Federal Register: November 13, 2000 (Volume 65, Number 219)
DOCID: FR Doc 00-28896
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
NOTICE: NOTICES
DOCUMENT ACTION: Nominations of topics for evidence reports and technology assessments.
SUBJECT CATEGORY:
Nominations of Topics for Evidence-Based Practice Centers (EPCs)
DATES: Topic nominations should be submitted by January 12, 2001 in order to be considered for the next group of evidence reports and technology assessments. In addition to timely responses to this request for nominations, AHRQ also accepts topic nominations on an ongoing basis. AHRQ will not reply to individual responses, but will consider all nominations during the selection process. Topics selected will be announced from time to time in the Federal Register and AHRQ press releases.
DOCUMENT SUMMARY:
AHRQ invites a fourth round of nominations of topics for evidence reports and technology assessments relating to the prevention, diagnosis, treatment and management of common diseases and clinical conditions, as well as topics relating to organization and financing of health care. AHRQ's previous requests for topic nominations were published in the Federal Register on December 23, 1996, November 28, 1997, and May 4, 1999.
SUMMARY:
Evidence-based practice centers; topics nominations,
SUPPLEMENTAL INFORMATION
1. Background
Under Title IX of the Public Health Service Act (42 U.S.C. 299a 299c) as amended by Pub. L. 106129 (1999), AHRQ is charged with enhancing the quality, appropriateness, and effectiveness of health care services and access to such services. AHRQ accomplishes these goals through scientific research and through promotion of improvements in clinical practice and health systems practices including the prevention of diseases and other health conditions.
2. Purpose
The purpose of this Federal Register notice is to encourage
participation and collaboration of professional societies, health
systems, payors, and providers, with AHRQ as it carries out its mission
to promote the practice of evidencebased health care. AHRQ serves as
the science partner with privatesector and public organizations in their efforts to improve the quality, effectiveness, and
appropriateness of health care delivery in the United States, and to
expedite the translation of evidencebased research findings into
improved health care services. AHRQ awards task order contracts to its
Evidencebased Practice Centers (EPCs) to undertake scientific analyses
and evidence syntheses on highpriority topics. The EPCs produce
science synthesesevidence reports and technology assessmentsthat
provide to public and private organizations the foundation for
developing and implementing their own practice guidelines, performance
measures, educational programs, and other strategies to improve the
quality of health care and decisionmaking related to the effectiveness
and appropriateness of specific health care technologies and services.
The evidence reports and technology assessments also may be used to inform coverage and reimbursement policies.
As the body of scientific studies related to the organization and financing of health care grows, systematic review and analyses of these studies can provide health system organizations with a scientific foundation for developing systemwide policies and practices. These reports may address and evaluate topics such as risk adjustment methodologies, market performance measures, provider payment mechanisms, and insurance purchasing tools, as well as provider integration of new scientific findings regarding health care and delivery innovations.
EvidenceBased Practice Centers (EPCs)
The EPCs prepare evidence reports and technology assessments on
topics for which there is significant demand for information by health
care providers, insurers, purchasers, healthrelated societies, and patient advocacy
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organizations. Such topics may include the prevention, diagnosis and/or
treatment of particular diseases or health conditions including, where
appropriate, the use of alternative/complementary therapies, as well as
the appropriate use of commonly provided services, procedures, or
technologies. Topics also may include issues related to the
organization and financing of care. AHRQ widely disseminates the EPC
evidence reports and technology assessments, both electronically and in
print. The EPC evidence reports and technology assessments do not
include clinical recommendations or recommendations on reimbursement and coverage policies.
Topic Nomination and Selection Process
The AHRQ will review topic nominations and supporting information and determine final topics, seeking additional information as appropriate. AHRQ encourages topic nominations from professional societies and organizations comprised of members of minority populations, as well as nomination of topics that have significant impact on the health status of women, children, ethnic and racial populations. Nominators of selected topics assume the role of Partners to AHRQ and the EPCs. Partners are expected to serve as resources to EPCs as they develop evidence reports and technology assessments. Partners may also serve as peer reviewers of draft evidence reports and assessments.
The processes that AHRQ employs to select topics nominated for
analyses by the EPCs is described below. Section A addresses AHRQ's
nomination process and selection criteria for clinical topics. Section
B addresses AHRQ's nomination process and selection criteria for organization and financing topics.
Section A: Clinical Topics
Nomination Process for Clinical Topics
Nominations of clinical topics for AHRQ evidence reports and technology assessments should focus on specific aspects of prevention, diagnosis, treatment and/or management of a particular condition, or on an individual procedure, treatment, or technology. Potential topics should be carefully defined and circumscribed so that the relevant published literature and other databases can be searched, evidence systematically reviewed, supplemental analyses performed, draft reports and assessments circulated for external peer review, and final evidence reports or technology assessments produced. Reports and assessments can be completed in three to six months, if there is a small volume of literature to be systematically reviewed and analyzed. Some evidence reports and technology assessments may require up to 12 months for completion due to complexity of the topic, the volume of literature to be searched, abstracted, and analyzed, and completion of the external peer review process. Topics selected will not duplicate current and widely available research syntheses, unless new evidence is available that suggests the need for revisions or updates.
For each topic, nominators should provide a rationale and
supporting evidence on the clinical relevance and importance of the
topic. Nominators also must state their plans are for rapid translation
of the evidence reports and technology assessments into clinical
guidelines, performance measures, educational programs, or other
strategies for strengthening the quality of health care services, or
plans to inform development of reimbursement or coverage policies. Nomination information should include.
Selection Criteria for Clinical Topics
Factors that will be considered in the selection of clinical topics
for AHRQ evidence report and technology assessment topics include: (1)
High incidence or prevalence in the general population and in special
populations, including women, racial and ethnic minorities, pediatric
and elderly populations, and those of low socioeconomic status; (2)
significance for the needs of the Medicare, Medicaid and other Federal
health programs; (3) high costs associated with a condition, procedure,
treatment, or technology, whether due to the number of people needing
care, high unit cost of care, or high indirect costs; (4) controversy
or uncertainty about the effectiveness or relative effectiveness of
available clinical strategies or technologies; (5) impact potential for
informing and improving patient or provider decision making; (6) impact
potential for reducing clinically significant variations in the
prevention, diagnosis, treatment, or clinical management of a disease
or condition, or in the use of a procedure or technology, or in the
health outcomes achieved; (7) availability of scientific data to
support the systematic review and analysis of the topic; (8)
demonstrated commitment by the nominating organization to incorporate
the report into its managerial or policy decision making; and (9) plans
by the nominating organization to measure the impact of the report on clinical practice.
Section B: Organization and Financing Topics
Nomination Process for Organization and Financing Topics
Nominations of organization and financing topics for AHRQ evidence
reports should focus on specific aspects of health care organization
and finance. Topics should be carefully defined and circumscribed so
that relevant databases may be searched, the evidence systematically
reviewed, supplemental analyses performed, draft reports circulated in
three to six months if there is a small volume of literature for
systematic review and analysis. Some evidence reports may require up to
12 months for completion due to the complexity of the topic and the
volume of literature to be searched, abstracted, and analyzed. Topics selected will not
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duplicate current and widely available research syntheses, unless new
evidence is available that suggests the need for revisions or updates.
For each topic, nominators should provide a rationale and
supporting evidence on the importance and relevance of the topic.
Nominators must also state their plans for use of the evidence report
and indicate how the report could be used by public and private decision makers. Nomination information should include:
Selection Criteria for Organization and Financing Topics
Factors that will be considered in the selection of topics related
to the organization and financing of care include the following: (1)
Uncertainty about the impact of the subject organizational or financing
strategy; (2) potential for the subject organizational or financing
strategy or the proposed research synthesis to significantly impact
aggregate health care costs; (3) policyrelevant to Medicare, Medicaid,
and/or other Federal and State health programs; (4) relevant to
vulnerable populations, including racial and ethnic minorities, and
particular communities, such as rural markets; (5) available scientific
data to support systematic review and analysis of the topic; (6)
demonstrated commitment by the nominating organization to incorporate
the report into its managerial or policy decisionmaking; and (7) plans
by the nominating organization to measure the impact of the report on practice.
Dated: November 2, 2000.
John M. Eisenberg,
Director.
[FR Doc. 0028896 Filed 11900; 8:45 am]
BILLING CODE 416090M
FOR FURTHER INFORMATION CONTACT
Jacqueline Besteman, J.D., M.A., Center for Practice and Technology Assessment, AHRQ, 6010 Executive Blvd., Suite 300, Rockville, MD 20852; Phone: (301) 5944017; Fax: (301) 5944027; Email: jbestema@ahrq.gov.
Arrangement for Public Inspection: All nominations will be available for public inspection at the Center for Practice and Technology Assessment, telephone (301) 5944015, weekdays between 8:30 a.m. and 5 p.m. (Eastern time).