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. 2012 May;50(5):388-93.
doi: 10.1097/MLR.0b013e3182422a3b.

Prioritization in comparative effectiveness research: the CANCERGEN Experience

Rahber Thariani  1 , William Wong, Josh J Carlson, Louis Garrison, Scott Ramsey, Patricia A Deverka, Laura Esmail, Sneha Rangarao, Carolyn J Hoban, Laurence H Baker, David L Veenstra; Center for Comparative Effectiveness Research in Cancer Genomics (CANCERGEN)
Affiliations

Prioritization in comparative effectiveness research: the CANCERGEN Experience

Rahber Thariani et al. Med Care. 2012 May.

Abstract

Background: Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes.

Objective: To develop and pilot test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG.

Methods: We conducted a landscape analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds.

Results: A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy makers, and community-based oncologists. We identified 9 domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and 1 test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities.

Conclusions: Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition, and integration with existing prioritization mechanisms.

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Figures

Figure 1
Figure 1
Landscape Analysis and Test Selection Overview: CANCERGEN project milestones including landscape analysis, and stakeholder assessment.
Figure 2
Figure 2
Overall results, showing tests contributed by the landscape analysis through to stakeholder voting.
Figure 3
Figure 3
Sections of the TTP used to communicate with stakeholders
See this image and copyright information in PMC

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