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Biomedical subjects

C W Maklan

Publications and source records attributed to C W Maklan.

10 recordsLinked to original sources
PubMed1994

Methodological challenges and innovations in patient outcomes research.

Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying out their individual 5-year research plans, and through collaborative work of six Inter-PORT Work Groups, PORTs have contributed to methodological advances related to their specific clinical focus and to outcomes research in general. Each of the PORTs has followed a standard research model, involving the application of: systematic literature review, measurement of outcomes, analysis of cost and claims data, decision analysis, and strategies for disseminating findings. This article reports what has been learned by individual PORTs, and by AHCPR, regarding the usefulness of each of these methodologies, both for the ongoing projects and for the next generation of effectiveness research. Example from individual PORTs and work groups illustrate some of the methodological gains that have been made in effectiveness research and provide a glimpse of the work that remains to be done.

Analysis of Variance↗
PubMed1994

Alternative methods for formal literature review and meta-analysis in AHCPR Patient Outcomes Research Teams. Agency for Health Care Policy and Research.

Formal literature review and synthesis is an important component of Patient Outcomes Research Teams (PORTs) and the development of clinical practice guidelines supported by the Agency for Health Care Policy and Research (AHCPR). Investigators face unresolved methodological issues and practical problems in carrying out this work because the use of such systematic reviews is relatively new in medicine. In addition, standard meta-analytic methods may not readily be applied to the literature pertinent to most PORTs. Representatives of the InterPORT Work Group on Literature Review and Meta-Analysis exchanged information to identify and assess their respective approaches to these challenges. All 12 PORTs used systematic approaches to identifying relevant studies and to gather and analyze data abstracted from these studies. Most PORTs had undertaken or made plans for several separate reviews, which focused on a specific question about the outcomes of therapeutic health care services or procedures, diagnosis, prevention or prognosis. The descriptive information provided by PORTs reveals substantial commonalities in their methods for searching literature and organizing bibliographic databases. However, there was considerable variation in other aspects of reviews, such as selection/exclusion criteria, the use of blinding, and the techniques used to assess the quality of studies. Alternative approaches to literature review and synthesis warrant further examination because they have implications for research and health policy both in terms of the substantive conclusions and efficiency of reviews.

Health Services Research↗
PubMed1994

The national medical effectiveness research initiative. The search for what really works in treating common clinical conditions.

In 1989, Congress established the Agency for Health Care Policy and Research within the U.S. Public Health Service and gave it the lead in a national effort to produce reliable evidence of which medical treatments are effective and which are not. The research program addresses the effectiveness of different available strategies for diagnosis, prevention, treatment, and management of common conditions, including diabetes, and emphasizes outcomes that matter to patients. The modest size of this program and the eagerness for its results have led to the development and use of innovative research methods. Illustrations of these methods and early findings are provided.

Aged↗
PubMed1991

Medical treatment effectiveness research. A view from inside the Agency for Health Care Policy and Research.

The Medical Treatment Effectiveness Program (MEDTEP) is an intradepartmental federal program of the Department of Health and Human Services, for which the Agency for Health Care Policy and Research (AHCPR) has lead responsibility. This article presents a staff perspective on the conceptual framework for the MEDTEP research agenda and on the opportunity to address empirically the relationships between particular health care services and patient outcomes. It reviews programmatic priorities and identifies active MEDTEP research projects, with descriptions of 11 patient outcomes research team projects. Finally, it addresses the need to produce useful research findings in the short term and the implications of a dual concern for the quality and cost of health care.

Databases, Factual↗