Priorities for Comparative Effectiveness Reviews in Cardiovascular Disease

Abstract

Background-Comparative effectiveness reviews offer a systematic method to critically appraise existing research and to identify unaddressed clinical areas in cardiovascular disease where significant morbidity, mortality, and variation in the use of resources persist. To delineate and help select areas where comparative effectiveness reviews are needed, the Effective Health Care Program of the Agency for Healthcare Research and Quality involved stakeholders in prioritization of the research agenda. Methods and Results-We involved a diverse panel of stakeholders representing a broad range of clinical, policy, and patient perspectives. To assist in prioritization of topics for evidence synthesis, we created a framework evaluating 12 cardiovascular disease subcategories that reflect American College of Cardiology/American Heart Association disease-based guidelines. We performed an environmental scan for each disease subcategory to populate this framework with existing knowledge, levels of evidence, and degrees of public interest. Through a formalized process, 4 disease subcategories were prioritized: chronic coronary artery disease, ventricular arrhythmias, heart failure, and cerebrovascular disease. Within these subcategories, 11 topics that address the comparative safety and effectiveness of existing treatments and evaluate emerging treatments were nominated by the stakeholder panel to proceed for feasibility assessment before developing comparative effectiveness reviews. Conclusions-Using a systematic process deriving consensus from multiple stakeholders across cardiovascular disease states, we generated a prioritized list of evidence synthesis topics to inform decision makers. The topics vetted through this process seek to determine the comparative safety and effectiveness of a range of treatments, both established and emerging, and are immediately relevant for prevalent disease states. (Circ Cardiovasc Qual Outcomes. 2013;6:139-147.)

Future research prioritization in cardiac resynchronization therapy

“…These steps broadly involved seeking input from clinical experts and evaluating recent systematic reviews to identify a preliminary list of evidence gaps; transforming these gaps into research questions; selecting and engaging stakeholders to identify additional gaps and prioritize them; and reviewing recently published and ongoing studies that were relevant to the stakeholders' list of priorities. Our team has used this process for similar work with AHRQ (18)(19)(20) and with the Patient-Centered Outcomes Research Institute (PCORI) (17,(21)(22)(23)) which has informed their future research needs portfolio and targeted funding announcements.…”

Epidemiology of infectious complications in endo-arterial interventional radiology in France: Feasibility of the nationwide hospital discharge database (PMSI), 2010 – 2013

“…Others have reported the occurrence of prosthetic vascular graft infection with a cumulative incidence varying from 0% to 3.1% [13] and 0.5% to 5% [11] [12]. Data were associated with a low level of evidence [15] and heterogeneous [14]. The majority studies provided information on a microbial ecology cannot be extrapolated to another center [16] and were monocentric [17].…”

Infectious complications of endoarterial interventional radiology: protocol for an observational study of a longitudinal national cohort of patients assessed in the French hospital discharge database (MOEVA study)

“…Other studies have reported the occurrence of prosthetic vascular graft infection with a cumulative incidence varying from 0.5% to 5%22 23 and from 0% to 3.1% 24. Data were heterogeneous25 and associated with a low level of evidence 26. Most studies were monocentric27 and provided information on a particular microbial ecology and cannot be extrapolated to another centre 6…”