A randomized-controlled trial of expressive writing

PubMed Central

Tondorf, Theresa; Kaufmann, Lisa-Katrin; Degel, Alexander; Locher, Cosima; Birkhäuer, Johanna; Gerger, Heike; Ehlert, Ulrike

2017-01-01

Psychotherapy has been shown to be effective, but efforts to prove specific effects by placebo-controlled trials have been practically and conceptually hampered. We propose that adopting open/hidden designs from placebo research would offer a possible way to establish specificity in psychotherapy. Therefore, we tested the effects of providing opposing treatment rationales in an online expressive writing intervention on affect in healthy subjects. Results indicate that it was possible to conduct the expressive writing intervention both covertly and openly, but that participants in the hidden administration condition did not fully benefit from the otherwise effective expressive writing intervention in the long-run. Effect sizes between open and hidden administration groups were comparable to pre-post effect sizes of the intervention. While this finding is important for the understanding of psychotherapy's effects per se, it also proves that alternative research approaches to establish specificity are feasible and informative in psychotherapy research. Trial registration: German Clinical Trials Register DRKS00009428 PMID:29176768

Alcohol Alert: Alcohol's Damaging Effects on the Brain

MedlinePlus

... early stages of development, as researchers strive to design therapies that can help prevent alcohol’s harmful effects ... of postnatal hippocampal neurogenesis in rats. Journal of Comparative Neurology 124(3):319–335, 1965. (30) Crews, ...

Addressing "waste" in diagnostic imaging: some implications of comparative effectiveness research.

PubMed

Elshaug, Adam G; Bessen, Taryn; Moss, John R; Hiller, Janet E

2010-08-01

Comparative effectiveness research is intended to provide evidence to improve patient outcomes through the use of the most appropriate health technology affordable. The authors present 5 case studies, focusing on the use of plain radiography in common clinical scenarios, to illustrate the considerable scope for comparative effectiveness research within medical imaging and the different levels of evidence currently in existence to guide the improved use of medical imaging. These are blunt ankle injury, breast cancer follow-up, low back pain, routine daily chest x-rays in intensive care, and screening for breast cancer. Although there are established models for evaluating new technologies, especially pharmaceuticals, against the most commonly used current technology, the evaluation of technologies in current clinical practice is in an early phase of development. Because evaluation resources are limited, one major challenge is developing ways to identify established technologies for evaluation to refine the indications for their use. A set of criteria with which to identify established technologies that may not be delivering value for money is described, and their use is illustrated in relation to the 5 case studies. These criteria could be incorporated into literature search strategies, stakeholder consultations, and utilization scanning. Once identified, these technologies should be formally evaluated for their performance in improving patient health without restricting the availability of other effective interventions. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Methodological challenges collecting parent phone-call healthcare utilization data.

PubMed

Moreau, Paula; Crawford, Sybil; Sullivan-Bolyai, Susan

2016-02-01

Recommendations by the National Institute of Nursing Research and other groups have strongly encouraged nurses to pay greater attention to cost-effectiveness analysis when conducting research. Given the increasing prominence of translational science and comparative effective research, cost-effective analysis has become a basic tool in determining intervention value in research. Tracking phone-call communication (number of calls and context) with cross-checks between parents and healthcare providers is an example of this type of healthcare utilization data collection. This article identifies some methodological challenges that have emerged in the process of collecting this type of data in a randomized controlled trial: Parent education Through Simulation-Diabetes (PETS-D). We also describe ways in which those challenges have been addressed with comparison data results, and make recommendations for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparative effectiveness of next generation genomic sequencing for disease diagnosis: design of a randomized controlled trial in patients with colorectal cancer/polyposis syndromes.

PubMed

Gallego, Carlos J; Bennette, Caroline S; Heagerty, Patrick; Comstock, Bryan; Horike-Pyne, Martha; Hisama, Fuki; Amendola, Laura M; Bennett, Robin L; Dorschner, Michael O; Tarczy-Hornoch, Peter; Grady, William M; Fullerton, S Malia; Trinidad, Susan B; Regier, Dean A; Nickerson, Deborah A; Burke, Wylie; Patrick, Donald L; Jarvik, Gail P; Veenstra, David L

2014-09-01

Whole exome and whole genome sequencing are applications of next generation sequencing transforming clinical care, but there is little evidence whether these tests improve patient outcomes or if they are cost effective compared to current standard of care. These gaps in knowledge can be addressed by comparative effectiveness and patient-centered outcomes research. We designed a randomized controlled trial that incorporates these research methods to evaluate whole exome sequencing compared to usual care in patients being evaluated for hereditary colorectal cancer and polyposis syndromes. Approximately 220 patients will be randomized and followed for 12 months after return of genomic findings. Patients will receive findings associated with colorectal cancer in a first return of results visit, and findings not associated with colorectal cancer (incidental findings) during a second return of results visit. The primary outcome is efficacy to detect mutations associated with these syndromes; secondary outcomes include psychosocial impact, cost-effectiveness and comparative costs. The secondary outcomes will be obtained via surveys before and after each return visit. The expected challenges in conducting this randomized controlled trial include the relatively low prevalence of genetic disease, difficult interpretation of some genetic variants, and uncertainty about which incidental findings should be returned to patients. The approaches utilized in this study may help guide other investigators in clinical genomics to identify useful outcome measures and strategies to address comparative effectiveness questions about the clinical implementation of genomic sequencing in clinical care. Copyright © 2014 Elsevier Inc. All rights reserved.

Commercial discharge packs and breast-feeding counseling: effects on infant-feeding practices in a randomized trial.

PubMed

Frank, D A; Wirtz, S J; Sorenson, J R; Heeren, T

1987-12-01

A randomized controlled trial was conducted to evaluate two interventions for prolonging the duration of breast-feeding in a multiethnic sample of 343 low-income urban women. One intervention compared research breast-feeding bedside counseling by a trained counselor, who also made eight telephone calls during the first 3 months of the infant's life, with the routine breast-feeding counseling provided in the hospital by nurses. The other intervention compared commercial discharge packs provided by formula companies with research discharge packs designed to be consistent with the WHO Code of Marketing of Breastmilk Substitutes. When infants were 4 months old, a telephone interviewer unaware of treatment status contacted 95% (324/343) of the women to determine the infants' feeding and health histories. Compared with routine counseling, research counseling delayed the first introduction of solid foods to the infant's diet (P = .03, one-tailed) but did not exert a statistically significant effect on breast-feeding by 4 months' postpartum. Women who received the research discharge pack, compared with those who received the commercial pack, were more likely to prolong exclusive breast-feeding (P = .004, one-tailed), to be partially breast-feeding at 4 months postpartum (P = .04, one-tailed), and to delay the daily use of solid foods in the infant's diet (P = .017, one-tailed). Among the women who received research counseling, the research discharge pack was associated with lower rates of rehospitalization of infants than was the commercial pack (1% v 14%; P = .014, two-tailed). We conclude that in high-risk maternity populations, commercial discharge materials for breast-feeding women should be replaced by materials consistent with the WHO Code.

The effect of federal funding on clinical productivity: the price of academics.

PubMed

McKenney, Mark M; Livingstone, Alan S; Schulman, Carl

2011-01-01

Research is time consuming and expensive. To offset this expense, federal agencies fund the research, but the financial impact of funded research on clinical surgical productivity has not been studied. The objective is to determine departmental impact of federal funding. The relative value units, professional revenue, and funding were evaluated for clinical Faculty in the Surgery Department for fiscal year 2008. Means were compared using t test, and significance was defined as p<0.05. The Department had 61 clinical surgeons. The Department was divided into three groups based on research funding: unfunded, industry funded, and federally funded. Surgeons with both federal funding and other funding were only included in the federally funded group. There were 42 unfunded, 8 industry funded, and 11 federally funded surgeons. The relative value units, professional revenue, and salary with benefits of the three groups were compared. Federal funding is associated with a significant reduction in clinical work and clinical reimbursement. Federally funded research results in a net loss of revenue for the Surgery Department. The net effect is that the Surgery Department sponsors Federal Research and this has not been previously reported in the literature.

Assessing the comparative effectiveness of long-acting injectable vs. oral antipsychotic medications in the prevention of relapse provides a case study in comparative effectiveness research in psychiatry.

PubMed

Kane, John M; Kishimoto, Taishiro; Correll, Christoph U

2013-08-01

As psychopathology and social functioning can worsen with repeated psychotic episodes in schizophrenia, relapse prevention is critical. Because high nonadherence rates limit the efficacy of pharmacotherapy, the use of long-acting injectable (LAI) antipsychotics is considered an important treatment option. To date, many studies comparing LAIs and oral antipsychotics have been conducted; however, the results are mixed, and careful interpretation of the data is required. Selective review of existing literature regarding LAIs. We especially focused the discussion on the impact of the design of studies with different approaches comparing LAIs and oral antipsychotics in preventing relapse. The results were diverse and were influenced by the design used, that is, randomized controlled trials (RCTs) showed LAIs and oral antipsychotics to have similar effects, whereas mirror-image and some large cohort studies showed LAIs to be superior to oral antipsychotics. Divergent results from studies using different methodologies create a dilemma for comparative effectiveness research, and LAI studies may serve as an example of a situation in which a conventional RCT is not the gold standard. Traditional RCTs generally increase adherence compared with clinical practice and, therefore, might not be well suited to detect differences between LAIs and oral medications, because any increase in adherence affects patients on oral medications more than those on LAIs and thus leads to an underestimation of any potential difference in effectiveness. A possible solution would be the implementation of a true effectiveness trial in which post-randomization involvement would be kept to a minimum to better reflect routine practice. Copyright © 2013 Elsevier Inc. All rights reserved.

Adjusting for geographic variation in observational comparative effectiveness studies: a case study of antipsychotics using state Medicaid data.

PubMed

Root, Elisabeth Dowling; Thomas, Deborah S K; Campagna, Elizabeth J; Morrato, Elaine H

2014-08-27

Area-level variation in treatment and outcomes may be a potential source of confounding bias in observational comparative effectiveness studies. This paper demonstrates how to use exploratory spatial data analysis (ESDA) and spatial statistical methods to investigate and control for these potential biases. The case presented compares the effectiveness of two antipsychotic treatment strategies: oral second-generation antipsychotics (SGAs) vs. long-acting paliperiodone palmitate (PP). A new-start cohort study was conducted analyzing patient-level administrative claims data (8/1/2008-4/30/2011) from Missouri Medicaid. ESDA techniques were used to examine spatial patterns of antipsychotic prescriptions and outcomes (hospitalization and emergency department (ED) visits). Likelihood of mental health-related outcomes were compared between patients starting PP (N = 295) and oral SGAs (N = 8,626) using multilevel logistic regression models adjusting for patient composition (demographic and clinical factors) and geographic region. ESDA indicated significant spatial variation in antipsychotic prescription patterns and moderate variation in hospitalization and ED visits thereby indicating possible confounding by geography. In the multilevel models for this antipsychotic case example, patient composition represented a stronger source of confounding than geographic context. Because geographic variation in health care delivery is ubiquitous, it could be a comparative effectiveness research (CER) best practice to test for possible geographic confounding in observational data. Though the magnitude of the area-level geography effects were small in this case, they were still statistically significant and should therefore be examined as part of this observational CER study. More research is needed to better estimate the range of confounding due to geography across different types of observational comparative effectiveness studies and healthcare utilization outcomes.

Bridging Cultures and Traditions for Educational and International Development: Comparative Research, Dialogue and Difference

NASA Astrophysics Data System (ADS)

Crossley, Michael

2008-07-01

Addressing the central theme of the XIII World Congress, the paper explores a number of contemporary theoretical, methodological and organisational developments in the field of comparative education. In doing so it draws upon the author's recent work and a selection of studies carried out in the South Pacific, the Caribbean and Africa. It is argued that disciplined comparative and international research can contribute much to the development of theory and methodology - as well as to the improvement of policy and practice in education world-wide. For this to be realised it is maintained that ongoing efforts to challenge and `reconceptualise' the field deserve sustained support - and increased attention to a more effective `bridging of cultures and traditions'. This `bridging' thesis is examined in greater depth, pointing to possible ways forward for those engaged in advancing the future of comparative research in education and in the social sciences more generally.

Comparing Social Worker and Non-Social Worker Outcomes: A Research Review

ERIC Educational Resources Information Center

Rubin, Allen; Parrish, Danielle E.

2012-01-01

This article reports on a review of the literature comparing the outcomes of social workers with those of non-social workers. The review was commissioned by NASW's Texas Chapter to examine empirical evidence regarding the comparative effectiveness of social work to possibly support efforts to educate employers and the public about the value of…

The use of clinical trials in comparative effectiveness research on mental health

PubMed Central

Blanco, Carlos; Rafful, Claudia; Olfson, Mark

2013-01-01

Objectives A large body of research on comparative effectiveness research (CER) focuses on the use of observational and quasi-experimental approaches. We sought to examine the use of clinical trials as a tool for CER, particularly in mental health. Study Design and Setting Examination of three ongoing randomized clinical trials in psychiatry that address issues which would pose difficulties for non-experimental CER methods. Results Existing statistical approaches to non-experimental data appear insufficient to compensate for biases that may arise when the pattern of missing data cannot be properly modeled such as when there are no standards for treatment, when affected populations have limited access to treatment, or when there are high rates of treatment dropout. Conclusions Clinical trials should retain an important role in CER, particularly in cases of high disorder prevalence, large expected effect sizes, difficult to reach populations or when examining sequential treatments or stepped-care algorithms. Progress in CER in mental health will require careful consideration of appropriate selection between clinical trials and non-experimental designs and on allocation of research resources to optimally inform key treatment decisions for each individual patient. PMID:23849150

Assessment of porous material anisotropy and its effect on gas permeability

NASA Astrophysics Data System (ADS)

Wałowski, Grzegorz

2017-10-01

The results of experimental research upon the assessment of porous material anisotropy and its effect on gas permeability of porous materials with respect to the gas flow. The conducted research applied to natural materials with an anisotropic gap-porous structure and - for comparative purposes - to model materials such as coke, pumice and polyamide agglomerates. The research was conducted with the use of a special test stand that enables measuring the gas permeability with respect to three flow orientations compared with symmetric cubic-shaped samples. The research results show an explicit impact of the flow direction on the permeability of materials porous, which results from their anisotropic internal structures. The anisotropy coefficient and permeability effective coefficient of such materials was determined and an experimental evaluation of the value of this coefficient was conducted with respect to the gas stream and the total pressure drop across the porous deposit. The process of gas permeability was considered in the category of hydrodynamics of gas flow through porous deposits. It is important to broaden the knowledge of gas hydrodynamics assessment in porous media so far unrecognised for the development of a new generation of clean energy sources, especially in the context of biogas or raw gas production.

Comparative Effectiveness Research in Lung Diseases and Sleep Disorders

PubMed Central

Lieu, Tracy A.; Au, David; Krishnan, Jerry A.; Moss, Marc; Selker, Harry; Harabin, Andrea; Connors, Alfred

2011-01-01

The Division of Lung Diseases of the National Heart, Lung, and Blood Institute (NHLBI) held a workshop to develop recommendations on topics, methodologies, and resources for comparative effectiveness research (CER) that will guide clinical decision making about available treatment options for lung diseases and sleep disorders. A multidisciplinary group of experts with experience in efficacy, effectiveness, implementation, and economic research identified (a) what types of studies the domain of CER in lung diseases and sleep disorders should include, (b) the criteria and process for setting priorities, and (c) current resources for and barriers to CER in lung diseases. Key recommendations were to (1) increase efforts to engage stakeholders in developing CER questions and study designs; (2) invest in further development of databases and other infrastructure, including efficient methods for data sharing; (3) make full use of a broad range of study designs; (4) increase the appropriate use of observational designs and the support of methodologic research; (5) ensure that committees that review CER grant applications include persons with appropriate perspective and expertise; and (6) further develop the workforce for CER by supporting training opportunities that focus on the methodologic and practical skills needed. PMID:21965016

Comparative Analysis of Particle Swarm and Differential Evolution via Tuning on Ultrasmall Titanium Oxide Nanoclusters

NASA Astrophysics Data System (ADS)

Inclan, Eric; Lassester, Jack; Geohegan, David; Yoon, Mina

Optimization algorithms (OA) coupled with numerical methods enable researchers to identify and study (meta) stable nanoclusters without the control restrictions of empirical methods. An algorithm's performance is governed by two factors: (1) its compatibility with an objective function, (2) the dimension of a design space, which increases with cluster size. Although researchers often tune an algorithm's user-defined parameters (UDP), tuning is not guaranteed to improve performance. In this research, Particle Swarm (PSO) and Differential Evolution (DE), are compared by tuning their UDP in a multi-objective optimization environment (MOE). Combined with a Kolmogorov Smirnov test for statistical significance, the MOE enables the study of the Pareto Front (PF), made of the UDP settings that trade-off between best performance in energy minimization (``effectiveness'') based on force-field potential energy, and best convergence rate (``efficiency''). By studying the PF, this research finds that UDP values frequently suggested in the literature do not provide best effectiveness for these methods. Additionally, monotonic convergence is found to significantly improve efficiency without sacrificing effectiveness for very small systems, suggesting better compatibility. Work is supported by the U.S. Department of Energy, Office of Science, Basic Energy Sciences, Materials Sciences and Engineering Division.

Design of the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study (NC ProCESS).

PubMed

Chen, Ronald C; Carpenter, William R; Kim, Mimi; Hendrix, Laura H; Agans, Robert P; Meyer, Anne-Marie; Hoffmeyer, Anna; Reeve, Bryce B; Nielsen, Matthew E; Usinger, Deborah S; Strigo, Tara S; Jackman, Anne M; Anderson, Mary; Godley, Paul A

2015-01-01

The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) was designed in collaboration with stakeholders to compare the effectiveness of different treatment options for localized prostate cancer. Using the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry, 1,419 patients (57% of eligible) with newly-diagnosed localized prostate cancer were enrolled from January 2011 to June 2013, on average 5 weeks after diagnosis. All participants were enrolled prior to treatment and this population-based cohort is sociodemographically diverse. Prospective follow-up continues to collect data on treatments received, disease control, survival and patient-reported outcomes. This study highlights several important considerations regarding stakeholder involvement, study design and generalizability regarding comparative effectiveness research in prostate cancer.

Evidence of Public Engagement with Science: Visitor Learning at a Zoo-Housed Primate Research Centre

PubMed Central

Waller, Bridget M.; Peirce, Kate; Mitchell, Heidi; Micheletta, Jerome

2012-01-01

Primate behavioural and cognitive research is increasingly conducted on direct public view in zoo settings. The potential of such facilities for public engagement with science is often heralded, but evidence of tangible, positive effects on public understanding is rare. Here, the effect of a new zoo-based primate research centre on visitor behaviour, learning and attitudes was assessed using a quasi-experimental design. Zoo visitors approached the primate research centre more often when a scientist was present and working with the primates, and reported greater awareness of primates (including conservation) compared to when the scientist was not present. Visitors also reported greater perceived learning when the scientist was present. Installation of information signage had no main effect on visitor attitudes or learning. Visitors who interacted with the signage, however, demonstrated increased knowledge and understanding when asked about the specific information present on the signs (which was related to the ongoing facial expression research at the research centre). The findings show that primate behaviour research centres on public view can have a demonstrable and beneficial effect on public understanding of science. PMID:23028580

Evidence of public engagement with science: visitor learning at a zoo-housed primate research centre.

PubMed

Waller, Bridget M; Peirce, Kate; Mitchell, Heidi; Micheletta, Jerome

2012-01-01

Primate behavioural and cognitive research is increasingly conducted on direct public view in zoo settings. The potential of such facilities for public engagement with science is often heralded, but evidence of tangible, positive effects on public understanding is rare. Here, the effect of a new zoo-based primate research centre on visitor behaviour, learning and attitudes was assessed using a quasi-experimental design. Zoo visitors approached the primate research centre more often when a scientist was present and working with the primates, and reported greater awareness of primates (including conservation) compared to when the scientist was not present. Visitors also reported greater perceived learning when the scientist was present. Installation of information signage had no main effect on visitor attitudes or learning. Visitors who interacted with the signage, however, demonstrated increased knowledge and understanding when asked about the specific information present on the signs (which was related to the ongoing facial expression research at the research centre). The findings show that primate behaviour research centres on public view can have a demonstrable and beneficial effect on public understanding of science.

Assessing the Sensitivity of Treatment Effect Estimates to Differential Follow-Up Rates: Implications for Translational Research

PubMed Central

McCaffrey, Daniel; Ramchand, Rajeev; Hunter, Sarah B.; Suttorp, Marika

2012-01-01

We develop a new tool for assessing the sensitivity of findings on treatment effectiveness to differential follow-up rates in the two treatment conditions being compared. The method censors the group with the higher response rate to create a synthetic respondent group that is then compared with the observed cases in the other condition to estimate a treatment effect. Censoring is done under various assumptions about the strength of the relationship between follow-up and outcomes to determine how informative differential dropout can alter inferences relative to estimates from models that assume the data are missing at random. The method provides an intuitive measure for understanding the strength of the association between outcomes and dropout that would be required to alter inferences about treatment effects. Our approach is motivated by translational research in which treatments found to be effective under experimental conditions are tested in standard treatment conditions. In such applications, follow-up rates in the experimental setting are likely to be substantially higher than in the standard setting, especially when observational data are used in the evaluation. We test the method on a case study evaluation of the effectiveness of an evidence-supported adolescent substance abuse treatment program (Motivational Enhancement Therapy/Cognitive Behavioral Therapy-5 [MET/CBT-5]) delivered by community-based treatment providers relative to its performance in a controlled research trial. In this case study, follow-up rates in the community based settings were extremely low (54%) compared to the experimental setting (95%) giving raise to concerns about non-ignorable drop-out. PMID:22956890

Effects of Text Illustrations: A Review of Research.

ERIC Educational Resources Information Center

Levie, W. Howard; Lentz, Richard

1982-01-01

Reviews results of 55 experiments comparing learning from illustrated text and learning from text alone. Research in closely related fields--nonrepresentational pictures (maps, diagrams, graphic organizers), learner-produced drawings, mental imagery, and oral prose--is also examined, and guidelines for practice are offered. A 160-item reference…

Effective Charter and Traditional School Characteristics: Aligning Findings for Informed Policy Making

ERIC Educational Resources Information Center

Maas, Tricia; Lake, Robin

2015-01-01

This literature review compares the current knowledge about the characteristics of effective charter schools to findings from the broader body of effective school research. We find that lists of effectiveness characteristics from the charter and traditional literatures are well aligned: good schools seem to look the same, regardless of governance…

Clinical effectiveness of a cognitive behavioral group treatment program for anxiety disorders: a benchmarking study.

PubMed

Oei, Tian P S; Boschen, Mark J

2009-10-01

Previous research has established efficacy of cognitive behavioral therapy (CBT) for anxiety disorders, yet it has not been widely assessed in routine community clinic practices. Efficacy research sacrifices external validity to achieve maximum internal validity. Recently, effectiveness research has been advocated as more ecologically valid for assessing routine clinical work in community clinics. Furthermore, there is a lack of effectiveness research in group CBT. This study aims to extend existing research on the effectiveness of CBT from individual therapy into group therapy delivery. It aimed also to examine outcome using not only symptom measures, but also measures of related symptoms, cognitions, and life quality and satisfaction. Results from a cohort of patients with various anxiety disorders demonstrated that treatment was effective in reducing anxiety symptoms to an extent comparable with other effectiveness studies. Despite this, only 43% of individuals showed reliable change, and 17% were 'recovered' from their anxiety symptoms, and the post-treatment measures were still significantly different from the level of anxiety symptoms observed in the general population.

Insights from a conference on implementing comparative effectiveness research through shared decision-making

PubMed Central

Politi, Mary C; Clayman, Marla L; Fagerlin, Angela; Studts, Jamie L; Montori, Victor

2013-01-01

For decades, investigators have conducted innovative research on shared decision-making (SDM), helping patients and clinicians to discuss health decisions and balance evidence with patients' preferences for possible outcomes of options. In addition, investigators have developed and used rigorous methods for conducting comparative effectiveness research (CER), comparing the benefits and risks of different interventions in real-world settings with outcomes that matter to patients and other stakeholders. However, incorporating CER findings into clinical practice presents numerous challenges. In March 2012, we organized a conference at Washington University in St Louis (MO, USA) aimed at developing a network of researchers to collaborate in developing, conducting and disseminating research about the implementation of CER through SDM. Meeting attendees discussed conceptual similarities and differences between CER and SDM, challenges in implementing CER and SDM in practice, specific challenges when engaging SDM with unique populations and examples of ways to overcome these challenges. CER and SDM are related processes that emphasize examining the best clinical evidence and how it applies to real patients in real practice settings. SDM can provide one opportunity for clinicians to discuss CER findings with patients and engage in a dialog about how to manage uncertainty about evidence in order to make decisions on an individual patient level. This meeting highlighted key challenges and suggested avenues to pursue such that CER and SDM can be implemented into routine clinical practice. PMID:23430243

Indirect Effects of Global Change: From Physiological and Behavioral Mechanisms to Ecological Consequences.

PubMed

Gunderson, Alex R; Tsukimura, Brian; Stillman, Jonathon H

2017-07-01

A major focus of current ecological research is to understand how global change makes species vulnerable to extirpation. To date, mechanistic ecophysiological analyses of global change vulnerability have focused primarily on the direct effects of changing abiotic conditions on whole-organism physiological traits, such as metabolic rate, locomotor performance, cardiac function, and critical thermal limits. However, species do not live in isolation within their physical environments, and direct effects of climate change are likely to be compounded by indirect effects that result from altered interactions with other species, such as competitors and predators. The Society for Integrative and Comparative Biology 2017 Symposium "Indirect Effects of Global Change: From Physiological and Behavioral Mechanisms to Ecological Consequences" was designed to synthesize multiple approaches to investigating the indirect effects of global change by bringing together researchers that study the indirect effects of global change from multiple perspectives across habitat, type of anthropogenic change, and level of biological organization. Our goal in bringing together researchers from different backgrounds was to foster cross-disciplinary insights into the mechanistic bases and higher-order ecological consequences of indirect effects of global change, and to promote collaboration among fields. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Comparing Peracetic Acid with Sodium Hypochlorite for Disinfection of Combined Sewer Overflows

EPA Science Inventory

This cooperative research and development agreement between U.S. EPA, Solvay, MSDGC, and CB&I is evaluating the potential of PAA for disinfection of Muddy Creek CSO wastewater and comparing that with sodium hypochlorite disinfection. This presentation will document the effective...

Prioritization in comparative effectiveness research: the CANCERGEN Experience.

PubMed

Thariani, Rahber; Wong, William; Carlson, Josh J; Garrison, Louis; Ramsey, Scott; Deverka, Patricia A; Esmail, Laura; Rangarao, Sneha; Hoban, Carolyn J; Baker, Laurence H; Veenstra, David L

2012-05-01

Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes. To develop and pilot test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG. We conducted a landscape analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds. A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy makers, and community-based oncologists. We identified 9 domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and 1 test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities. Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition, and integration with existing prioritization mechanisms.

Prioritization in Comparative Effectiveness Research: The CANCERGEN Experience in Cancer Genomics

PubMed Central

Thariani, Rahber; Wong, William; Carlson, Josh J; Garrison, Louis; Ramsey, Scott; Deverka, Patricia A; Esmail, Laura; Rangarao, Sneha; Hoban, Carolyn J; Baker, Laurence H; Veenstra, David L

2012-01-01

Background Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes. Objective To develop and pilot-test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG. Methods We conducted a landscape-analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds. Results A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy-makers, and community-based oncologists. We identified nine domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape-analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and one test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities. Conclusions Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition and integration with existing prioritization mechanisms. PMID:22274803

The Effects of Post-Compulsory Education and Training Systems on Literacy and Numeracy Skills: A Comparative Analysis Using PISA 2000 and the 2011 Survey of Adult Skills

ERIC Educational Resources Information Center

Pensiero, Nicola; Green, Andy

2018-01-01

This article analyses the contribution of post-compulsory education and training systems to the development of literacy and numeracy skills across OECD countries. While there is extensive cross-country comparative research on the effects of primary and lower secondary education systems on aggregate skills levels, there has been little comparative…

The Effectiveness of an Individualized Learning Method of Instruction When Compared to the Lecture-Discussion Method. A Research Report of a Graduate Study.

ERIC Educational Resources Information Center

Oen, Urban T.; Sweany, H. Paul

To compare the effectiveness of individualized and lecture-discussion methods with a non-instruction (Control) method in developing turfgrass competencies in 11th and 12th grade students as measured by achievement in a battery of tests, teachers from 29 Michigan schools were randomly placed in three groups and attended workshops where they were…

The Comparative Effectiveness of Positive Reinforcement Versus Negative Verbal Reinforcement in the Training of Autistic Children to Avoid Self-Inflicted Injury.

ERIC Educational Resources Information Center

Alvir, Claire

After a brief review of the literature the research proposal focuses on the comparative effectiveness of non-verbal positive reinforcement vs. verbal negative reinforcement in the reduction of self-inflicted injury on 23 elementary age autistic children. In the two phase study each child would be paired by age, sex, length of time in school,…

Speech Output Technologies in Interventions for Individuals with Autism Spectrum Disorders: A Scoping Review.

PubMed

Schlosser, Ralf W; Koul, Rajinder K

2015-01-01

The purpose of this scoping review was to (a) map the research evidence on the effectiveness of augmentative and alternative communication (AAC) interventions using speech output technologies (e.g., speech-generating devices, mobile technologies with AAC-specific applications, talking word processors) for individuals with autism spectrum disorders, (b) identify gaps in the existing literature, and (c) posit directions for future research. Outcomes related to speech, language, and communication were considered. A total of 48 studies (47 single case experimental designs and 1 randomized control trial) involving 187 individuals were included. Results were reviewed in terms of three study groupings: (a) studies that evaluated the effectiveness of treatment packages involving speech output, (b) studies comparing one treatment package with speech output to other AAC modalities, and (c) studies comparing the presence with the absence of speech output. The state of the evidence base is discussed and several directions for future research are posited.

Preparing Electronic Clinical Data for Quality Improvement and Comparative Effectiveness Research: The SCOAP CERTAIN Automation and Validation Project

PubMed Central

Devine, Emily Beth; Capurro, Daniel; van Eaton, Erik; Alfonso-Cristancho, Rafael; Devlin, Allison; Yanez, N. David; Yetisgen-Yildiz, Meliha; Flum, David R.; Tarczy-Hornoch, Peter

2013-01-01

Background: The field of clinical research informatics includes creation of clinical data repositories (CDRs) used to conduct quality improvement (QI) activities and comparative effectiveness research (CER). Ideally, CDR data are accurately and directly abstracted from disparate electronic health records (EHRs), across diverse health-systems. Objective: Investigators from Washington State’s Surgical Care Outcomes and Assessment Program (SCOAP) Comparative Effectiveness Research Translation Network (CERTAIN) are creating such a CDR. This manuscript describes the automation and validation methods used to create this digital infrastructure. Methods: SCOAP is a QI benchmarking initiative. Data are manually abstracted from EHRs and entered into a data management system. CERTAIN investigators are now deploying Caradigm’s Amalga™ tool to facilitate automated abstraction of data from multiple, disparate EHRs. Concordance is calculated to compare data automatically to manually abstracted. Performance measures are calculated between Amalga and each parent EHR. Validation takes place in repeated loops, with improvements made over time. When automated abstraction reaches the current benchmark for abstraction accuracy - 95% - itwill ‘go-live’ at each site. Progress to Date: A technical analysis was completed at 14 sites. Five sites are contributing; the remaining sites prioritized meeting Meaningful Use criteria. Participating sites are contributing 15–18 unique data feeds, totaling 13 surgical registry use cases. Common feeds are registration, laboratory, transcription/dictation, radiology, and medications. Approximately 50% of 1,320 designated data elements are being automatically abstracted—25% from structured data; 25% from text mining. Conclusion: In semi-automating data abstraction and conducting a rigorous validation, CERTAIN investigators will semi-automate data collection to conduct QI and CER, while advancing the Learning Healthcare System. PMID:25848565

The role of private industry in pragmatic comparative effectiveness trials.

PubMed

Buesching, Don P; Luce, Bryan R; Berger, Marc L

2012-03-01

Comparative effectiveness research (CER) includes pragmatic clinical trials (PCTs) to address 'real-world' effectiveness. CER interest would be expected to stimulate biopharmaceutical manufacturer PCT investment; however, this does not seem to be the case. In this article we identify all industry-sponsored PCT studies from 1996 to 2010; analyze them across a variety of characteristics, including sponsor, research question, design, comparators and results; and suggest methodological and policy changes to spur future manufacturer PCT investment. Nine 'naturalistic', head-to-head versus standard of care or similar agent PCTs were identified. Two included a 'usual care' arm. Chronic care trials' length averaged 12 months (range: 6-24 months), six of which reported equivocal or no difference in effectiveness; results of two chronic and the single acute care PCTs favored the sponsor drug. None reported the sponsor drug inferior. Of seven that evaluated utilization or costs, six reported no differences and four of five studies comparing brand-generic drugs reported no difference. Whereas private investment in PCTs is in the public interest, manufacturers apparently have not yet seen the business case. To induce investment, we propose several methodological and regulatory policy innovations designed to reduce business risk by decreasing outcome variability and increasing trial efficiency, flexibility and market applicability.

Three essays on the economics of science policy: The impact of funding, collaboration and research chairs

NASA Astrophysics Data System (ADS)

Mirnezami, Seyed Reza

This thesis studies the determinants that influence the number of citations, the effect of having a research collaboration with top-funded scientists on scientific productivity, and the effect of holding a research chair on scientific productivity. Based on a review study by Bornmann and Daniel (2008), one can argue that non-scientific factors determining the decision to cite do not significantly alter the role of citation as a measure of research impact. Assuming that the number of citations is a good measure for research impact and, in turn, for a certain kind of quality, we showed that the number of articles and the visibility of a researcher, the impact factor of the journal, the size of the research team, and the institutional setting of the university are the important determinants of citation counts. However, we have found that there is no significant effect of public funding and gender in most of the domains examined. The point that funding amount is not a significant determinant of citation counts does not necessarily contradict the positive effect of funding on scientific productivity. We also developed a theoretical model and proposed some hypotheses about the effect of collaboration with top-funded scientists on scientific productivity. We then validated the hypotheses with empirical analysis and showed that such collaboration has a positive effect on scientific productivity. This significant effect may exist through different channels: transfer of tacit knowledge, more scientific publications, economy of scale in knowledge production because of better research equipment, and expanded research network. The results also verified the positive effect of funding, the positive effect of networking (measured by number of co-authors), the inverted U-shaped effect of age, and the fewer number of publications by women compared to men. Finally, we made a distinction between different attributes of research chairs and their effect on scientific productivity. One of the important questions is to find out whether a research chair still has better scientific productivity (compared to non-chair holders) after controlling for the research funds available to the researchers. To investigate that question, we employed a matching technique to identify pairs of scientists (chair and non-chair holders) of the same gender, funding and research field. After such matching, we found that the effect of the Canada research chair program on scientific productivity remains significant and positive, while the effect of industrial chairs and the chairs appointed by the Canadian federal granting councils (NSERC and CIHR) become non-significant. This finding highlights the effectiveness of our matching technique methodology; because before matching, holding any type of chair had a positive and significant effect on scientific productivity. This finding highlights the special attributes of the Canada research chair program, which are not replicated in other chairs. Those specific attributes may significantly push scientific productivity. For example, Canada research chairs are generally associated with some degree of prestige or higher visibility to recruit talented students or to have research collaboration with top scientists in the field. In addition, the Canada research chair program has a firm and efficient method of allocation (which is explained in the thesis). This approach institutionally synchronizes different chairs in universities and research fields. The fact that other types of research chairs, once matched with equivalent scientists, do not have an impact on scientific output in terms of quantity does not imply that these chair holders are lesser scientists, but that they are devoting part of their time to other endeavours of a more practical nature. Hence universities are maintaining a balance between the pursuit of pure scientific knowledge and its application to socioeconomic benefits. By solely studying scientific articles, we are missing a great deal of the university professors' activities. Although not trivial, future research should aim to cast a wider net on outputs, outcomes and impacts of university research.

Who reaps the benefits, who bears the risks? Comparative optimism, comparative utility, and regulatory preferences for mobile phone technology.

PubMed

White, Mathew P; Eiser, J Richard; Harris, Peter R; Pahl, Sabine

2007-06-01

Although the issue of risk target (e.g., self, others, children) is widely acknowledged in risk perception research, its importance appears underappreciated. To date, most research has been satisfied with demonstrating comparative optimism, i.e., lower perceived risk for the self than others, and exploring its moderators, such as perceived controllability and personal exposure. Much less research has investigated how the issue of target may affect benefit perceptions or key outcomes such as stated preferences for hazard regulation. The current research investigated these issues using data from a public survey of attitudes toward mobile phone technology (N= 1,320). First, results demonstrated comparative optimism for this hazard, and also found moderating effects of both controllability and personal exposure. Second, there was evidence of comparative utility, i.e., users believed that the benefits from mobile phone technology are greater for the self than others. Third, and most important for policy, preferences for handset regulation were best predicted by perceptions of the risks to others but perceived benefits for the self. Results suggest a closer awareness of target can improve prediction of stated preferences for hazard regulation and that it would be profitable for future research to pay more attention to the issue of target for both risk and benefit perceptions.

High Priority Future Research Needs for Obstructive Sleep Apnea Diagnosis and Treatment

PubMed Central

Patel, Kamal; Moorthy, Denish; Chan, Jeffrey A.; Concannon, Thomas W.; Ratichek, Sara J.; Chung, Mei; Balk, Ethan M.

2013-01-01

Study Objectives: To identify and prioritize future research needs (FRN) topics for diagnosis and treatment of obstructive sleep apnea (OSA). Methods: Twenty-one panel members represented six stake-holder categories: patients and the public, providers; purchasers of health care, payers, policymakers, and principal investigators. Building on a recently completed comparative effectiveness review, stakeholders nominated and discussed potential FRN topics. Stakeholders then nominated their top priority FRN topics based on the Agency for Healthcare Research and Quality Effective Health Care Program Selection Criteria. From these nominations, the highest priority FRN topics were determined and were elaborated upon to include possible study designs to address the topics. Results: Thirty-seven topics were discussed and prioritized. The nine highest priority FRN topics included: cost-effectiveness of management strategies, defining age- and sex-specific criteria for OSA, evaluating routine preoperative screening for OSA, evaluating involvement of a sleep medicine specialist in diagnosis of OSA, evaluating clinical prediction rules, assessing the effect of treating sleep disordered breathing and long-term clinical outcomes, comparing treatments for patients who do not tolerate positive airway pressure, evaluating strategies to improve treatment compliance, and evaluating the association between sleep apnea severity and long-term clinical outcomes. Conclusions: While there are numerous specific research questions with low or insufficient strength of evidence for OSA management, OSA patients, their healthcare providers, and society at large would benefit from refocusing research efforts into the prioritized research questions and away from simple comparisons of short-term outcomes between specific interventions. Citation: Patel K; Moorthy D; Chan JA; Concannon TW. High priority future research needs for obstructive sleep apnea diagnosis and treatment. J Clin Sleep Med 2013;9(4):395-402. PMID:23585757

Meta-Analysis With Complex Research Designs: Dealing With Dependence From Multiple Measures and Multiple Group Comparisons

PubMed Central

Scammacca, Nancy; Roberts, Greg; Stuebing, Karla K.

2013-01-01

Previous research has shown that treating dependent effect sizes as independent inflates the variance of the mean effect size and introduces bias by giving studies with more effect sizes more weight in the meta-analysis. This article summarizes the different approaches to handling dependence that have been advocated by methodologists, some of which are more feasible to implement with education research studies than others. A case study using effect sizes from a recent meta-analysis of reading interventions is presented to compare the results obtained from different approaches to dealing with dependence. Overall, mean effect sizes and variance estimates were found to be similar, but estimates of indexes of heterogeneity varied. Meta-analysts are advised to explore the effect of the method of handling dependence on the heterogeneity estimates before conducting moderator analyses and to choose the approach to dependence that is best suited to their research question and their data set. PMID:25309002

Research on Long Tail Recommendation Algorithm

NASA Astrophysics Data System (ADS)

Hu, Xuezhi; Zhang, Chuang; Wu, Ming; Zeng, Yang

2017-10-01

Most recommendation systems in the major electronic commerce platforms are influenced by the long tail effect more or less. There are sufficient researches of how to assess recommendation effect while no criteria to evaluate long tail recommendation rate. In this study, we first discussed the existing problems of recommending long tail products through specific experiments. Then we proposed a long tail evaluation criteria and compared the performance in long tail recommendation between different models.

Comparative Effectiveness of TI-84 Graphing Calculators on Algebra I and Geometry Outcomes: A Report of Randomized Experiments in the East Side Union High School District and San Diego Unified School District. Research Report

ERIC Educational Resources Information Center

Miller, Gloria I.; Jaciw, Andrew; Hoshiko, Brandon; Wei, Xin

2007-01-01

Texas Instruments has undertaken a research program with the goal of producing scientifically-based evidence of the effectiveness of graphing calculators and the "TI-Navigator"[TM] classroom networking system in the context of a professional development and curriculum framework. The program includes a two-year longitudinal study. The…

Comparative Effectiveness Research in Oncology

PubMed Central

2013-01-01

Although randomized controlled trials represent the gold standard for comparative effective research (CER), a number of additional methods are available when randomized controlled trials are lacking or inconclusive because of the limitations of such trials. In addition to more relevant, efficient, and generalizable trials, there is a need for additional approaches utilizing rigorous methodology while fully recognizing their inherent limitations. CER is an important construct for defining and summarizing evidence on effectiveness and safety and comparing the value of competing strategies so that patients, providers, and policymakers can be offered appropriate recommendations for optimal patient care. Nevertheless, methodological as well as political and social challenges for CER remain. CER requires constant and sophisticated methodological oversight of study design and analysis similar to that required for randomized trials to reduce the potential for bias. At the same time, if appropriately conducted, CER offers an opportunity to identify the most effective and safe approach to patient care. Despite rising and unsustainable increases in health care costs, an even greater challenge to the implementation of CER arises from the social and political environment questioning the very motives and goals of CER. Oncologists and oncology professional societies are uniquely positioned to provide informed clinical and methodological expertise to steer the appropriate application of CER toward critical discussions related to health care costs, cost-effectiveness, and the comparative value of the available options for appropriate care of patients with cancer. PMID:23697601

Effect of Acting Experience on Emotion Expression and Recognition in Voice: Non-Actors Provide Better Stimuli than Expected.

PubMed

Jürgens, Rebecca; Grass, Annika; Drolet, Matthis; Fischer, Julia

Both in the performative arts and in emotion research, professional actors are assumed to be capable of delivering emotions comparable to spontaneous emotional expressions. This study examines the effects of acting training on vocal emotion depiction and recognition. We predicted that professional actors express emotions in a more realistic fashion than non-professional actors. However, professional acting training may lead to a particular speech pattern; this might account for vocal expressions by actors that are less comparable to authentic samples than the ones by non-professional actors. We compared 80 emotional speech tokens from radio interviews with 80 re-enactments by professional and inexperienced actors, respectively. We analyzed recognition accuracies for emotion and authenticity ratings and compared the acoustic structure of the speech tokens. Both play-acted conditions yielded similar recognition accuracies and possessed more variable pitch contours than the spontaneous recordings. However, professional actors exhibited signs of different articulation patterns compared to non-trained speakers. Our results indicate that for emotion research, emotional expressions by professional actors are not better suited than those from non-actors.

When People Co-occur With Good or Bad Events: Graded Effects of Relational Qualifiers on Evaluative Conditioning.

PubMed

Hughes, Sean; Ye, Yang; Van Dessel, Pieter; De Houwer, Jan

2018-06-01

Studies on evaluative conditioning show that a change in liking can occur whenever stimuli are paired. Such instances of attitude change are known to depend on the type of relation established between stimuli (e.g., "Bob is a friend of Mike" vs. "Bob is an enemy of Mike"). Research has so far only compared assimilative and contrastive relational qualifiers (e.g., friend vs. enemy). For the first time, we compared the effect of nonoppositional qualifiers on attitude change in an evaluative conditioning procedure (e.g., "Bob causes Positive Outcomes" vs. "Bob predicts Positive Outcomes"). Differential effects of nonoppositional relational qualifiers were observed on explicit and implicit evaluations. We discuss the implications of our findings for attitude research, theories of attitude change, and optimizing evaluative conditioning for changing attitudes in applied settings.

Recruitment of healthy participants for studies on risks for alcoholism: effectiveness of random digit dialling.

PubMed

Sorocco, Kristen H; Vincent, Andrea S; Collins, Frank L; Johnson, Christine A; Lovallo, William R

2006-01-01

To compare the effectiveness of two strategies for recruiting healthy research volunteers. Demographic characteristics and recruitment costs of participants who completed a laboratory study examining risk factors for alcoholism recruited through random digit dialling (N = 11) and community advertisements (N = 102) were compared. Advertisement yielded a more representative sample [76% Caucasian, less well educated (M = 15.2 years, SEM = 0.2; P < 0.05), more equally divided by family history of alcoholism (43% FH- and 57% FH+), and lower in SES (M = 42.8, SEM = 1.3; P < 0.05)] and was more cost effective (72 dollars vs 2272 dollars per participant) than random digit dialling. Findings are relevant to alcohol researchers trying to determine the recruitment strategy that will yield the most representative sample at the lowest cost.

How Comparative Effectiveness Research Can Help To Advance ‘Personalized Medicine’ In Cancer Treatment

PubMed Central

Ramsey, Scott D.; Veenstra, David L.; Tunis, Sean R.; Garrison, Louis P.; Crowley, John J.; Baker, Laurence H.

2012-01-01

The use of biomarkers to “personalize” cancer treatment —identifying discrete genes, proteins, or other indicators that can differentiate one type of cancer from another and enable the use of highly tailored therapies -- offers tremendous potential for improved outcomes and lower treatment costs. However, the rapid development of cancer biomarker, or genomic, tests— combined with a paucity of evidence to support the effectiveness of the tests—presents a challenge for patients, clinicians and other stakeholders. In this article, we propose that comparative effectiveness research be used to strengthen what is now a haphazard process for developing and marketing cancer biomarker tests. We suggest novel funding approaches and a systematic process for moving from regulatory approval to the generation of evidence that meets the needs of stakeholders and, ultimately, patients. PMID:22147853

A Meta-Analysis of Individualized Instruction in Dental Education.

ERIC Educational Resources Information Center

Dacanay, Lakshmi S; Cohen, Peter A.

1992-01-01

Meta-analysis of 34 comparative studies on conventional vs. individualized instruction (II) found most favored the latter but with small-moderate overall effect. Pacing had significant effect, with teacher-pacing more effective than student-paced learning. On average, II required less time than conventional teaching. Additional research on this…

Do Leadership Styles Influence Organizational Health? A Study in Educational Organizations

ERIC Educational Resources Information Center

Toprak, Mustafa; Inandi, Bulent; Colak, Ahmet Levent

2015-01-01

This research aims to investigate the effect of leadership styles of school principals on organizational health. Causal-comparative research model was used to analyze the relationships between leadership types and organizational health. For data collection, a Likert type Multifactor Leadership scale questionnaire and Organizational Health scale…

75 FR 18512 - National Institute of Mental Health; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... U.S.C. App.), notice is hereby given of an Interagency Autism Coordinating Committee (IACC) meeting... several presentations on a variety of topics: the Autism Treatment Network, changes in the DSM-V related to autism, stem cell research, non-verbal autism and comparative effectiveness research. The meeting...

Trends in Financial Satisfaction: Does Poverty Make a Difference?

ERIC Educational Resources Information Center

Hsieh, Chang-Ming

2002-01-01

Gerontological studies on financial satisfaction have been limited by the dearth of longitudinal research and the lack of research that includes the concept of poverty. In order to bridge these gaps, this longitudinal study examines and compares the intracohort and intercohort effects on financial satisfaction trends by poverty status among…

Effectiveness of United Nation’s Missions in Africa: A Comparative Assessment of UNAMSIL, MONUC, and UNAMID

DTIC Science & Technology

2010-06-11

29 CHAPTER 3 RESEARCH METHODOLOGY ................................................................30 Congruence Method ...32 Method of Research/Criteria of Analysis...systems of taxation have collapsed and physical infrastructure has been destroyed, trade and any form of business are cut off and a climate of

Report on the Effects of Parachutes on Risk Mitigation to Third Party Property and Individuals

DOT National Transportation Integrated Search

1993-03-01

This report looks at what research has been done to evaluate the public's risk by descent of a payload from its orbital or suborbital flight. Compared is the difference in risk between a parachute descent and that in free fall. The research indicates...

An Examination of Commercial Motor Vehicle Hours of Service Safety Regulation

DTIC Science & Technology

2016-09-01

enough data for a statistical analysis of its effects on truck driver safety. This research found that by comparing truck driving safety data prior...impact on the commercial motor vehicle industry. Research has demonstrated how fatigue leads to increased accident rates by decreasing reaction time

The Value of Decision Analytical Modeling in Surgical Research: An Example of Laparoscopic Versus Open Distal Pancreatectomy.

PubMed

Tax, Casper; Govaert, Paulien H M; Stommel, Martijn W J; Besselink, Marc G H; Gooszen, Hein G; Rovers, Maroeska M

2017-11-02

To illustrate how decision modeling may identify relevant uncertainty and can preclude or identify areas of future research in surgery. To optimize use of research resources, a tool is needed that assists in identifying relevant uncertainties and the added value of reducing these uncertainties. The clinical pathway for laparoscopic distal pancreatectomy (LDP) versus open (ODP) for nonmalignant lesions was modeled in a decision tree. Cost-effectiveness based on complications, hospital stay, costs, quality of life, and survival was analyzed. The effect of existing uncertainty on the cost-effectiveness was addressed, as well as the expected value of eliminating uncertainties. Based on 29 nonrandomized studies (3.701 patients) the model shows that LDP is more cost-effective compared with ODP. Scenarios in which LDP does not outperform ODP for cost-effectiveness seem unrealistic, e.g., a 30-day mortality rate of 1.79 times higher after LDP as compared with ODP, conversion in 62.2%, surgically repair of incisional hernias in 21% after LDP, or an average 2.3 days longer hospital stay after LDP than after ODP. Taking all uncertainty into account, LDP remained more cost-effective. Minimizing these uncertainties did not change the outcome. The results show how decision analytical modeling can help to identify relevant uncertainty and guide decisions for future research in surgery. Based on the current available evidence, a randomized clinical trial on complications, hospital stay, costs, quality of life, and survival is highly unlikely to change the conclusion that LDP is more cost-effective than ODP.

Optimizing trial design in pharmacogenetics research: comparing a fixed parallel group, group sequential, and adaptive selection design on sample size requirements.

PubMed

Boessen, Ruud; van der Baan, Frederieke; Groenwold, Rolf; Egberts, Antoine; Klungel, Olaf; Grobbee, Diederick; Knol, Mirjam; Roes, Kit

2013-01-01

Two-stage clinical trial designs may be efficient in pharmacogenetics research when there is some but inconclusive evidence of effect modification by a genomic marker. Two-stage designs allow to stop early for efficacy or futility and can offer the additional opportunity to enrich the study population to a specific patient subgroup after an interim analysis. This study compared sample size requirements for fixed parallel group, group sequential, and adaptive selection designs with equal overall power and control of the family-wise type I error rate. The designs were evaluated across scenarios that defined the effect sizes in the marker positive and marker negative subgroups and the prevalence of marker positive patients in the overall study population. Effect sizes were chosen to reflect realistic planning scenarios, where at least some effect is present in the marker negative subgroup. In addition, scenarios were considered in which the assumed 'true' subgroup effects (i.e., the postulated effects) differed from those hypothesized at the planning stage. As expected, both two-stage designs generally required fewer patients than a fixed parallel group design, and the advantage increased as the difference between subgroups increased. The adaptive selection design added little further reduction in sample size, as compared with the group sequential design, when the postulated effect sizes were equal to those hypothesized at the planning stage. However, when the postulated effects deviated strongly in favor of enrichment, the comparative advantage of the adaptive selection design increased, which precisely reflects the adaptive nature of the design. Copyright © 2013 John Wiley & Sons, Ltd.

Office design and health: a systematic review.

PubMed

Richardson, Ann; Potter, John; Paterson, Margaret; Harding, Thomas; Tyler-Merrick, Gaye; Kirk, Ray; Reid, Kate; McChesney, Jane

2017-12-15

To carry out a systematic review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. The research question was "Does workplace design (specifically individual offices compared with shared workspaces) affect the health of workers?" A literature search limited to articles published between 2000 and 2017 was undertaken. A systematic review was carried out, and the findings of the reviewed studies grouped into themes according to the primary outcomes measured in the studies. The literature search identified 15 relevant studies addressing health effects of shared or open-plan offices compared with individual offices. Our systematic review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees' health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. Our findings are also consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.

What do providers, payers and patients need from comparative effectiveness research on diagnostics? The case of HER2/Neu testing in breast cancer.

PubMed

Trosman, Julia R; Weldon, Christine B; Schink, Julian C; Gradishar, William J; Benson, Al B

2013-07-01

Comparing effectiveness of diagnostic tests is one of the highest priorities for comparative effectiveness research (CER) set by the Institute of Medicine. Our study aims to identify what information providers, payers and patients need from CER on diagnostics, and what challenges they encounter implementing comparative information on diagnostic alternatives in practice and policy. Using qualitative research methods and the example of two alternative protocols for HER2 testing in breast cancer, we conducted interviews with 45 stakeholders: providers (n = 25) from four academic and eight nonacademic institutions, executives (n = 13) from five major US private payers and representatives (n = 7) from two breast cancer patient advocacies. The need for additional scientific evidence to determine the preferred HER2 protocol was more common for advocates than payers (100 vs 54%; p = 0.0515) and significantly more common for advocates than providers (100 vs 40%; p = 0.0077). The availability of information allowing assessment of the implementation impact from alternative diagnostic protocols on provider institutions may mitigate the need for additional scientific evidence for some providers and payers (24 and 46%, respectively). The cost-effectiveness of alternative protocols from the societal perspective is important to payers and advocates (69 and 71%, respectively) but not to providers (0%; p = 0.0001 and p = 0.0001). The lack of reporting laboratory practices is a more common implementation challenge for payers and advocates (77 and 86%, respectively) than for providers (32%). The absence of any mechanism for patient involvement was recognized as a challenge by payers and advocates (69 and 100%, respectively) but not by providers (0%; p = 0.0001 and p = 0.0001). Comparative implementation research is needed to inform the stakeholders considering diagnostic alternatives. Transparency of laboratory practices is an important factor in enabling implementation of CER on diagnostics in practice and policy. The incongruent views of providers versus patient advocates and payers on involving patients in diagnostic decisions is a concerning challenge to utilizing the results of CER.

The Effects of Ability Grouping on Gifted & Talented Third, Fourth, and Fifth Grade Students in Selected South Carolina Public School Districts

ERIC Educational Resources Information Center

White, Tammy Tara

2013-01-01

This is a quantitative research study using archival data to focus on the achievement of Gifted & Talented students in two South Carolina public school districts. The researcher used an open cohort comparative research design for this study. This study attempted to find if differences in student performance existed between students labeled as…

When the Test of Mediation is More Powerful than the Test of the Total Effect

PubMed Central

O'Rourke, Holly P.; MacKinnon, David P.

2014-01-01

Although previous research has studied power in mediation models, the extent to which the inclusion of a mediator will increase power has not been investigated. First, a study compared analytical power of the mediated effect to the total effect in a single mediator model to identify the situations in which the inclusion of one mediator increased statistical power. Results from the first study indicated that including a mediator increased statistical power in small samples with large coefficients and in large samples with small coefficients, and when coefficients were non-zero and equal across models. Next, a study identified conditions where power was greater for the test of the total mediated effect compared to the test of the total effect in the parallel two mediator model. Results indicated that including two mediators increased power in small samples with large coefficients and in large samples with small coefficients, the same pattern of results found in the first study. Finally, a study assessed analytical power for a sequential (three-path) two mediator model and compared power to detect the three-path mediated effect to power to detect both the test of the total effect and the test of the mediated effect for the single mediator model. Results indicated that the three-path mediated effect had more power than the mediated effect from the single mediator model and the test of the total effect. Practical implications of these results for researchers are then discussed. PMID:24903690

Systematic Desensitization Of Test Anxiety: A Comparison Of Group And Individual Treatment

ERIC Educational Resources Information Center

Scissons, Edward H.; Njaa, Lloyd J.

1973-01-01

The results indicate the effectiveness of both individual desensitization and group desensitization in the treatment of high test anxiety. More research is needed in comparing the effectiveness of group desensitization and individual desensitization with intratreatment variables. (Author)

Social welfare and the Affordable Care Act: is it ever optimal to set aside comparative cost?

PubMed

Mortimer, Duncan; Peacock, Stuart

2012-10-01

The creation of the Patient-Centered Outcomes Research Institute (PCORI) under the Affordable Care Act has set comparative effectiveness research (CER) at centre stage of US health care reform. Comparative cost analysis has remained marginalised and it now appears unlikely that the PCORI will require comparative cost data to be collected as an essential component of CER. In this paper, we review the literature to identify ethical and distributional objectives that might motivate calls to set priorities without regard to comparative cost. We then present argument and evidence to consider whether there is any plausible set of objectives and constraints against which priorities can be set without reference to comparative cost. We conclude that - to set aside comparative cost even after accounting for ethical and distributional constraints - would be truly to act as if money is no object. Copyright © 2012 Elsevier Ltd. All rights reserved.

Differences between patients' and clinicians' research priorities from the Anaesthesia and Peri-operative Care Priority Setting Partnership.

PubMed

Boney, O; Nathanson, M H; Grocott, M P W; Metcalf, L

2017-09-01

The James Lind Alliance Anaesthesia and Peri-operative Care Priority Setting Partnership was a recent collaborative venture bringing approximately 2000 patients, carers and clinicians together to agree priorities for future research into anaesthesia and critical care. This secondary analysis compares the research priorities of 303 service users, 1068 clinicians and 325 clinicians with experience as service users. All three groups prioritised research to improve patient safety. Service users prioritised research about improving patient experience, whereas clinicians prioritised research about clinical effectiveness. Clinicians who had experience as service users consistently prioritised research more like clinicians than like service users. Individual research questions about patient experience were more popular with patients and carers than with clinicians in all but one case. We conclude that patients, carers and clinicians prioritise research questions differently. All groups prioritise research into patient safety, but service users also favour research into patient experience, whereas clinicians favour research into clinical effectiveness. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

A Study on the Wind Environment and Effects of Wind Fences around the Jang-Bogo Antarctica Station

NASA Astrophysics Data System (ADS)

Wang, J. W.; Kim, J.; Choi, W.; Kwon, H.

2017-12-01

This study investigated the influence of Jang-Bogo Antarctic Research Station on detailed flow and the effectiveness of wind fences on the surrounding observation environment using a computational fluid dynamics (CFD) model. The data obtained from the computer aided design (CAD) drawing were used to construct the terrain and buildings around Jang-Bogo Antarctic Research Station. To investigate the flow characteristics altered by Jang-Bogo Antarctic Research Station, we conducted the simulations for 16 different inflow directions and, for each inflow direction, we compared the flow characteristics before and after the construction of Jang-Bogo Antarctic Research Station. The observation data of automatic weather system (AWS) were used for comparison. The wind rose analysis shows that the wind speed and direction after the construction of the Jang-Bogo Antarctic Research Station are quite different from those before the construction. We also investigated effects of wind fences on the reduction of wind speeds around Jang-Bogo Antarctic Research Station, as one of the studies to reduce potential damages caused by katabatic wind. For this, we changed systematically the distance between the fences and the Jang-Bogo Antarctic Research Station (2H 8H with the increment of 2H, H is fence of height) and porosity of fences (0%, 25%, 33%, 50%, 67% and 75%). In the affiliated westerly cases, the AWS was located at the downwind side of the Jang-Bogo Antarctic Research Station and the effect of the construction were maximized (in the west-north-westerly case, the maximum decrease in wind speed was 81% compared to the wind speeds before the construction). In the case that the distance between the wind fence and the Jang-Bogo Antarctic Research Station was shortest, the wind speed reduction was maximized. With the same distance, the fence with medium porosities (25 33%) maximized the wind speed reduction.

Music Programs in Charter and Traditional Schools: A Comparative Study of Chicago Elementary Schools

ERIC Educational Resources Information Center

Kelley, Jamey; Demorest, Steven M.

2016-01-01

Since the arrival of the first charter school in Minnesota in 1991, charter schools have become one of the largest movements in educational reform. In recent years, research has emerged that has compared the effectiveness of charter schools with their traditional school counterparts. The purpose of this study was to compare the extent of music…

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

PubMed Central

2014-01-01

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges. PMID:24499316

Effectiveness of objectivist online instruction on graduate learners' knowledge and competence

NASA Astrophysics Data System (ADS)

Maryannakis, Artemios

Online courses currently offered by aeronautical institutions are unstructured conversions of traditional courses into Web-based courses that lack the learning theory and instructional design principles framework, thus lacking the efficiency and effectiveness in dealing with the academic demands required to prepare aviation/aerospace professionals for the challenges of the technologically driven twenty-first century. The purpose of this study was to compare the effectiveness of two versions of an aeronautical online graduate course on research methods knowledge and competence: a comprehensive objectivist design and an unstructured design. Quantitative, causal comparative, quasi-experimental methodology was utilized. Using criteria derived from literature, criteria were established for the development and eventual online delivery of a comprehensive objectivist instructional design on graduate research methods learning. Results revealed that the comprehensive objectivist design was significantly more effective than its unstructured counterpart on graduate learners' competence in research methods, but found no significant difference in knowledge. It was recommended that aeronautical institutions (a) create programs with critical thinking and problem solving embedded in their curriculum for enhancing learner competence, and (b) thoroughly train every online instructor in the development and use of comprehensive online instruction.

Identifying Issue Frames in Text

PubMed Central

Sagi, Eyal; Diermeier, Daniel; Kaufmann, Stefan

2013-01-01

Framing, the effect of context on cognitive processes, is a prominent topic of research in psychology and public opinion research. Research on framing has traditionally relied on controlled experiments and manually annotated document collections. In this paper we present a method that allows for quantifying the relative strengths of competing linguistic frames based on corpus analysis. This method requires little human intervention and can therefore be efficiently applied to large bodies of text. We demonstrate its effectiveness by tracking changes in the framing of terror over time and comparing the framing of abortion by Democrats and Republicans in the U.S. PMID:23874909

Comparative Effectiveness of PCI Education's "PCI Reading Program": Phase 2--A Report of a Comparison Group Study in Brevard Public Schools and Miami-Dade County Public Schools. Research Summary

ERIC Educational Resources Information Center

Empirical Education Inc., 2010

2010-01-01

PCI Education sought scientifically based evidence on the comparative effectiveness of the "PCI Reading Program" through a five-year longitudinal study. Phase 1 of the study consisted of a randomized control trial studying the efficacy of the "PCI Reading Program-Level One" that was conducted in the 2007-2008 in Miami-Dade…

The use of clinical trials in comparative effectiveness research on mental health.

PubMed

Blanco, Carlos; Rafful, Claudia; Olfson, Mark

2013-08-01

A large body of comparative effectiveness research (CER) focuses on the use of observational and quasi-experimental approaches. We sought to examine the use of clinical trials as a tool for CER, particularly in mental health. Examination of three ongoing randomized clinical trials in psychiatry addressing issues that would pose difficulties for nonexperimental CER methods. Existing statistical approaches to nonexperimental data appear insufficient to compensate for biases that may arise when the pattern of missing data cannot be properly modeled such as when there are no standards for treatment, when affected populations have limited access to treatment, or when there are high rates of treatment dropout. Clinical trials should retain an important role in CER, particularly in cases of high disorder prevalence, large expected effect sizes, difficult-to-reach populations, or when examining sequential treatments or stepped-care algorithms. Progress in CER on mental health will require careful consideration of appropriate selection between clinical trials and nonexperimental designs and on allocation of research resources to optimally inform key treatment decisions for each patient. Copyright © 2013 Elsevier Inc. All rights reserved.

Attitudes Toward Research During Residency: A Survey of Canadian Residents in Obstetrics and Gynecology.

PubMed

Clancy, Aisling A; Posner, Glenn

2015-01-01

Obstetrics and Gynecology (Ob/Gyn) residency programs in Canada mandate participation in scholarly research activity, yet there remains a lack of literature on trainees' opinions regarding its value, feasibility, and perceived effect on future practice. An understanding of resident attitudes toward research during residency is essential in effectively engaging trainees and fostering a robust research community in the field. We sought to identify factors reported to influence involvement in resident research, including perceived barriers. Anonymous data were collected via an online survey distributed to all residents enrolled in accredited Ob/Gyn residency programs throughout Canada. The 10-minute, previously piloted questionnaire covered questions related to demographic information, research experience, career goals, current research activities, opinions on research environment, and opinions regarding the effect of research on future practice. Descriptive statistics were used to describe demographics, research background, and current research activities. Categorical variables were compared using the chi-square analysis and continuous variables were compared using the Mann-Whitney rank sum tests. A total of 175 residents completed the survey; 61% agreed/strongly agreed that they participate in research solely because it is mandated by their program, 22% felt that their training environment did not promote research, 19% disagreed/strongly disagreed that research is a positive experience, while 70% agreed/strongly agreed that they would prefer to complete another educational activity other than a research project. Time constraints owing to residency duties, time constraints owing to personal reasons, and lack of statistical knowledge were reported as barriers to research involvement by 97%, 90%, and 74% of trainees, respectively. Residents with graduate degrees were less likely to report lack of training on research design as a moderate/extreme barrier (7% vs 32%, p = 0.007). There exists considerable disparity in enthusiasm for scholarly research activity among Ob/Gyn residents. Curricular development should focus on addressing resident-reported barriers, including the provision of protected time for research and access to statistical support and education, particularly for residents without graduate degrees. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Kidney stones

MedlinePlus

... Eidman KE, et al. Recurrent nephrolithiasis in adults: comparative effectiveness of preventive medical strategies [Internet]. Rockville, MD. Agency for Healthcare Research and Quality (US) 2012; Report No.: 12-EHC049- ...

Stakeholder Priorities for Comparative Effectiveness Research in Chronic Obstructive Pulmonary Disease

PubMed Central

Lindenauer, Peter K.; Au, David H.; Carson, Shannon S.; Lee, Todd A.; McBurnie, Mary Ann; Naureckas, Edward T.; Vollmer, William M.; Mularski, Richard A.

2013-01-01

Comparative effectiveness research (CER) is intended to address the expressed needs of patients, clinicians, and other stakeholders. Representatives of 54 stakeholder groups with an interest in chronic obstructive pulmonary disease (COPD) participated in workshops convened by the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) over a 2-year period. Year 1 focused on chronic care and care coordination. Year 2 focused on acute care and transitions in care between healthcare settings. Discussions and provisional voting were conducted via teleconferences and e-mail exchanges before the workshop. Final prioritization votes occurred after in-person discussions at the workshop. We used a modified Delphi approach to facilitate discussions and consensus building. To more easily quantify preferences and to evaluate the internal consistency of rankings, the Analytic Hierarchy Process was incorporated in Year 2. Results of preworkshop and final workshop voting often differed, suggesting that prioritization efforts relying solely on requests for topics from stakeholder groups without in-person discussion may provide different research priorities. Research priorities varied across stakeholder groups, but generally focused on studies to evaluate different approaches to healthcare delivery (e.g., spirometry for diagnosis and treatment, integrated healthcare strategies during transitions in care) rather than head-to-head comparisons of medications. This research agenda may help to inform groups intending to respond to CER funding opportunities in COPD. The methodologies used, detailed in the online supplement, may also help to inform prioritization efforts for CER in other health conditions. PMID:23155144

Stakeholder priorities for comparative effectiveness research in chronic obstructive pulmonary disease: a workshop report.

PubMed

Krishnan, Jerry A; Lindenauer, Peter K; Au, David H; Carson, Shannon S; Lee, Todd A; McBurnie, Mary Ann; Naureckas, Edward T; Vollmer, William M; Mularski, Richard A

2013-02-01

Comparative effectiveness research (CER) is intended to address the expressed needs of patients, clinicians, and other stakeholders. Representatives of 54 stakeholder groups with an interest in chronic obstructive pulmonary disease (COPD) participated in workshops convened by the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) over a 2-year period. Year 1 focused on chronic care and care coordination. Year 2 focused on acute care and transitions in care between healthcare settings. Discussions and provisional voting were conducted via teleconferences and e-mail exchanges before the workshop. Final prioritization votes occurred after in-person discussions at the workshop. We used a modified Delphi approach to facilitate discussions and consensus building. To more easily quantify preferences and to evaluate the internal consistency of rankings, the Analytic Hierarchy Process was incorporated in Year 2. Results of preworkshop and final workshop voting often differed, suggesting that prioritization efforts relying solely on requests for topics from stakeholder groups without in-person discussion may provide different research priorities. Research priorities varied across stakeholder groups, but generally focused on studies to evaluate different approaches to healthcare delivery (e.g., spirometry for diagnosis and treatment, integrated healthcare strategies during transitions in care) rather than head-to-head comparisons of medications. This research agenda may help to inform groups intending to respond to CER funding opportunities in COPD. The methodologies used, detailed in the online supplement, may also help to inform prioritization efforts for CER in other health conditions.

The effects of energy beverages in counteracting the symptoms of mild hypoxia at legal general aviation altitudes

NASA Astrophysics Data System (ADS)

Bull, Daniel Mark

The purpose of this thesis was to conduct preliminary research, in the form of a pilot study, concerning the natural effects of hypoxia compared to the effects of hypoxia experienced after the consumption of an energy beverage. The study evaluated the effects of hypoxia on FAA certificated pilots at a simulated legal general aviation altitude, utilizing the normobaric High Altitude Lab (HAL) located at Embry Riddle Aeronautical University, Daytona Beach, Florida. The researcher tested 11 subjects, who completed three simulated flight tasks within the HAL using the Frasca International Mentor Advanced Aviation Training Device (AATD). The flight tasks were completed after consuming Red BullRTM, MonsterRTM , or a placebo beverage. The researcher derived three test variables from core outputs of the AATD: lateral deviations from the glide slope, vertical deviations from the localizer, and airspeed deviations from the target speed of 100 knots. A repeated-measures ANOVA was carried out to determine effects of the beverages on the test variables. While results were non-significant, the researcher concluded that further research should be conducted with a larger sample.

Clinical relevance of the effects of reach-to-grasp training using trunk restraint in individuals with hemiparesis poststroke: A systematic review.

PubMed

Greisberger, Andrea; Aviv, Hanna; Garbade, Sven F; Diermayr, Gudrun

2016-04-28

To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk restraint during reach-to-grasp training poststroke on movement patterns and functional abilities within the framework of the International Classification of Functioning, Disability and Health. PubMed, Web of Science, CINAHL, Embase, PEDro, Cochrane Library (publication dates January 1985 to March 2015). Randomized controlled trials comparing training using trunk restraint with any other exercise training. Data were extracted by one researcher and checked by two other researchers. The Cochrane Collaboration's tool for assessing risk of bias and the Physiotherapy Evidence Database scale were used by two researchers to assess study quality and risk of bias. Eight studies met the inclusion criteria. Five studies found better recovery of movement patterns (trunk displacement, elbow extension, and/or shoulder flexion - body function/structure) at post-test in the experimental compared with the control groups. Functional abilities (activity/participation) improved more in the experimental groups in 3 studies at post-test. Long-term effects were found in one study after 4 weeks. Trunk restraint has immediate and some long-term effects in adults with chronic stroke. However, these effects are not consistently clinically relevant when referring to minimal detectable change or minimal clinically important difference values.

Cerebral Economics: Resource Competition within but not Between Hemispheres.

DTIC Science & Technology

1981-06-01

the Office of Naval Research and by the Air Force Office of Scientific Research. 19. KEY WORDS (Continue on reveree side ifneceset, and Identify by...consistent RVF advantage on the naming task when it LI 6 was performed alone, the effect of adding the memory load made left hemisphere resources so...might be argued that the equivalent tradeoff effects we found when comparing the complete with the partial overlap situation might be evidence for some

Research for assessment, not deployment, of Climate Engineering: The German Research Foundation's Priority Program SPP 1689

NASA Astrophysics Data System (ADS)

Oschlies, Andreas; Klepper, Gernot

2017-01-01

The historical developments are reviewed that have led from a bottom-up responsibility initiative of concerned scientists to the emergence of a nationwide interdisciplinary Priority Program on the assessment of Climate Engineering (CE) funded by the German Research Foundation (DFG). Given the perceived lack of comprehensive and comparative appraisals of different CE methods, the Priority Program was designed to encompass both solar radiation management (SRM) and carbon dioxide removal (CDR) ideas and to cover the atmospheric, terrestrial, and oceanic realm. First, key findings obtained by the ongoing Priority Program are summarized and reveal that, compared to earlier assessments such as the 2009 Royal Society report, more detailed investigations tend to indicate less efficiency, lower effectiveness, and often lower safety. Emerging research trends are discussed in the context of the recent Paris agreement to limit global warming to less than two degrees and the associated increasing reliance on negative emission technologies. Our results show then when deployed at scales large enough to have a significant impact on atmospheric CO2, even CDR methods such as afforestation—often perceived as "benign"—can have substantial side effects and may raise severe ethical, legal, and governance issues. We suppose that before being deployed at climatically relevant scales, any negative emission or CE method will require careful analysis of efficiency, effectiveness, and undesired side effects.

The relative allergenicity of Stachybotrys chartarum compared to house dust mite extracts in a mouse model

EPA Science Inventory

A report by the Institute of Medicine suggested that more research is needed to better understand mold effects on allergic disease, particularly asthma development. The authors compared the ability of the fungus Stachybotrys chartarum (SCE) and house dust mite (HDM) extracts to i...

Focus on Clinical Research: Cognitive Rehabilitation of Severely Closed-Head-Injured Patients Using Computer-Assisted and Noncomputerized Treatment Techniques.

ERIC Educational Resources Information Center

Batchelor, J.; And Others

1988-01-01

The study compared computer assisted cognitive retraining of 47 patients with severe closed head injury with comparable noncomputerized treatment techniques. Results on neuropsychological tests did not support the increased effectiveness of the computer assisted cognitive therapy. (DB)

Marriage Type and Reproductive Decisions: A Comparative Study in Sub-Saharan Africa.

ERIC Educational Resources Information Center

Dodoo, F. Nii-Amoo

1998-01-01

The effect of marriage type (polygamy vs. monogamy) on reproductive decisions is investigated using comparative data from the 1988, 1989, and 1993 Demographic and Health Surveys of Ghana and Kenya. Multivariate analysis is used. Inconclusive results are discussed with a focus on future research directions. (Author/EMK)

A Systematic Replication Comparing Interteaching and Lecture in the Community College Classroom

ERIC Educational Resources Information Center

Felderman, Theresa A.

2016-01-01

Researchers demonstrated the effectiveness of interteaching relative to lecture in 4-year university classrooms, but exploration in other settings is deficient. This systematic replication examines the extent to which interteaching leads to increased exam scores compared to traditional lecture in the community college classroom. Participants in…

PAYER PERSPECTIVES ON FUTURE ACCEPTABILITY OF COMPARATIVE EFFECTIVENESS AND RELATIVE EFFECTIVENESS RESEARCH.

PubMed

Moloney, Rachael; Mohr, Penny; Hawe, Emma; Shah, Koonal; Garau, Martina; Towse, Adrian

2015-01-01

Our objective was to gather perspectives from payers on how comparative effectiveness research (CER) in the United States and relative effectiveness (RE) research in Europe will impact evidentiary standards for access decisions of new drugs by 2020. We conducted semi-structured interviews with fourteen senior officials representing public and private payers, health technology assessment groups, and pricing and reimbursement bodies in the United States and Europe. An online survey assessed current use of CER/RE evidence and potential trends that might influence its use for decision making by 2020. A semi-structured interview elicited payers' definitions of CER/RE and was structured around four hypothetical cases resembling drugs expected to be more common or poised to create policy challenges by 2020. Topics included acceptance of study designs and analytic methods associated with CER/RE. A systematic content review was done to extract relevant information. According to key informants, randomization will remain an essential component for assessing comparative or relative effectiveness. They anticipate greater use of policy levers such as conditional reimbursement or prior authorization to manage diffusion of new drugs. Case studies provided important insights into situations when certain types of CER evidence may be acceptable (e.g., observational data when differences between drugs are largely convenience). Industry perceptions that CER/RE will change payers' evidentiary requirements in the future are consistent with our findings. Growing investment in payers' own data and increased reliance on policy tools to control diffusion of new drugs may also influence the type of evidence industry will be required to produce by 2020.

Effects of Interpretation as a Counseling Technique

ERIC Educational Resources Information Center

Helner, Philip A.; Jessell, John C.

1974-01-01

This research was an inquiry into the effects of interpretation in counseling. The feelings of subjects toward interpretation were compared with their feelings toward the techniques of reflection, advice giving, and probing. The implications of the use of interpretation in counseling are discussed. (Author)

Challenges in using electronic health record data for CER: experience of 4 learning organizations and solutions applied.

PubMed

Bayley, K Bruce; Belnap, Tom; Savitz, Lucy; Masica, Andrew L; Shah, Nilay; Fleming, Neil S

2013-08-01

To document the strengths and challenges of using electronic health records (EHRs) for comparative effectiveness research (CER). A replicated case study of comparative effectiveness in hypertension treatment was conducted across 4 health systems, with instructions to extract data and document problems encountered using a specified list of required data elements. Researchers at each health system documented successes and challenges, and suggested solutions for addressing challenges. Data challenges fell into 5 categories: missing data, erroneous data, uninterpretable data, inconsistencies among providers and over time, and data stored in noncoded text notes. Suggested strategies to address these issues include data validation steps, use of surrogate markers, natural language processing, and statistical techniques. A number of EHR issues can hamper the extraction of valid data for cross-health system comparative effectiveness studies. Our case example cautions against a blind reliance on EHR data as a single definitive data source. Nevertheless, EHR data are superior to administrative or claims data alone, and are cheaper and timelier than clinical trials or manual chart reviews. All 4 participating health systems are pursuing pathways to more effectively use EHR data for CER.A partnership between clinicians, researchers, and information technology specialists is encouraged as a way to capitalize on the wealth of information contained in the EHR. Future developments in both technology and care delivery hold promise for improvement in the ability to use EHR data for CER.

Relating quality of life to Glasgow outcome scale health states.

PubMed

Kosty, Jennifer; Macyszyn, Luke; Lai, Kevin; McCroskery, James; Park, Hae-Ran; Stein, Sherman C

2012-05-01

There has recently been a call for the adoption of comparative effectiveness research (CER) and related research approaches for studying traumatic brain injury (TBI). These methods allow researchers to compare the effectiveness of different therapies in producing patient-oriented outcomes of interest. Heretofore, the only measures by which to compare such therapies have been mortality and rate of poor outcome. Better comparisons can be made if parametric, preference-based quality-of-life (QOL) values are available for intermediate outcomes, such as those described by the Glasgow Outcome Scale Extended (GOSE). Our objective was therefore to determine QOL for the health states described by the GOSE. We interviewed community members at least 18 years of age using the standard gamble method to assess QOL for descriptions of GOSE scores of 2-7 derived from the structured interview. Linear regression analysis was also performed to assess the effect of age, gender, and years of education on QOL. One hundred and one participants between the ages of 18 and 83 were interviewed (mean age 40 ± 19 years), including 55 men and 46 women. Functional impairment and QOL showed a strong inverse relationship, as assessed by both linear regression and the Spearman rank order coefficient. No consistent effect or age, gender, or years of education was seen. As expected, QOL decreased with functional outcome as described by the GOSE. The results of this study will provide the groundwork for future groups seeking to apply CER methods to clinical studies of TBI.

Effects of Humidity Swings on Adsorption Columns for Air Revitalization: Modeling and Experiments

NASA Technical Reports Server (NTRS)

LeVan, M. Douglas; Finn, John E.

1997-01-01

The goal of this research was to develop a dynamic model which can predict the effect of humidity swings on activated carbon adsorption beds used to remove trace contaminants from the atmosphere in spacecraft. Specifically, the model was to be incorporated into a computer simulation to predict contaminant concentrations exiting the bed as a function of time after a humidity swing occurs. Predicted breakthrough curves were to be compared to experimentally measured results. In all respects the research was successful. The two major aspects of this research were the mathematical model and the experiments. Experiments were conducted by Mr. Appel using a fixed-bed apparatus at NASA-Ames Research Center during the summers of 1994 and 1995 and during the first 8 months of 1996. Mr. Appel conducted most of his mathematical modeling work at the University of Virginia. The simulation code was used to predict breakthrough curves using adsorption equilibrium correlations developed previously by M. D. LeVan's research group at the University of Virginia. These predictions were compared with the experimental measurements, and this led to improvements in both the simulation code and the apparatus.

[Effects of foot reflexology on essential hypertension patients].

PubMed

Park, Hyoung-Sook; Cho, Gyoo-Yeong

2004-08-01

This study was to evaluate the effects of foot reflexology on blood pressure, serum lipids level and life satisfaction in essential hypertension patients. The research design used was a nonequivalent control group pretest-posttest design. Foot Reflexology was used as the experimental treatment from June 23rd, 2003 until August 31st, 2003. Thirty-four subjects were assigned to an experimental group(18) and control group(16). Foot Reflexology was administered twice a week for 6 weeks and self foot Reflexology was administered twice a week for 4 weeks on the experimental group. There was a significant decrease in systolic blood pressure but no significant decrease in diastolic pressure in the experimental group compared to the control group. The total cholesterol level in the experimental group compared to the control group was not significantly decreased after foot reflexology. However, the triglyceride level in the experimental group compared to the control group was significantly decreased after foot reflexology. On the other hand, high density lipoprotein and low density lipoprotein levels in the experimental group compared to the control group was not significantly decreased after foot reflexology. Life satisfaction in the experimental group compared to the control group was significantly improved after foot reflexology. The results proved that foot reflexology was an effective nursing intervention to decrease systolic pressure, and triglyceride but not for the blood cholesterol and to improve life satisfaction. Therefore, blood cholesterol should be further evaluated in a larger group of subjects and for a longer period. Further research is regarded as necessary to evaluate and to compare effects of self-foot reflexology and foot reflexology.

Effects of Problem-Based Learning on Recognition Learning and Transfer Accounting for GPA and Goal Orientation

ERIC Educational Resources Information Center

Bergstrom, Cassendra M.; Pugh, Kevin J.; Phillips, Michael M.; Machlev, Moshe

2016-01-01

Conflicting research results have stirred controversy over the effectiveness of problem-based learning (PBL) compared to direct instruction at fostering content learning, particularly for novices. We addressed this by investigating effectiveness with respect to recognition learning and transfer and conducting an aptitude-treatment interaction…

Choosing Assessment Instruments for Bulimia Practice and Outcome Research

ERIC Educational Resources Information Center

Sandberg, Katie; Erford, Bradley T.

2013-01-01

Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using the…

Analyzing the Effect of Metaconceptual Teaching Practices on Students' Understanding of Force and Motion Concepts

ERIC Educational Resources Information Center

Yuruk, Nejla; Beeth, Michael E.; Andersen, Christopher

2009-01-01

This study investigated the effect of metaconceptual teaching interventions on students' understanding of force and motion concepts. A multimethod research design including quasi-experimental design and case study designs was employed to compare the effect of the metaconceptual activities and traditional instruction and investigate students'…

Flaws in Flynn Effect Research with the Wechsler Scales

ERIC Educational Resources Information Center

Weiss, Lawrence G.; Gregoire, Jacques; Zhu, Jianjun

2016-01-01

Many Flynn effect (FE) studies compare scores across different editions of Wechsler's IQ tests. When construct changes are introduced by the test developers in the new edition, however, the presumed generational effects are difficult to untangle from changes due to test content. To remove this confound, we use the same edition of Wechsler…

Online Homework Effectiveness for Underprepared and Repeating College Algebra Students

ERIC Educational Resources Information Center

Brewer, David Shane; Becker, Kurt

2010-01-01

This research compared the effectiveness, in terms of mathematical achievement, of online homework to textbook homework over an entire semester for 145 students enrolled in multiple sections of college algebra at a large community college. A quasi-experimental, posttest design was used to analyze the effect on mathematical achievement, as measured…

Stickie removal using neutral enzymatic repulping pressure screening

Treesearch

Marguerite Sykes; John Klungness; Roland Gleisner; Said Abubakr

1998-01-01

Removal of stickie contaminants is currently a major focus of paper recycling research. Medium consistency alkaline repulping followed by pressure screening has proven to be effective for stickie removal. There is, however, an alternate method that is equally effective and more environmentally benign. This study compares the effectiveness of this alternative method,...

Understanding Effective High Schools: Evidence for Personalization for Academic and Social Emotional Learning

ERIC Educational Resources Information Center

Rutledge, Stacey A.; Cohen-Vogel, Lora; Osborne-Lampkin, La'Tara; Roberts, Ronnie L.

2015-01-01

This article presents findings from a year-long multilevel comparative case study exploring the characteristics of effective urban high schools. We developed a comprehensive framework from the school effectiveness research that guided our data collection and analysis at the four high schools. Using value-added methodology, we identified two higher…

A standardized mean difference effect size for multiple baseline designs across individuals.

PubMed

Hedges, Larry V; Pustejovsky, James E; Shadish, William R

2013-12-01

Single-case designs are a class of research methods for evaluating treatment effects by measuring outcomes repeatedly over time while systematically introducing different condition (e.g., treatment and control) to the same individual. The designs are used across fields such as behavior analysis, clinical psychology, special education, and medicine. Emerging standards for single-case designs have focused attention on methods for summarizing and meta-analyzing findings and on the need for effect sizes indices that are comparable to those used in between-subjects designs. In the previous work, we discussed how to define and estimate an effect size that is directly comparable to the standardized mean difference often used in between-subjects research based on the data from a particular type of single-case design, the treatment reversal or (AB)(k) design. This paper extends the effect size measure to another type of single-case study, the multiple baseline design. We propose estimation methods for the effect size and its variance, study the estimators using simulation, and demonstrate the approach in two applications. Copyright © 2013 John Wiley & Sons, Ltd.

Comparing research investment to United Kingdom institutions and published outputs for tuberculosis, HIV and malaria: a systematic analysis across 1997-2013.

PubMed

Head, Michael G; Fitchett, Joseph R; Derrick, Gemma; Wurie, Fatima B; Meldrum, Jonathan; Kumari, Nina; Beattie, Benjamin; Counts, Christopher J; Atun, Rifat

2015-11-04

The "Unfinished Agenda" of infectious diseases is of great importance to policymakers and research funding agencies that require ongoing research evidence on their effective management. Journal publications help effectively share and disseminate research results to inform policy and practice. We assess research investments to United Kingdom institutions in HIV, tuberculosis and malaria, and analyse these by numbers of publications and citations and by disease and type of science. Information on infection-related research investments awarded to United Kingdom institutions across 1997-2010 were sourced from funding agencies and individually categorised by disease and type of science. Publications were sourced from the Scopus database via keyword searches and filtered to include only publications relating to human disease and containing a United Kingdom-based first and/or last author. Data were matched by disease and type of science categories. Investment (United Kingdom pounds) and publications were compared to generate an 'investment per publication' metric; similarly, an 'investment per citation' metric was also developed as a measure of the usefulness of research. Total research investment for all three diseases was £1.4 billion, and was greatest for HIV (£651.4 million), followed by malaria (£518.7 million) and tuberculosis (£239.1 million). There were 17,271 included publications, with 9,322 for HIV, 4,451 for malaria, and 3,498 for tuberculosis. HIV publications received the most citations (254,949), followed by malaria (148,559) and tuberculosis (100,244). According to UK pound per publication, tuberculosis (£50,691) appeared the most productive for investment, compared to HIV (£61,971) and malaria (£94,483). By type of science, public health research was most productive for HIV (£27,296) and tuberculosis (£22,273), while phase I-III trials were most productive for malaria (£60,491). According to UK pound per citation, tuberculosis (£1,797) was the most productive area for investment, compared to HIV (£2,265) and malaria (£2,834). Public health research was the most productive type of science for HIV (£2,265) and tuberculosis (£1,797), whereas phase I-III trials were most productive for malaria (£1,713). When comparing total publications and citations with research investment to United Kingdom institutions, tuberculosis research appears to perform best in terms of efficiency. There were more public health-related publications and citations for HIV and tuberculosis than other types of science. These findings demonstrate the diversity of research funding and outputs, and provide new evidence to inform research investment strategies for policymakers, funders, academic institutions, and healthcare organizations.

The GRACE Checklist: A Validated Assessment Tool for High Quality Observational Studies of Comparative Effectiveness.

PubMed

Dreyer, Nancy A; Bryant, Allison; Velentgas, Priscilla

2016-10-01

Recognizing the growing need for robust evidence about treatment effectiveness in real-world populations, the Good Research for Comparative Effectiveness (GRACE) guidelines have been developed for noninterventional studies of comparative effectiveness to determine which studies are sufficiently rigorous to be reliable enough for use in health technology assessments. To evaluate which aspects of the GRACE Checklist contribute most strongly to recognition of quality. We assembled 28 observational comparative effectiveness articles published from 2001 to 2010 that compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. Twenty-two volunteers from academia, pharmaceutical companies, and government agencies applied the GRACE Checklist to those articles, providing 56 assessments. Ten senior academic and industry experts provided assessments of overall article quality for the purpose of decision support. We also rated each article based on the number of annual citations and impact factor of the journal in which the article was published. To identify checklist items that were most predictive of quality, classification and regression tree (CART) analysis, a binary, recursive, partitioning methodology, was used to create 3 decision trees, which compared the 56 article assessments with 3 external quality outcomes: (1) expert assessment of overall quality, (2) citation frequency, and (3) impact factor. A fourth tree looked at the composite outcome of all 3 quality indicators. The best predictors of quality included the following: use of concurrent comparators, limiting the study to new initiators of the study drug, equivalent measurement of outcomes in study groups, collecting data on most if not all known confounders or effect modifiers, accounting for immortal time bias in the analysis, and use of sensitivity analyses to test how much effect estimates depended on various assumptions. Only sensitivity analyses appeared consistently as a predictor of quality in all 4 trees. When a composite outcome of the 3 quality measures was used, the GRACE Checklist showed high sensitivity and specificity (71.43% and 80.95%, respectively). The GRACE Checklist stands out from other consensus-driven and expert guidance documents because of its extensive validation efforts. This most recent work shows that the checklist has strong sensitivity and specificity, increasing its utility as a screening tool to identify high-quality observational comparative effectiveness research worthy of in-depth review and applicability for decision support. No outside funding supported this research. All authors are full-time employees of Quintiles, which provides research and consulting services to the biopharmaceutical industry. The authors have no other disclosures to report. Two of the 3 CART trees were presented at the International Society of Pharmacepidemiology in 2015 ("Article Citations per Year" and "Journal Impact Factor"). The original validation study was published in the March 2014 issue of the Journal of Managed Care & Specialty Pharmacy. The checklist questions and scoring were included using a table that was originally published by this journal in 2014. Study concept and design were primarily contributed by Dreyer and Velentgas, along with Bryant. Bryant took the lead in data collection and analysis, along with Dreyer and Velentgas, and data interpretation was performed by Dreyer, Velentgas, and Bryant. The manuscript was written and revised primarily by Dreyer, along with Bryant and Velentgas.

Evaluating the effectiveness of an online medical laboratory technician program.

PubMed

Hansen-Suchy, Kara

2011-01-01

The purpose of this study was to analyze the effectiveness of an online medical laboratory technician program in the academic preparation and development of laboratory professionals. A semi-quantitative comparative research design was used. Several factors were considered in this evaluation. Academic outcomes between online and campus medical laboratory technician (MLT) students was determined by comparing overall and categorical scores on certification exams as well as first time pass rate. Certification exam scores and first time pass rates were also compared to national norms when possible to do so. Demographic data, including age and experience were compared. Additionally, learning styles were assessed to determine if there was a correlation to overall GPA and MLT GPA and if learning styles could be used to predict successful completion of an online Associates of Applied Science. The research was conducted at an academic university located in the mountain west United States. Participants consisted of online and campus students enrolled in a Medical Laboratory Technician program that graduated with their Associate of Applied Science degree between the years 2007-2009. Results of these years were also compared to graduates from 2004-2006 in the same program. Certification performance and first time pass rates were the major outcomes measured. Age and experience were correlated. Online learning styles and GPA were also compared to successful degree completion. The researcher found no significant difference in certification performance with regard to total and categorical scores, and first time pass rates between campus and online MLT students. Online students were slightly older and had more experience working in a laboratory in some capacity. Correlation studies showed significant positive correlation between learning styles, GPA, and successful completion of an Associate of Applied Science degree. When registry scores were compared to the prior cohort of online students, some subcategories scores demonstrated a significant increase using Chi-squared analysis. The research demonstrated that the online MLT students studied were as academically prepared as their campus counterparts.

Opportunities and challenges for comparative effectiveness research (CER) with Electronic Clinical Data: a perspective from the EDM forum.

PubMed

Holve, Erin; Segal, Courtney; Hamilton Lopez, Marianne

2012-07-01

The Electronic Data Methods (EDM) Forum brings together perspectives from the Prospective Outcome Systems using Patient-specific Electronic data to Compare Tests and therapies (PROSPECT) studies, the Scalable Distributed Research Networks, and the Enhanced Registries projects. This paper discusses challenges faced by the research teams as part of their efforts to develop electronic clinical data (ECD) infrastructure to support comparative effectiveness research (CER). The findings reflect a set of opportunities for transdisciplinary learning, and will ideally enhance the transparency and generalizability of CER using ECD. Findings are based on 6 exploratory site visits conducted under naturalistic inquiry in the spring of 2011. Themes, challenges, and innovations were identified in the visit summaries through coding, keyword searches, and review for complex concepts. : The identified overarching challenges and emerging opportunities include: the substantial level of effort to establish and sustain data sharing partnerships; the importance of understanding the strengths and limitations of clinical informatics tools, platforms, and models that have emerged to enable research with ECD; the need for rigorous methods to assess data validity, quality, and context for multisite studies; and, emerging opportunities to achieve meaningful patient and consumer engagement and work collaboratively with multidisciplinary teams. The new infrastructure must evolve to serve a diverse set of potential users and must scale to address a range of CER or patient-centered outcomes research (PCOR) questions. To achieve this aim-to improve the quality, transparency, and reproducibility of CER and PCOR-a high level of collaboration and support is necessary to foster partnership and best practices as part of the EDM Forum.

Effects of Tactile Sensations during Finger Painting on Mindfulness, Emotions, and Scope of Attention

ERIC Educational Resources Information Center

Stanko-Kaczmarek, Maja; Kaczmarek, Lukasz D.

2016-01-01

Research has shown that creative performance, such as painting, influences affective and cognitive processes. Yet little is known about how tactile sensations experienced during painting determine what individuals feel and how they think while they create. Based on prior research, finger painting (compared to brush painting) was expected to…

Breadth in Design Problem Scoping: Using Insights from Experts to Investigate Student Processes. Research Brief

ERIC Educational Resources Information Center

Morozov, Andrew; Kilgore, Deborah; Atman, Cynthia

2007-01-01

In this study, the authors used two methods for analyzing expert data: verbal protocol analysis (VPA) and narrative analysis. VPA has been effectively used to describe the design processes employed by engineering students, expert designers, and expert-novice comparative research. VPA involves asking participants to "think aloud" while…

Learning from Comparing Multiple Examples: On the Dilemma of "Similar" or "Different"

ERIC Educational Resources Information Center

Guo, Jian-Peng; Pang, Ming Fai; Yang, Ling-Yan; Ding, Yi

2012-01-01

Although researchers have demonstrated that studying multiple examples is more effective than studying one example to facilitate learning, the principles found in the literature for designing multiple examples remain ambiguous. This paper reviews variation theory research on example design which sheds light on unclear issues regarding the effects…

Preschoolers' Self-Regulation Moderates Relations between Mothers' Representations and Children's Adjustment to School

ERIC Educational Resources Information Center

Sher-Censor, Efrat; Khafi, Tamar Y.; Yates, Tuppett M.

2016-01-01

Consistent with models of environmental sensitivity (Pluess, 2015), research suggests that the effects of parents' behaviors on child adjustment are stronger among children who struggle to regulate their thoughts, feelings, and behaviors compared with children with better self-regulation. This study extended prior research by assessing maternal…

Feeling the Strain: An Overview of the Literature on Teachers' Stress.

ERIC Educational Resources Information Center

Wilson, Valerie

The Scottish Council for Research in Education (SCRE) reviewed the literature on teacher stress, examining what stress is, causes and effects of stress in teaching, how teaching compares with other professions, what Scottish research says, and how teachers cope with stress. Stress has increasingly acquired a negative connotation, implying…

Using Augmented Reality to Support a Software Editing Course for College Students

ERIC Educational Resources Information Center

Wang, Y.-H.

2017-01-01

This study aimed to explore whether integrating augmented reality (AR) techniques could support a software editing course and to examine the different learning effects for students using online-based and AR-based blended learning strategies. The researcher adopted a comparative research approach with a total of 103 college students participating…

Mentoring in Higher Education: Does It Enhance Mentees' Research Productivity?

ERIC Educational Resources Information Center

Muschallik, Julia; Pull, Kerstin

2016-01-01

Mentoring programs are increasingly widespread in academia. Still, comparatively little is known about their effects. With the help of a self-collected dataset of 368 researchers in two different fields and accounting for self-selection via matching techniques, we find mentees in formal mentoring programs to be more productive than comparable…

Is Online Instruction Perceived as Effective as Campus Instruction by Graduate Students in Education?

ERIC Educational Resources Information Center

Robertson, Janna Siegel; Grant, Michael M.; Jackson, Lorrie

2005-01-01

At a southern metropolitan university, the researchers examined the students' perceived quality of the learning experience of the online courses as compared to classroom-based learning for graduate education courses. The researchers used Chickering and Gamson's (1987) [Chickering, A. W., & Gamson, Z. F. (1987, March). Seven principles for good…

Analysis of Computer Algebra System Tutorials Using Cognitive Load Theory

ERIC Educational Resources Information Center

May, Patricia

2004-01-01

Most research in the area of Computer Algebra Systems (CAS) has been designed to compare the effectiveness of instructional technology to traditional lecture-based formats. While results are promising, research also indicates evidence of the steep learning curve imposed by the technology. Yet no studies have been conducted to investigate this…

Systematically Retrieving Research: A Case Study Evaluating Seven Databases

ERIC Educational Resources Information Center

Taylor, Brian; Wylie, Emma; Dempster, Martin; Donnelly, Michael

2007-01-01

Objective: Developing the scientific underpinnings of social welfare requires effective and efficient methods of retrieving relevant items from the increasing volume of research. Method: We compared seven databases by running the nearest equivalent search on each. The search topic was chosen for relevance to social work practice with older people.…

Insect thermotolerance comparing host infestation methods: Anastrepha ludens (Diptera: Tephritidae) reared in grapefruit or diet

USDA-ARS?s Scientific Manuscript database

Research on insect control should be conducted in a manner that mimics as closely as is feasible its commercial application in all of its practicably conceivable forms. When significant deviations from commercial application are used in research the effect of the deviations on efficacy should be eva...

The Effects of Career Magnet Schools. IEE Brief Number 22.

ERIC Educational Resources Information Center

Crain, Robert L.; Allen, Anna; Little, Judith Warren; Sullivan, Debora; Thaler, Robert; Quigley, Denise; Zellman, Gail

A research study compared graduates of career magnet programs to graduates of comprehensive high schools in a large metropolitan area. The career magnet programs studied are located either within regular comprehensive high schools or combined with other magnet programs to fill an entire building. Research was conducted through school records of…

Changes in Grouping Practices over Primary and Secondary School

ERIC Educational Resources Information Center

Baines, Ed; Blatchford, Peter; Kutnick, Peter

2003-01-01

The research detailed in this paper provides a systematic description and analysis of classroom grouping practices in primary and secondary schools in England. Practices are compared to main findings in developmental and educational literature with regard to effective contexts for learning and recent ideas about pedagogy. The research is based on…

A Two Group-Two Treatment Research Design.

ERIC Educational Resources Information Center

Maxey, James H.

A two group-two treatment research design is presented; it allows for the assessment of the individual and the combined effects of the two treatments. Advantages include: (1) Initial evaluation represents an estimate of the stabilities of the measurements; and (2) Observation 4 compared with the average of Observation 1 and Observation 2 tests the…

Research on Flipping College Algebra: Lessons Learned and Practical Advice for Flipping Multiple Sections

ERIC Educational Resources Information Center

Overmyer, Jerry

2015-01-01

This quantitative research compares five sections of College Algebra using flipped classroom methods with six sections using the traditional lecture/homework structure and its effect on student achievement as measured through a common final exam. Common final exam scores were the dependent variables. Instructors of flipped sections who had…

Using Reciprocal Peer Review to Help Graduate Students Develop Scholarly Writing Skills

ERIC Educational Resources Information Center

Palmer, Betsy; Major, Claire Howell

2008-01-01

We developed an innovative instructional method to actively engage students in writing and critiquing scholarly work. We tested the effectiveness of this pedagogy using a mixed methods research design. Compared to control group peers, students in the experimental classes perceived gains in their own writing, research ability, and motivation to…

Prescriptive Authority in the Face of Research Revelations

ERIC Educational Resources Information Center

Greenberg, Roger P.

2010-01-01

Fox and his colleagues (May-June 2009) listed three occurrences beginning in the 1980s that have dampened psychologists' desires to procure the right to prescribe psychotropic medications. That research review highlighted the fact that antidepressants produce a very modest effect at best when compared with placebos. I briefly summarize here some…

Sport, Health, Fitness and Dance. AAHPER Research Consortium Symposium Papers.

ERIC Educational Resources Information Center

Corbin, Charles B., Ed.

This collection of symposium papers provides current synthesis of research in the field of physical education and health. In this volume the physiological aspects of physical activities are discussed. The effects of chronic heavy physical training in swimming are examined, comparing age groups and males and females. Stress factors are also…

Changing patterns of use of osteoporosis medications in the years after launch: implications for comparative effectiveness research.

PubMed

Reams, B Diane; O'Malley, Cynthia D; Critchlow, Cathy W; Lauffenburger, Julie C; Brookhart, M Alan

2014-03-01

Newly marketed medications may be used selectively in patients with more severe disease. Changes in patterns of use following a drug's introduction to the market can greatly influence results from non-experimental comparative effectiveness research. We sought to explore this issue by characterizing trends in oral and injectable prescription drug claims for the prevention and treatment of osteoporosis. We examined a post-menopausal population of women age 55 years and older in the Truven Health Analytics MarketScan® Databases. We used propensity score (PS) methods to describe how predictors of new users of oral and injectable osteoporosis medications change over time. We found that injectable osteoporosis medications tended to be used more selectively in the higher risk patients shortly after launch. Over time, they appeared to be used increasingly in lower risk patients. If disease severity is incompletely captured in the data, comparative effectiveness of novel osteoporosis medications may be difficult to accurately estimate, particularly when medications are new to market. Copyright © 2013 John Wiley & Sons, Ltd.

Unanticipated Insights into Biomedicine from the Study of Acupuncture.

PubMed

MacPherson, Hugh; Hammerschlag, Richard; Coeytaux, Remy R; Davis, Robert T; Harris, Richard E; Kong, Jiang-Ti; Langevin, Helene M; Lao, Lixing; Milley, Ryan J; Napadow, Vitaly; Schnyer, Rosa N; Stener-Victorin, Elisabet; Witt, Claudia M; Wayne, Peter M

2016-02-01

Research into acupuncture has had ripple effects beyond the field of acupuncture. This paper identifies five exemplars to illustrate that there is tangible evidence of the way insights gleaned from acupuncture research have informed biomedical research, practice, or policy. The first exemplar documents how early research into acupuncture analgesia has expanded into neuroimaging research, broadening physiologic understanding and treatment of chronic pain. The second describes how the acupuncture needle has become a tool to enhance biomedical knowledge of connective tissue. The third exemplar, which illustrates use of a modified acupuncture needle as a sham device, focuses on emergent understanding of placebo effects and, in turn, on insights into therapeutic encounters in treatments unrelated to acupuncture. The fourth exemplar documents that two medical devices now in widespread use were inspired by acupuncture: transcutaneous electrical nerve stimulators for pain control and antinausea wrist bands. The final exemplar describes how pragmatic clinical trial designs applied in acupuncture research have informed current general interest in comparative effectiveness research. In conclusion, these exemplars of unanticipated outcomes of acupuncture research comprise an additional rationale for continued support of basic and clinical research evaluating acupuncture and other under-researched therapies.

Study groups: are they effective in preparing students for NCLEX-RN?

PubMed

Ashley, J; O'Neil, J

1994-10-01

The effectiveness of faculty-directed study groups as an intervention to prepare nurse candidates for NCLEX-RN was evaluated. The NCLEX-RN performance of a baccalaureate class who had participated in study groups was compared to the performance of a prior class who had not participated in study groups. Academic subgroups within the classes were compared to determine if study groups were equally effective across levels of academic achievement. The possible reasons for the significant difference in the NCLEX-RN passing rate between "at-risk" students who participated in study groups and at-risk students who did not participate in study groups are discussed. Discussion also considers possible factors influencing the generally better performance of study group participants at all academic levels. Suggestions for future intervention research direct attention to time intensity of interventions and research control through random assignments to treatment groups.

Smiling faces, sometimes they don't tell the truth: facial expression in the ultimatum game impacts decision making and event-related potentials.

PubMed

Mussel, Patrick; Hewig, Johannes; Allen, John J B; Coles, Michael G H; Miltner, Wolfgang

2014-04-01

Facial expressions are an important aspect of social interaction, conveying not only information regarding emotional states, but also regarding intentions, personality, and complex social characteristics. The present research investigates how a smiling, compared to a nonsmiling, expression impacts decision making and underlying cognitive and emotional processes in economic bargaining. Our results using the ultimatum game show that facial expressions have an impact on decision making as well as the feedback-related negativity following the offer. Furthermore, a moderating effect of sex on decision making was observed, with differential effects of facial expressions from male compared to female proposers. It is concluded that predictions of bargaining behavior must account for aspects of social interactions as well as sex effects to obtain more precise estimates of behavior. Copyright © 2014 Society for Psychophysiological Research.

Does Mentoring Matter? A Multidisciplinary Meta-Analysis Comparing Mentored and Non-Mentored Individuals

PubMed Central

Eby, Lillian T.; Allen, Tammy D.; Evans, Sarah C.; Ng, Thomas; DuBois, David

2008-01-01

The study of mentoring has generally been conducted within disciplinary silos with a specific type of mentoring relationship as a focus. The purpose of this article is to quantitatively review the three major areas of mentoring research (youth, academic, workplace) to determine the overall effect size associated with mentoring outcomes for protégés. We also explored whether the relationship between mentoring and protégé outcomes varied by the type of mentoring relationship (youth, academic, workplace). Results demonstrate that mentoring is associated with a wide range of favorable behavioral, attitudinal, health-related, relational, motivational, and career outcomes, although the effect size is generally small. Some differences were also found across type of mentoring. Generally, larger effect sizes were detected for academic and workplace mentoring compared to youth mentoring. Implications for future research, theory, and applied practice are provided. PMID:19343074

TH-CD-209-05: Impact of Spot Size and Spacing On the Quality of Robustly-Optimized Intensity-Modulated Proton Therapy Plans for Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, W; Ding, X; Hu, Y

Purpose: To investigate how spot size and spacing affect plan quality, especially, plan robustness and the impact of interplay effect, of robustly-optimized intensity-modulated proton therapy (IMPT) plans for lung cancer. Methods: Two robustly-optimized IMPT plans were created for 10 lung cancer patients: (1) one for a proton beam with in-air energy dependent large spot size at isocenter (σ: 5–15 mm) and spacing (1.53σ); (2) the other for a proton beam with small spot size (σ: 2–6 mm) and spacing (5 mm). Both plans were generated on the average CTs with internal-gross-tumor-volume density overridden to irradiate internal target volume (ITV). Themore » root-mean-square-dose volume histograms (RVH) measured the sensitivity of the dose to uncertainties, and the areas under RVH curves were used to evaluate plan robustness. Dose evaluation software was developed to model time-dependent spot delivery to incorporate interplay effect with randomized starting phases of each field per fraction. Patient anatomy voxels were mapped from phase to phase via deformable image registration to score doses. Dose-volume-histogram indices including ITV coverage, homogeneity, and organs-at-risk (OAR) sparing were compared using Student-t test. Results: Compared to large spots, small spots resulted in significantly better OAR sparing with comparable ITV coverage and homogeneity in the nominal plan. Plan robustness was comparable for ITV and most OARs. With interplay effect considered, significantly better OAR sparing with comparable ITV coverage and homogeneity is observed using smaller spots. Conclusion: Robust optimization with smaller spots significantly improves OAR sparing with comparable plan robustness and similar impact of interplay effect compare to larger spots. Small spot size requires the use of larger number of spots, which gives optimizer more freedom to render a plan more robust. The ratio between spot size and spacing was found to be more relevant to determine plan robustness and the impact of interplay effect than spot size alone. This research was supported by the National Cancer Institute Career Developmental Award K25CA168984, by the Fraternal Order of Eagles Cancer Research Fund Career Development Award, by The Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, by Mayo Arizona State University Seed Grant, and by The Kemper Marley Foundation.« less

Effect of Time on Perceived Gains from an Undergraduate Research Program

PubMed Central

Adedokun, Omolola A.; Parker, Loran C.; Childress, Amy; Burgess, Wilella; Adams, Robin; Agnew, Christopher R.; Leary, James; Knapp, Deborah; Shields, Cleveland; Lelievre, Sophie; Teegarden, Dorothy

2014-01-01

The current study examines the trajectories of student perceived gains as a result of time spent in an undergraduate research experience (URE). Data for the study come from a survey administered at three points over a 1-yr period: before participation in the program, at the end of a Summer segment of research, and at the end of the year. Repeated-measures analysis of variance was used to examine the effect of time on perceived gains in student research skills, research confidence, and understanding of research processes. The results suggest that the students experienced different gains/benefits at developmentally different stages of their UREs. Participants reported gains in fewer areas at the end of the Summer segment compared with the end of the yearlong experience, thus supporting the notion that longer UREs offer students more benefit. PMID:24591512

Optical properties of different graphene concentration in P3HT

NASA Astrophysics Data System (ADS)

Shariff, N. S. M.; Sarah, M. S. P.; Rusop, M.

2018-05-01

The discovery of Graphene has led to many new findings in material research. P3HT is a polymer that is well used in photovoltaic studies but the main problem is its low photocurrent due to its low electron mobility. Therefore the objective of this research is to increase the mobility in order to achieve higher photocurrent. In this research, P3HT will be mixed with Graphene and used as an active layer. The fabrication method used in this research is spin coating technique. Optical properties such as absorbance, transmittance and photoluminescence is characterized. Each optical properties shows a positive results when compared to P3HT layer. A concentration of 2 wt % shows the optimum absorbance and transmittance while quenching effect can be seen when compared to P3HT layer.

Evaluating the Comparability of Paper-and-Pencil and Computerized Versions of a Large-Scale Certification Test. Research Report. ETS RR-05-21

ERIC Educational Resources Information Center

Puhan, Gautam; Boughton, Keith A.; Kim, Sooyeon

2005-01-01

The study evaluated the comparability of two versions of a teacher certification test: a paper-and-pencil test (PPT) and computer-based test (CBT). Standardized mean difference (SMD) and differential item functioning (DIF) analyses were used as measures of comparability at the test and item levels, respectively. Results indicated that effect sizes…

Some decks are better than others: the effect of reinforcer type and task instructions on learning in the Iowa Gambling Task.

PubMed

Fernie, Gordon; Tunney, Richard J

2006-02-01

The Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994) has become widely used as a laboratory test of "real-life" decision-making. However, aspects of its administration that have been varied by researchers may differentially affect performance and the conclusions researchers can draw. Some researchers have used facsimile money reinforcers while others have used real money reinforcers. More importantly, the instructions participants receive have also been varied. While no differences have been reported in performance dependent on reinforcer type, no previous comparison of participants' instructions has been conducted. This is despite one set of instructions giving participants a clear hint about the nature of the task. Additionally, in previous research one set of instructions have not been used exclusively with one reinforcer type making any differential or cumulative effects of these factors difficult to interpret. The present study compared the effects of instruction and reinforcer type on IGT performance. When participants received instructions without a hint performance was affected by reinforcer type. This was not the case when the instructions included a hint. In a second IGT session performance was improved in participants who had received the hint instructions compared with those who had not.

Helicopter crashworthiness research program

NASA Technical Reports Server (NTRS)

Farley, Gary L.; Boitnott, Richard L.; Carden, Huey D.

1988-01-01

Results are presented from the U.S. Army-Aerostructures Directorate/NASA-Langley Research Center joint research program on helicopter crashworthiness. Through the on-going research program an in-depth understanding was developed on the cause/effect relationships between material and architectural variables and the energy-absorption capability of composite material and structure. Composite materials were found to be efficient energy absorbers. Graphite/epoxy subfloor structures were more efficient energy absorbers than comparable structures fabricated from Kevlar or aluminum. An accurate method predicting the energy-absorption capability of beams was developed.

The Academic Performance of Catholic Schools.

ERIC Educational Resources Information Center

Morris, Andrew B.

1994-01-01

Although the (British) government's "league tables" may be an inappropriate method of comparing schools' relative effectiveness, analysis of the 1992 examination results points to Catholic schools' apparent success. A summary of the limited research evidence on Catholic school effectiveness suggests that a rigorous study of their…

Experimental effective intensity of steady and flashing light emitting diodes for aircraft anti-collision lighting.

DOT National Transportation Integrated Search

2013-08-01

Research was conducted to determine the effective intensity of flashing lights that incorporate light-emitting diodes (LEDs). LEDs require less power and have the ability to flash without the addition of moving parts. Compared with incandescent bulbs...

A Comparison of Meditation with Other Relaxation Techniques.

ERIC Educational Resources Information Center

Fling, Sheila

This paper critiques a negative 1984 review, "Meditation and Somatic Arousal Reduction" (Holmes), on the absolute effectiveness of meditation in reducing somatic arousal and reviews research on the relative effectiveness of meditation compared to techniques such as biofeedback, hypnosis, progressive muscle relaxation, and autogenics in…

Operational effectiveness of blended e-learning program for nursing research ethics.

PubMed

Cho, Kap-Chul; Shin, Gisoo

2014-06-01

Since 2006, the Korean Ministry of Education, Science and Technology, and the National Research Foundation of Korea have taken the lead in developing an institutional guideline for research ethics. The purpose was to identify the effectiveness of the Good Research Practice program, developed on a fund granted by the National Research Foundation of Korea, for nurses and nursing students whose knowledge and perception of research ethics were compared before and after the implementation of the Good Research Practice program. This study was conducted to compare the levels of knowledge and perception of research ethics in the participants before and after the program was implemented. The participants included 45 nurses and 69 nursing students from hospitals, colleges of nursing, and the Korean Nurses Association, located in Seoul, Korea. This study was approved by the Institutional Research Board in Korea. Based on the Analysis, Design, Development, Implementation, and Evaluation model, the Good Research Practice program was made up of a total of 30 h of the blended learning both online and off-line. The results of this study showed that there were statistically significant differences in both knowledge and perception of research ethics in nursing students and nurses before and after the program had been implemented. The concepts of professional nursing ethics, moral issues, and bioethics were often confused with one another and not clearly defined. Therefore, the concept and scope of bioethics, moral judgment, and overall nursing ethics should be well defined and conceptualized in the future. This study suggested integrating research ethics education in the nursing curriculum as a required course of study for nursing students and as part of the in-service training program for nurses in order to improve research ethics in nursing research in Korea. © The Author(s) 2013.

Choosing a Control Group in Effectiveness Trials of Behavioral Drug Abuse Treatments

PubMed Central

Brigham, Gregory S.; Feaster, Daniel J.; Wakim, Paul G.; Dempsey, Catherine L.

2009-01-01

Effectiveness trials are an important step in the scientific process of developing and evaluating behavioral treatments. The focus on effectiveness research presents a different set of requirements on the research design when compared with efficacy studies. The choice of a control condition has many implications for a clinical trial's internal and external validity. The purpose of this manuscript is to provide a discussion of the issues involved in choosing a control group for effectiveness trials of behavioral interventions in substance abuse treatment. The authors provide a description of four trial designs and a discussion of the advantages and disadvantages of each. PMID:19553062

Graphic organizers and their effects on the reading comprehension of students with LD: a synthesis of research.

PubMed

Kim, Ae-Hwa; Vaughn, Sharon; Wanzek, Jeanne; Wei, Shangjin

2004-01-01

Previous research studies examining the effects of graphic organizers on reading comprehension for students with learning disabilities (LD) are reviewed. An extensive search of the professional literature between 1963 and June 2001 yielded a total of 21 group design intervention studies that met the criteria for inclusion in the synthesis. Using graphic organizers (i.e., semantic organizers, framed outlines, cognitive maps with and without a mnemonic) was associated with improved reading comprehension overall for students with LD. Compared to standardized reading measures, researcher-developed comprehension measures were associated with higher effect sizes. Initial gains demonstrated when using graphic organizers were not revealed during later comprehension tasks or on new comprehension tasks.

Making the business case for enhanced depression care: the National Institute of Mental Health-harvard Work Outcomes Research and Cost-effectiveness Study.

PubMed

Wang, Philip S; Simon, Gregory E; Kessler, Ronald C

2008-04-01

Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.

The effectiveness of using computer simulated experiments on junior high students' understanding of the volume displacement concept

NASA Astrophysics Data System (ADS)

Choi, Byung-Soon; Gennaro, Eugene

Several researchers have suggested that the computer holds much promise as a tool for science teachers for use in their classrooms (Bork, 1979, Lunetta & Hofstein, 1981). It also has been said that there needs to be more research in determining the effectiveness of computer software (Tinker, 1983).This study compared the effectiveness of microcomputer simulated experiences with that of parallel instruction involving hands-on laboratory experiences for teaching the concept of volume displacement to junior high school students. This study also assessed the differential effect on students' understanding of the volume displacement concept using sex of the students as another independent variable. In addition, it compared the degree of retention, after 45 days, of both treatment groups.It was found that computer simulated experiences were as effective as hands-on laboratory experiences, and that males, having had hands-on laboratory experiences, performed better on the posttest than females having had the hands-on laboratory experiences. There were no significant differences in performance when comparing males with females using the computer simulation in the learning of the displacement concept. This study also showed that there were no significant differences in the retention levels when the retention scores of the computer simulation groups were compared to those that had the hands-on laboratory experiences. However, an ANOVA of the retention test scores revealed that males in both treatment conditions retained knowledge of volume displacement better than females.

Big Data: transforming drug development and health policy decision making.

PubMed

Alemayehu, Demissie; Berger, Marc L

The explosion of data sources, accompanied by the evolution of technology and analytical techniques, has created considerable challenges and opportunities for drug development and healthcare resource utilization. We present a systematic overview these phenomena, and suggest measures to be taken for effective integration of the new developments in the traditional medical research paradigm and health policy decision making. Special attention is paid to pertinent issues in emerging areas, including rare disease drug development, personalized medicine, Comparative Effectiveness Research, and privacy and confidentiality concerns.

Health technology assessment and comparative effectiveness research: a pharmaceutical industry perspective.

PubMed

Hao, Yanni; Thomas, Adrian

2013-08-01

We briefly review the characteristics of several established health technology assessment (HTA) programs in industrialized societies including Germany, the UK and France. Special attention is paid on two issues: the position of HTA in coverage decision making and the role of economic assessment in evaluation processes. Although law makers in the USA have barred the use of NICE's cost/quality-adjusted life year or similar health economics approaches by public payers for coverage decision making, there are suggestions of prioritizing relative efficacy evaluation over economic assessment under a comparative effectiveness research (CER) framework to inform payment rates of public payers (an approach similar to German and French HTA processes). However, such an approach is unlikely to prove viable. It should also be noted that, if cost considerations are made explicit in US CER policy decisions, CER may become an unsustainable approach undermined by a conflicting emphasis on both cost containment and a demand for costly comparative evidence. On the other hand, properly designed CER initiatives can serve as a facilitator of more efficient research activities and drug development models. With these points in mind, the likely pathway of US CER is explored and the plausible impact on industry innovation is discussed.

Some participants may be better than others: sustained attention and motivation are higher early in semester.

PubMed

Nicholls, Michael E R; Loveless, Kellie M; Thomas, Nicole A; Loetscher, Tobias; Churches, Owen

2015-01-01

Many studies use multiexperiment designs where experiments are carried out at different times of semester. When comparing between experiments, the data may be confounded by between-participants effects related to motivation. Research indicates that course-credit participants who engage in research early in semester have different personality and performance characteristics compared to those tested late in semester. This study examined whether the semester effect is caused by internal (inherent motivation of the participant) or external (looming exams, essays) factors. To do this, sustained attention and intrinsic/extrinsic motivation was measured in groups of course-credit (n = 40) and paid (n = 40) participants early and late in semester. While there was no difference in sustained attention between the groups early in semester, the course-credit group performed significantly worse late in semester. The course-credit group also showed a significant decrease in intrinsic motivation with time whereas the paid participants showed no change. Because changes were not seen for both groups, the semester difference cannot be due to external factors. Instead, the data demonstrate that course-credit participants who engage early have high sustained attention and intrinsic motivation compared to their late counterparts, who leave their participation to the last minute. Researchers who use multiexperimental designs across semester need to control for these effects--perhaps by using paid participants who do not vary across semester.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods.

PubMed

Davies, Benjamin; Kotter, Mark

2018-02-05

Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website's Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. ©Benjamin Davies, Mark Kotter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 05.02.2018.

Systematic review finds that study data not published in full text articles have unclear impact on meta-analyses results in medical research.

PubMed

Schmucker, Christine M; Blümle, Anette; Schell, Lisa K; Schwarzer, Guido; Oeller, Patrick; Cabrera, Laura; von Elm, Erik; Briel, Matthias; Meerpohl, Joerg J

2017-01-01

A meta-analysis as part of a systematic review aims to provide a thorough, comprehensive and unbiased statistical summary of data from the literature. However, relevant study results could be missing from a meta-analysis because of selective publication and inadequate dissemination. If missing outcome data differ systematically from published ones, a meta-analysis will be biased with an inaccurate assessment of the intervention effect. As part of the EU-funded OPEN project (www.open-project.eu) we conducted a systematic review that assessed whether the inclusion of data that were not published at all and/or published only in the grey literature influences pooled effect estimates in meta-analyses and leads to different interpretation. Systematic review of published literature (methodological research projects). Four bibliographic databases were searched up to February 2016 without restriction of publication year or language. Methodological research projects were considered eligible for inclusion if they reviewed a cohort of meta-analyses which (i) compared pooled effect estimates of meta-analyses of health care interventions according to publication status of data or (ii) examined whether the inclusion of unpublished or grey literature data impacts the result of a meta-analysis. Seven methodological research projects including 187 meta-analyses comparing pooled treatment effect estimates according to different publication status were identified. Two research projects showed that published data showed larger pooled treatment effects in favour of the intervention than unpublished or grey literature data (Ratio of ORs 1.15, 95% CI 1.04-1.28 and 1.34, 95% CI 1.09-1.66). In the remaining research projects pooled effect estimates and/or overall findings were not significantly changed by the inclusion of unpublished and/or grey literature data. The precision of the pooled estimate was increased with narrower 95% confidence interval. Although we may anticipate that systematic reviews and meta-analyses not including unpublished or grey literature study results are likely to overestimate the treatment effects, current empirical research shows that this is only the case in a minority of reviews. Therefore, currently, a meta-analyst should particularly consider time, effort and costs when adding such data to their analysis. Future research is needed to identify which reviews may benefit most from including unpublished or grey data.

Systematic review finds that study data not published in full text articles have unclear impact on meta-analyses results in medical research

PubMed Central

Blümle, Anette; Schell, Lisa K.; Schwarzer, Guido; Oeller, Patrick; Cabrera, Laura; von Elm, Erik; Briel, Matthias; Meerpohl, Joerg J.

2017-01-01

Background A meta-analysis as part of a systematic review aims to provide a thorough, comprehensive and unbiased statistical summary of data from the literature. However, relevant study results could be missing from a meta-analysis because of selective publication and inadequate dissemination. If missing outcome data differ systematically from published ones, a meta-analysis will be biased with an inaccurate assessment of the intervention effect. As part of the EU-funded OPEN project (www.open-project.eu) we conducted a systematic review that assessed whether the inclusion of data that were not published at all and/or published only in the grey literature influences pooled effect estimates in meta-analyses and leads to different interpretation. Methods and findings Systematic review of published literature (methodological research projects). Four bibliographic databases were searched up to February 2016 without restriction of publication year or language. Methodological research projects were considered eligible for inclusion if they reviewed a cohort of meta-analyses which (i) compared pooled effect estimates of meta-analyses of health care interventions according to publication status of data or (ii) examined whether the inclusion of unpublished or grey literature data impacts the result of a meta-analysis. Seven methodological research projects including 187 meta-analyses comparing pooled treatment effect estimates according to different publication status were identified. Two research projects showed that published data showed larger pooled treatment effects in favour of the intervention than unpublished or grey literature data (Ratio of ORs 1.15, 95% CI 1.04–1.28 and 1.34, 95% CI 1.09–1.66). In the remaining research projects pooled effect estimates and/or overall findings were not significantly changed by the inclusion of unpublished and/or grey literature data. The precision of the pooled estimate was increased with narrower 95% confidence interval. Conclusions Although we may anticipate that systematic reviews and meta-analyses not including unpublished or grey literature study results are likely to overestimate the treatment effects, current empirical research shows that this is only the case in a minority of reviews. Therefore, currently, a meta-analyst should particularly consider time, effort and costs when adding such data to their analysis. Future research is needed to identify which reviews may benefit most from including unpublished or grey data. PMID:28441452

A review of the cost-effectiveness of vedolizumab for treating moderate- to severely active ulcerative colitis.

PubMed

Tsai, Her Hsin; Black, Christopher

2016-12-01

Vedolizumab is a novel humanised monoclonal IgG1 antibody gut selective anti-integrin specifically targeting α4β7 integrins in the gut and found to be efficacious in the treatment of ulcerative colitis. Areas covered: Research investigating the cost-effectiveness of vedolizumab is limited. This review considers data from the manufacturers, the evidence research group commissioned by NICE to conduct a single technology appraisal, and the decision of NICE itself to appraise what is currently known about the cost-effectiveness of vedolizumab for moderately to severely active ulcerative from a UK perspective. Expert commentary: Based on the very limited data currently available, it can be concluded that vedolizumab is a cost-effective option for those with moderately to severely active ulcerative colitis who are anti-TNFa naive; however, there is a need for further research comparing vedolizumab with other biologic therapies which may alter perceptions of cost-effectiveness.