Stakeholder Priorities for Comparative Effectiveness Research in Chronic Obstructive Pulmonary Disease A Workshop Report
Stakeholder Priorities for Comparative Effectiveness Research in Chronic Obstructive Pulmonary Disease A Workshop Report
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DOI：
10.1164/rccm.201206-0994ws
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发表时间：
2013-02-01
影响因子：
24.7
通讯作者：
Mularski, Richard A.
中科院分区：
文献类型：
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作者：
Krishnan, Jerry A.;Lindenauer, Peter K.;Mularski, Richard A.
比较有效性研究（CER）旨在解决患者、临床医生和其他利益相关者的明确需求。54个对慢性阻塞性肺疾病（COPD）感兴趣的利益相关团体的代表参加了由基于COPD结果的临床有效性和研究转化网络（CONCERT）召集的为期2年的研讨会。第一年的重点是慢性护理和护理协调。第二年的重点是急性护理和医疗保健设置之间的护理过渡。在研讨会开始前，通过电话会议和电子邮件交流进行了讨论和临时投票。最终的优先顺序投票是在研讨会的面对面讨论之后进行的。我们采用了改进的德尔菲法来促进讨论和建立共识。为了更容易地量化偏好和评估排名的内部一致性，层次分析法被纳入第二年。研讨会前和最终的投票结果往往不同，这表明仅仅依靠利益相关者群体对主题的请求而不进行面对面讨论的优先级工作可能会提供不同的研究优先级。不同利益相关者群体的研究重点各不相同，但通常侧重于评估不同的医疗保健提供方法（例如，用于诊断和治疗的肺活量测定法，护理过渡期间的综合医疗保健战略）的研究，而不是对药物的直接比较。该研究议程可能有助于告知有意响应慢性阻塞性肺病CER资助机会的团体。在线补编中详细介绍了所使用的方法，这些方法也可能有助于为其他健康状况下的CER优先工作提供信息。
Comparative effectiveness research (CER) is intended to address the expressed needs of patients, clinicians, and other stakeholders. Representatives of 54 stakeholder groups with an interest in chronic obstructive pulmonary disease (COPD) participated in workshops convened by the COPD Outcomes-based Network for Clinical Effectiveness and Research Translation (CONCERT) over a 2-year period. Year 1 focused on chronic care and care coordination. Year 2 focused on acute care and transitions in care between healthcare settings. Discussions and provisional voting were conducted via teleconferences and e-mail exchanges before the workshop. Final prioritization votes occurred after in-person discussions at the workshop. We used a modified Delphi approach to facilitate discussions and consensus building. To more easily quantify preferences and to evaluate the internal consistency of rankings, the Analytic Hierarchy Process was incorporated in Year 2. Results of preworkshop and final workshop voting often differed, suggesting that prioritization efforts relying solely on requests for topics from stakeholder groups without in-person discussion may provide different research priorities. Research priorities varied across stakeholder groups, but generally focused on studies to evaluate different approaches to healthcare delivery (e.g., spirometry for diagnosis and treatment, integrated healthcare strategies during transitions in care) rather than head-to-head comparisons of medications. This research agenda may help to inform groups intending to respond to CER funding opportunities in COPD. The methodologies used, detailed in the online supplement, may also help to inform prioritization efforts for CER in other health conditions.