Assessing applicability when comparing medical interventions: AHRQ and the Effective Health Care Program.
Abstract
<h4>Objective</h4>To describe a systematic approach for identifying, reporting, and
synthesizing information to allow consistent and transparent consideration of the
applicability of the evidence in a systematic review according to the Population,
Intervention, Comparator, Outcome, Setting domains.<h4>Study design and setting</h4>Comparative
effectiveness reviews need to consider whether available evidence is applicable to
specific clinical or policy questions to be useful to decision makers. Authors reviewed
the literature and developed guidance for the Effective Health Care program.<h4>Results</h4>Because
applicability depends on the specific questions and needs of the users, it is difficult
to devise a valid uniform scale for rating the overall applicability of individual
studies or body of evidence. We recommend consulting stakeholders to identify the
factors most relevant to applicability for their decisions. Applicability should be
considered separately for benefits and harms. Observational studies can help determine
whether trial populations and interventions are representative of "real world" practice.
Reviewers should describe differences between available evidence and the ideally applicable
evidence for the question being asked and offer a qualitative judgment about the importance
and potential effect of those differences.<h4>Conclusion</h4>Careful consideration
of applicability may improve the usefulness of systematic reviews in informing practice
and policy.
Type
Journal articleSubject
HumansDecision Making
Evidence-Based Medicine
Research Design
United States Agency for Healthcare Research and Quality
Government Programs
Adult
Aged
Middle Aged
Policy Making
United States
Female
Male
Review Literature as Topic
Guidelines as Topic
Comparative Effectiveness Research
Outcome Assessment, Health Care
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https://hdl.handle.net/10161/22904Published Version (Please cite this version)
10.1016/j.jclinepi.2010.11.021Publication Info
Atkins, David; Chang, Stephanie M; Gartlehner, Gerald; Buckley, David I; Whitlock,
Evelyn P; Berliner, Elise; & Matchar, David (2011). Assessing applicability when comparing medical interventions: AHRQ and the Effective
Health Care Program. Journal of clinical epidemiology, 64(11). pp. 1198-1207. 10.1016/j.jclinepi.2010.11.021. Retrieved from https://hdl.handle.net/10161/22904.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
David Bruce Matchar
Professor of Medicine
My research relates to clinical practice improvement - from the development of clinical
policies to their implementation in real world clinical settings. Most recently my
major content focus has been cerebrovascular disease. Other major clinical areas in
which I work include the range of disabling neurological conditions, cardiovascular
disease, and cancer prevention. Notable features of my work are: (1) reliance on
analytic strategies such as meta-analysis, simulation, decision analy

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