[Adta] evidence based practice

Sat Feb 17 19:08:05 EST 2007

Hi Joan

I'm sending this to the whole listserve so that everypne can benefit from
your message. I hope that's ok

Susan

  _____  

From: Joan S. Ingalls [mailto:joan.ingalls at verizon.net] 
Sent: Saturday, February 17, 2007 6:09 PM
To: skdmt2
Subject: Re: [Adta] evidence based practice

Susan,

 Thanks for asking.

  My thoughts are that we need to be clear about what we mean by
evidenced-base practice, and in addition, not mix up evidence-based practice
with evidience-based research (which seems redundant)

   Evidence-based practice from what I understeood a few years ago meant
merely a class of programs like job programs where the evidence was there
easy to see whether or not a person got a job (or a home or a degree or quit
smoking or quit drinking or merely attended over a period of time - reached
the goal of the program whatever it was).

  The term did not refer at all to the method or theory that was used in the
program. 

  I think that recently "evidence-based" has been misunderstood. There has
always been a pull to "prove our method works." So that is not new. What has
caused all the recent "buzz" is that there is funding or special recognition
for "evidence-based" programs, ie the attachment I sent. My thinking is that
dance therapy could never qualify because it is not a "program" with a
concrete goal. It is a methodology or theory or therapy. It is a means by
which evidence based progams may or may not succeed. 

  I think the attachment is asking for people to suggest criteria, or
programs that could be considered evidence-based. This effort is a service
to agencies that want to send clients to programs that are in this catagory.
I guess they get a special kind of funding or recognition when they do that.

  I am in the field of sport psychology and the people interested in
promoting bio-feedback are thowing this term around trying to intimidate
others and win disciples. I don't think too many of us are taken in. Those
people want to prove "what we do works" will continue to do  research as
they always have - basing it on data (a form of evidence, but a different
flavor than that in "evidence-based practice") that they collect. Joan

----- Original Message ----- 

From: skdmt2 <mailto:skdmt2 at bellsouth.net>  

To: 'Joan <mailto:joan.ingalls at verizon.net>  S. Ingalls' ; 'Adta
<mailto:adta at adta.org>  listserve' 

Sent: Saturday, February 17, 2007 10:32 AM

Subject: RE: [Adta] evidence based practice

Joan Ingalls sent this info:

Thanks you Joan.

Do you have thoughts re this material?
Susan

Susan Kleinman, MA, ADTR, NCC

SUMMARY: AHRQ invites nominations of topics for evidence reports and 
technology assessments conducted by its Evidence-based Practice Centers 
(EPC) Program relating to the prevention, diagnosis, treatment and 
management of common diseases and clinical conditions, as well as 
topics relating to the organization and financing of health care. 
Previous evidence reports can be found at
http://www.ahrq.gov/clinic/epcix.htm
<http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log
=linklog&to=http://www.ahrq.gov/clinic/epcix.htm> 
.

DATES: Topic nominations should be submitted by December 1, 2005, in 
order to be considered for fiscal year 2006. In addition to timely 
responses to this request for nominations, AHRQ also accepts topic 
nominations on an ongoing basis for consideration for future years. 
AHRQ will not reply to individual responses, but will consider all 
nominations during the selection processes. Those who submit topics 
that are selected will be notified by AHRQ.

ADDRESSES: Topics nominations should be submitted to Kenneth Fink, MD, 
MGA, MPH, Director, Evidence-based Practice Centers (EPC) Program, 
Center for Outcomes and Evidence, AHRQ, 540 Gaither Road, Rockville, MD 
20850. Electronic submissions to epc at ahrq.gov are preferred.

FOR FURTHER INFORMATION CONTACT: Kenneth Fink, MD, MGA, MPH, Center for 
Outcomes and Evidence, AHRQ, 540 Gaither Rod, Rockville, MD 20850; 
Phone: (301) 427-1617; Fax; (301) 427-1640; E-mail: kfink at ahrq.gov.
    Arrangement for Public Inspection: All nominations will be 
available for public inspections at the Center for Outcomes and 
Evidence, telephone (301) 427-1600, weekdays between 8:30 a.m. and 5 
p.m. (eastern time).

SUPPLEMENTARY INFORMATION: 

[[Page 55398]]

1. Background

    Under Title IX of the Public Health Service Act, AHRQ is charged 
with enhancing the quality, appropriateness, and effectiveness of 
health care services and access to such services. AHRQ accomplishes 
these goals through scientific research and through the promotion of 
improvements in clinical practice and health systems practices, 
including the prevention of diseases and other health conditions.

2. Purpose and Overview

    The purpose of this notice is to solicit topic nominations for 
evidence reports and technology assessments. Professional societies, 
health systems, employers, insurers, providers, and consumer groups are 
encouraged to nominate topics and then collaborate with AHRQ, as it 
carries out its mission to promote the practice of evidence-based 
health care. In this endeavor, AHRQ serves as a science partner with 
private-sector and public organizations in their efforts to improve the 
quality, effectiveness, and appropriateness of health care delivery in 
the United States, and to expedite the translation of evidence-based 
research findings into improved health care services. To undertake 
scientific analyses and evidence syntheses on topics of high-priority 
to its public and private healthcare partners and the health care 
community generally, AHRQ awards task order contracts to its Evidence-
based Practice Centers (EPCs).
    The EPCs produce science syntheses--evidence reports and technology 
assessments--that provide to public and private organizations the 
foundation for developing and implementing their own practice 
guidelines, performance measures, educational programs, and other 
strategies to improve the quality of health care and decision-making 
related to the effectiveness and appropriateness of specific health 
care technologies and services. The evidence reports and technology 
assessments also may be used to inform coverage and reimbursement 
polices. As the body of scientific studies related to organization and 
financing of health care grows, systematic review and analysis of these 
studies, in addition to clinical and behavioral research, can provide 
health system organizations with a scientific foundation for developing 
or improving system-wide policies and practices.
    Currently, AHRQ supports approximately nine evidence reports per 
year, in collaboration with non-Federal partners, including national 
associations medical societies, health plans, and others. Nominations 
of topics from non-federal partners are solicited annually through a 
notice in the Federal Register. However, topic nominations are accepted 
on an ongoing basis. All nominations received in the previous year as 
well as topics that were previously submitted but not selected are 
considered for the upcoming year.
    Reports and assessments usually require about 12 months for 
completion. AHRQ widely disseminates the EPC evidence reports and 
technology assessments, both electronically and in print. The EPC 
evidence reports and technology assessments do not make clinical 
recommendations or recommendations regarding reimbursement and coverage 
policies.

3. Role/Responsibilities of Partners

    Nominators of topics selected for development of an EPC evidence 
report or technology assessment assume the role of Partners of AHRQ and 
the EPCs. Partners have defined roles and responsibilities. AHRQ places 
high value on these cooperative relationships, and takes into 
consideration a Partner organization's past performance of these 
responsibilities when considering whether to accept additional topics 
nominated by that organization in subsequent years. Specifically, 
Partners are expected to serve as resources to EPCs as they develop the 
evidence reports and technology assessments related to the nominated 
topic; serve as external peer reviewers of relevant draft evidence 
reports and assessments; and commit to timely translation of the EPC 
reports and assessments into their own quality improvement tools (e.g., 
clinical practice guidelines, performance measures), educational 
programs, or reimbursement policies; and dissemination of these 
derivative products to their membership as appropriate. AHRQ also is 
interested in members' use of these derivative products and the 
products' impact on enhanced health care. AHRQ looks to its Partners to 
provide use and impact data on products that are based on EPC evidence 
reports and technology assessment.

4. Topics for Reports

    The EPCs prepare evidence reports and technology assessments on 
topics for which there is significant demand for information by health 
care providers, insurers, purchasers, health-related societies, and 
patient advocacy organizations. Such topics may include the prevention, 
diagnosis and/or treatment of particular clinical and behavioral 
conditions, use of alternative or complementary therapies, and 
appropriate use of commonly provided services, procedures, or 
technologies. Topics also may include issues related to the 
organization and financing of care such as risk adjustment 
methodologies, market performance measures, provider payment 
mechanisms, and insurance purchasing tools, as well as measurement or 
evaluation of provider integration of new scientific findings regarding 
health care and delivery innovations. Previous evidence reports can be 
found at http://www.ahrq.gov/clinic/epcix.htm
<http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log
=linklog&to=http://www.ahrq.gov/clinic/epcix.htm> .

    AHRQ is very interested in receiving topic nominations from 
professional societies and organizations composed of members of 
minority populations, as well as topic nominations that have 
significant impact on AHRQ priority populations including low income 
groups, minority groups, women, children, the elderly, and individuals 
with special health care needs, such as those with disabilities, those 
who need chronic care or end-of-life healthcare, or those who live in 
inner-city and rural areas.

5. Topic Nomination

    Nominations of topics for AHRQ evidence reports and technology 
assessments should focus on specific aspects of prevention, diagnosis, 
treatment and/or management of a particular condition; an individual 
procedure, treatment, or technology; or a specific healthcare 
organizational or financial strategy. The EPC Coordinating Center can 
be contacted at partnerTA at lewin.com to assist with topic nominations 
(e.g., methods, processes, other guidance). The processes that AHRQ 
employs to select clinical and behavioral topics as well as 
organization and financing topics nominated by the EPCs are described 
below. For each topic, the nominating organization must provide the 
following information:
    A. Rationale and supporting evidence on the relevance and 
importance of the topic;
    B. Three to five focused questions on the topic to be addressed;
    C. Plans for rapid translation of the evidence reports and 
technology assessments into clinical guidelines, performance measures, 
educational programs, or other strategies for strengthening the quality 
of health care services, or plans to inform development of 
reimbursement or coverage policies;
    D. Plans for use and/or dissemination of these derivative products, 
e.g. to membership if appropriate; and

[[Page 55399]]

    E. Process by which the nominating organization will measure the 
use of these products and impact of such use.

6. Topic Selection

    Factors that will be considered in the selection of topics for AHRQ 
evidence report and technology assessment topics include:
    A. Burden of disease including severity, incidence and/or 
prevalence or relevance of the organization/financial topic to the 
general population and/or AHRQ's priority;
    B. Controversy or uncertainty about the topic and availability of 
scientific data to support the systematic review and analysis of the 
topic;
    C. Total costs associated with a condition, procedure, treatment, 
technology, or organization/financial topic taking into account the 
number of people needing such care, the unit cost of care, and related 
or indirect costs;
    D. Potential for reducing clinically significant variations in the 
prevention, diagnosis, treatment, or management of a disease or 
condition; or in changing the use of a procedure or technology; 
informing and improving patient and/or provider decision making; 
improving health outcomes; and/or reducing costs;
    E. Relevance to the needs of the Medicare, Medicaid and other 
Federal healthcare programs; and
    F. Nominating organization's plan to disseminate derivative 
products, measure use and impact of these products on outcomes, or 
otherwise incorporate the report into its managerial or policy decision 
making.

7. Submission of Nominations

    Topics nominations should be submitted to Kenneth Fink, MD, MGA, 
MPH, Director Evidence-based Practice Centers (EPC) Program, Center for 
Outcomes and Evidence, AHRQ, 540 Gaither Road, Rockville, MD 20850. 
Electronic submissions to epc at ahrq.gov are preferred.

    Dated: September 12, 2005.
Carolyn M. Clancy,
Director.
[FR Doc. 05-18870 Filed 9-20-05; 8:45 am]

BILLING CODE 4160-90-M

  _____  

From: Joan S. Ingalls [mailto:joan.ingalls at verizon.net] 
Sent: Saturday, February 17, 2007 9:19 AM
To: skdmt2
Subject: Re: [Adta] evidence based practice

To learn more about evidence-based practice see:
http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov
/2005/05-18870.htm

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