Matching the Research Design to the Study Question

Matching the Research Design to the Study Question ,[object Object],[object Object]

Overview ,[object Object],[object Object],[object Object],[object Object]

AcademyHealth: Improving Health & Health Care ,[object Object],[object Object],[object Object],[object Object],[object Object]

In Other Words… ,[object Object],[object Object],[object Object],[object Object]

Overview ,[object Object],[object Object],[object Object]

National Quality Strategy ,[object Object],[object Object]

National Quality Strategy: Three Aims ,[object Object],[object Object],[object Object]

National Quality Strategy: Six Priorities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NQS and IOM: Priorities in Sync ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NQS and FCC CER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

National Quality Strategy Principles ,[object Object],[object Object],[object Object],[object Object],[object Object],6. Consistent national standards 7. Primary care will become a bigger focus 8. Coordination will be enhanced 9. Integration of care delivery 10. Providing clear information CER focused at the individual level, responsive to patient needs CER examining discrete &/or complex comorbid conditions Importance of sub group analyses, examination of context, & within group heterogeneity Enterprise dependent on public & private sources Examination of system level effectiveness and co-occurring interventions Methodologic standards for priority setting, engaging patients & research Focus on real world setting and heterogeneous patient populations as well as practice variations Implementation and Dissemination CER Importance of system level studies

A brief (& Selected) History of Time… 1989 AHCPR PCORI Public/Private Funding Priority Questions Methods & Standards Stakeholder input 1999 AHRQ 2003 MMA 2009 ARRA 2009 ACA Outcomes PORTS Outcomes CERTS Quality & Safety AHRQ EHC Program Priority Conditions Payer focus Public input CER enterprise Priority Questions Methods & Standards Stakeholder input

Over That Time… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CER Defining Characteristics ,[object Object],[object Object],[object Object],Tunis, 2009

CER Defining Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tunis, 2009

CER vs PCOR: is there a difference? Not comparative Patient reported outcomes Subgroups Patient-Centered Outcomes Research Comparative Effectiveness Research Comparisons No patient reported data

[object Object],[object Object]

Who is asking the question? Why? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The design depends on who is asking the question ,[object Object],[object Object],[object Object],[object Object],[object Object],Source: Zerzan, JT et al. “Improving State Medicaid Policies with Comparative Effectiveness Research: A Key Role for Academic Health Centers.” Academic Medicine, Vol. 86, No. 6. June 2011. Pgs 695-700.

Categories of CER Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tunis, 2009

The skeptical, “purist” view... ,[object Object],Source: Lauer, MS. “Will Academia Embrace Comparative Effectiveness Research?” Academic Medicine, Vol. 86, No. 6. June 2011. Pgs 671-673.

Matching the Designs Source: Thorpe KE et al, Journal of Clinical Epidemiology, 2009

Matching the Designs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Matching the Design to the Question Observational Studies RCTs Balance Rigor Relevance Timeliness

All methods have a role ,[object Object],[object Object],[object Object],[object Object],Tunis, 2009

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source: Adapted from Van Lare, Conway & Sox, NEJM, 2010

Questions? Lisa Simpson, MB, BCh, MPH, FAAP President and CEO

Matching the Research Design to the Study Question

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Matching the Research Design to the Study Question

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