Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Fall;17(4):4-13.
doi: 10.7812/TPP/13-036.

Comparative effectiveness topics from a large, integrated delivery system

Kim N Danforth  1 , Carrie D Patnode  2 , Tanya J Kapka  3 , Melissa G Butler  4 , Bernadette Collins  5 , Amy Compton-Phillips  6 , Raymond J Baxter  7 , Jed Weissberg  8 , Elizabeth A McGlynn  9 , Evelyn P Whitlock  10
Affiliations

Comparative effectiveness topics from a large, integrated delivery system

Kim N Danforth et al. Perm J. 2013 Fall.

Abstract

Objective: To identify high-priority comparative effectiveness questions directly relevant to care delivery in a large, US integrated health care system.

Methods: In 2010, a total of 792 clinical and operational leaders in Kaiser Permanente were sent an electronic survey requesting nominations of comparative effectiveness research questions; most recipients (83%) had direct clinical roles. Nominated questions were divided into 18 surveys of related topics that included 9 to 23 questions for prioritization. The next year, 648 recipients were electronically sent 1 of the 18 surveys to prioritize nominated questions. Surveys were assigned to recipients on the basis of their nominations or specialty. High-priority questions were identified by comparing the frequency a question was selected to an "expected" frequency, calculated to account for the varying number of questions and respondents across prioritization surveys. High-priority questions were those selected more frequently than expected.

Results: More than 320 research questions were nominated from 181 individuals. Questions most frequently addressed cardiovascular and peripheral vascular disease; obesity, diabetes, endocrinology, and metabolic disorders; or service delivery and systems-level questions. Ninety-five high-priority research questions were identified, encompassing a wide range of health questions that ranged from prevention and screening to treatment and quality of life. Many were complex questions from a systems perspective regarding how to deliver the best care.

Conclusions: The 95 questions identified and prioritized by leaders on the front lines of health care delivery may inform the national discussion regarding comparative effectiveness research. Additionally, our experience provides insight in engaging real-world stakeholders in setting a health care research agenda.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Project overview. CER = comparative effectiveness research.
See this image and copyright information in PMC

References

    1. Committee on Comparative Effectiveness Research Prioritization, Institute of Medicine of the National Academies . Initial national priorities for comparative effectiveness research: report brief [monograph on the Internet] Washington, DC: Institute of Medicine of the National Academies; 2009. Jun 30, [cited 2013 Aug 14]. Available from: www.iom.edu/~/media/Files/Report%20Files/2009/ComparativeEffectivenessRe....
    1. Federal Coordinating Council for Comparative Effectiveness Research . Report to the President and the Congress . Washington, DC: US Department of Health and Human Services; 2009. Jun 30,
    1. Dubois RW, Graff JS. Setting priorities for comparative effectiveness research: from assessing public health benefits to being open with the public. Health Aff (Millwood) 2011 Dec;30(12):2235–42. DOI: http://dx.doi.org/10.1377/hlthaff.2011.0136. - DOI - PubMed
    1. American Recovery and Reinvestment Act of 2009, Pub L No. 111-5 (Feb 17, 2009).
    1. Iglehart JK. Prioritizing comparative-effectiveness research—IOM recommendations. N Engl J Med. 2009 Jul 23;361(4):325–8. DOI: http://dx.doi.org/10.1056/NEJMp0904133. - DOI - PubMed

Publication types

LinkOut - more resources