Effectiveness Initiative Setting Priorities for Clinical Conditions (1989) / Chapter Skim
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Introduction
Introduction
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During this time, HCFA consulted widely with many individuals and organizations in medicine, heal care financing, and health services and policy research for guidance on this new program initiative. In August 1988 HCFA requested the Institute of Medicine, National Academy of Sciences, to recommend clinical conditions that should receive priority attention initially.
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Second, when indicated, it will go beyond these administrative data sets to acquire data through clinical demonstration projects and dials. Specially collected information might include data from medical charts (abstracted by He Medicare PROs as part of the Uniform Clinical Data Set effort)
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We wish to underscore the view that initial assessments of any clinical problem area cannot provide satisfactory effectiveness data in the absence of prospective assessments, even though these can and will be guided by retrospective review of data. We also want to emphasize our particular concern that interpretations of data concerning prevention, management, and rehabilitation are critically dependent on adequate risk-adjusted information, properly matched populations, comparison of alternative approaches, and valid endpoints other than mortality; that is, we believe that both the potential utility and the limitations of the HCFA data sets must be clearly understood and acknowledged.
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