Knowing What Works in Health Care A Roadmap for the Nation (2008) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 17-32
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 17... ...
The committee was charged with recommending an organizational framework for assessing evidence on clinical effectiveness so that consum ers, clinicians, professional specialty societies, payers, purchasers, and other decision makers have independent, valid information for making health care decisions. The central premise underlying the report is that decisions about the care of individual patients should be based on the con scientious, explicit, and judicious use of the current best evidence on the effectiveness of clinical services.
|
From page 18... ...
The IOM appointed the Committee on Reviewing Evidence to Identify Highly Effective Clinical Services in June 2006 to respond to RWJF's request and prepare this report. The 16-member committee included experts in clinical research, health care coverage, drug development, health care benefits selection (large employers and other purchasers)
|
From page 19... ...
First, in the United States, the role of cost in government health policy and coverage decisions, clinical guidelines, and practice measures is unresolved albeit often debated (Congressional Budget Office, 2007; Medicare Payment Advisory Commission, 2007; Wilensky, 2006)
|
From page 20... ...
for age-related macular degeneration; and two technologies related to the early identification and treatment of colorectal cancer; the fecal DNA screening test and an assay to test toxicity for the chemotherapy agent irinotecan. The second workshop, held in January 2007, focused on organizations that set priorities for developing systematic reviews, clinical practice guidelines, and practice standards.
|
From page 21... ...
and is also imperative if consumers are to take an active role in making informed health care decisions based on known risks and benefits. The committee also recognizes that health care resources are finite.
|
From page 22... ...
Every decision maker needs credible, unbiased, and understandable evidence on the effectiveness of health care services. Conceptual Context for the Study The committee defined the conceptual context for this study as the continuum that begins with research evidence and that then moves to a scientific, systematic review of the overall body of evidence and then to the interpretation of the strength of the overall evidence for the development of trusted clinical practice guidelines (Figure 1-1)
|
From page 23... ...
Below the dashed line, decision makers and developers of clinical recommendations interpret 1-1 the findings of systematic reviews to decide which patients, health care settings, or other circumstances they relate to. SOURCE: Adapted from Systems to Rate the Strength of Scientific Evidence (West et al., 2002)
|
From page 24... ...
SOURCES: Cochrane Collaboration (2005) ; Haynes et al.
|
From page 25... ...
Marked increases in the evidence base for health care decision making will inevitably bring a concomitant need for an increased capability for the synthesis and the interpretation of the evidence. The recent efforts to expand comparative effectiveness research follow more than four decades of progress and setbacks in this area.
|
From page 26... ...
95 623) in 1978 to conduct medical technology assessments related to Medicare coverage decisions.
|
From page 27... ...
. Health plans, specialty societies, disease-based associations, and foundations create numerous programs that produce clinical guidelines.
|
From page 28... ...
Chapter 4, Systematic Reviews: The Central Link Between Evidence and Clinical Decision Making, reviews how high-quality evidence assessment (systematic review) is integral to identifying effective clinical services and presents the committee's recommendations for ensuring high-quality evidence assessment.
|
From page 29... ...
Key programmatic challenges are highlighted. REFERENCES America's Health Insurance Plans.
|
From page 30... ...
:2635-2645. Medicare Payment Advisory Commission.
|
From page 31... ...
2006a. Consumer-directed health plans: Small but growing enrollment fueled by rising cost of health care coverage.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.