SUSTAINABILITY OF EVIDENCE-BASED HEALTHCARE: THE CONCEPTUAL AND METHODOLOGICAL AG

描述(由申请人提供)：这一小型会议拨款提案解决了我们这个时代最重要的翻译研究问题之一：尽管循证医学取得了快速进步，但我们对医疗保健创新一旦投入实践后在多大程度上或在什么条件下得以维持知之甚少。根据2010年AHRQ支持的一次关于扩大和传播的会议的建议，我们提议召开一次工作会议，将公共政策领导人、捐助者、实践者和研究人员集中在“维持成果”这一主题上。我们将提供可持续发展成功和失败的真实世界例子，流行的概念和方法方法，以及关于循证医疗可持续性的经验发现。这一小型会议拨款申请追求三个目标：1.通过确定关于循证医疗保健可持续性的关键概念和方法工作来捕捉该领域的状况；2.召开思想领袖和利益相关者的密集工作会议，共同投资于有效医疗实践的可持续性；以及3.制定和传播研究可持续性的详细议程，包括为持续有效的医疗保健创新建立证据基础的研究和政策和实践行动计划的建议。这些产品可以用来提供信息，并帮助形成围绕各种卫生保健干预措施的可持续性实证研究。这项工作还将为未来的政策、实践、卫生服务研究人员的培训以及研究人员和社区之间合作关系的形成提供信息。具体的会议成果包括：关于循证医疗在实施或实验试验后在日常护理中维持的频率和条件的现有证据的清晰图景；对用于研究可持续性的主流研究方法的批判性评估；以及一套具体的研究议程建议，以帮助围绕可持续性研究中的四个关键方法论挑战建立经验基础。会议产品将通过NIH传播和实施科学会议、实施科学培训网络、资助机构和CMS的联邦计划工作人员以及主要卫生和公共卫生政策和实践领导人网络进行传播。 公共卫生相关性：项目叙事每年花费数十亿美元的美国税收用于研究，数千亿美元用于服务提供项目，但我们对如何在医疗创新实施后保持下去知之甚少。这次会议将制定可持续发展实证研究的议程，这反过来将导致对如何维持高质量医疗保健的坚实理解。

DESCRIPTION (provided by applicant): This small conference grant proposal addresses one of the most significant translational research problems of our time: in spite of rapid advances in evidence-based medicine, we know very little about how well or under what conditions healthcare innovations are sustained once they are put into practice. Building on recommendations from a 2010 AHRQ-supported conference on scale up and spread, we propose a working meeting to coalesce public policy leaders, donors, practitioners, and researchers around the topic of "sustaining the gains". We will present real-world examples of sustainability successes and failures, prevailing conceptual and methodological approaches, and empirical findings regarding the sustainability of evidence-based healthcare. This small conference grant application pursues three aims: 1. To capture the state of the field by identifying key conceptual and methodological work on the sustainability of evidence-based healthcare; 2. To convene an intensive working meeting of thought leaders and stakeholders with a shared investment in the sustainability of effective healthcare practices; and 3. To produce and disseminate a detailed agenda for studying sustainability, including recommendations for research and policy and practice action plans to build the evidence-base for sustaining effective healthcare innovations. These products can be used to inform and help shape empirical study of sustainability around a variety of health care interventions. This work will also inform future policy, practice, training of health services researchers, and formation of collaborative relationships between researchers and communities. Specific conference outcomes include a clear picture of existing evidence about how often and under what conditions evidence-based healthcare is sustained in usual care, following its implementation or experimental trial; a critical assessment of prevailing research methods used to study sustainability; and a set of specific recommendations for a research agenda to help build an empirical base around four key methodological challenges in sustainability research. Conference products will be disseminated through the NIH conference on the science of dissemination and implementation, through implementation science training networks, to federal program staff of funding agencies and CMS, and through networks of key health and public health policy and practice leaders. PUBLIC HEALTH RELEVANCE: Project Narrative Billions of U.S. tax dollars are spent each year on research and hundreds of billions are spent on service delivery programs, but we know very little about how to sustain healthcare innovations once they are implemented. This conference will produce an agenda for empirical study of sustainability, which in turn will lead to a solid understanding of how to sustain high quality healthcare.