ࡱ> TS(@ N/ 0DTimesNew Romanttzx: 0DArialNew Romanttzx: 0" DTimes New Romanttzx: 0@ .  @n?" dd@  @@``  A(*= p  $( *3456789:;<=>?@A 0AA@d g45d5dDzx: 0ppp@ <4BdBd@ 0t|z g4ddddzx: 0Phpp p<4!d!d@ 0t|z9j ʚ;.,ʚ;<4dddd@U 0@r0___PPT10 2___PPT9/ 0? %O =^0< Methods for Comparative Evidence Reviews September 2005L=C$(AC$ =   Oregon Evidence-based Practice Center for the Drug Effectiveness Review Project Marian McDonagh, Pharm D, Project Director Mark Helfand, MD, MPH, EPC Director<Z|0Z$Z&      JHealth Resources Commission Remit to Oregon Evidence-based Practice CenterKK Apply Systematic Review Methods to Comparative Questions Drug vs Drug within class Ensure that reviews are: Methodologically Consistent Methodologically Transparent Reports are User Friendly Lowest risk of bias in methods and researchersV:: Key Question DevelopmentQuestion 1:Effectiveness and/or Efficacy Health Outcomes preferred over intermediate outcomes Question 2: Harms and Tolerability Short-term adverse events Long-term safety Question 3: Sub-populations Age Race/ethnicity Gender Co-morbidities Inclusion Criteria based on key questions)Z5Z$Z+ZZ)Z*Z)5$+)*n<o=Quality Assessment(Each study included in review is assessed for internal validity (quality) and external validity (generalizability / applicability) Quality rated using predefined criteria Good: meets all criteria Fair: meets most criteria Poor:  fatal flaw , combinations of criteria are not met that indicate significant risk of bias Not used in analysisLZZZaData Collection and Analysis(Study data abstracted into tables for cross-study comparison Qualitative synthesis of data Quantitative synthesis of data Meta-analysis when appropriate Overall grade allocated for the body of evidence for each key question@zGzF$Reports(GReports written with user in mind Draft reports undergo: Peer Review Public Comment AHRQ review for methods Every report includes a summary table that provides summary of evidence by Key Question Every report has a slide show Researchers make presentations to committees Available for questions relating to the evidence (only)T938938Updates(Every report is updated 6-month or yearly basis Determined by committees with input from researchers Update process starts with revisiting the Key Questions Modifications needed? New drugs? New populations/indications to consider? Update process identical to original reviewNJ,J, m;/c    0` ̙33` ` ff3333f` 333MMM` f` f` 3>?" dd@,|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>> JB@ (  4  # T  ' " ( BC.DEF.. . @` ) BlC/DEF/l/l / @`` * BZC0DEF0Z.Z 0 @`(HB + # " , 0Xz" B Oregon EPC   - 0^z" : 2  . 0az"0 ;DRUG  2  / 0^z". PEFFECTIVENESS & 2    0 0hz" IREVIEW & 2   1 0Lmz" HPROJECT $ 2 `B 2 s *DjJ"V`B 3 s *DjJ"==`B 4 s *DjJ"`B 5 s *DjJ"ZB 6 c $D"fB 7 0DjJ"VWfB 8 0DjJ"VW`B 9 s *DjJ"`B : s *DjJ"f ; 0 "f < 0 "f = 0 ".Kf > 0 "fB ? 0DjJ"fB @ 0DjJ"B  s *޽h ? $Blank Presentation 0 ,(    NXEakk z%  a r*   K%%KKpp   NtDkk  @% a t*   K%%KKppd  c $ ?XK  a8  N8akk  M) a RClick to edit Master text styles Second level Third level Fourth level Fifth level!    S    THDkk z  a r*   K%%KKpp  T'Dkk  @ D t*   K%%KKppH  0.k ? ̙3380___PPT10.m   (    N1[kk z%   ~*     K%%KKpp  Nוkk  @% [ *     K%%KKpp  T@[kk z  [ ~*     K%%KKpp  T?[kk  @ [ *     K%%KKppH  0.k ? ̙3380___PPT10.m0CH 0 0 N(    08|a  a    6}a  P a B  s *޽h ? ̙33y___PPT10Y+D=' a= @B +H  0 0H(    0[   [   0[  ` [ H  0޽h ? 80___PPT10.P|H  0 @H(    0Lz  `  z   0z ` `` z H  0޽h ? 80___PPT10.03 0L0 @(0(  ( ( 0la P GSearch for Literature(I ( 0Aa  Search electronic databases of published literature: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO Pharmaceutical company submissions Reference lists ExpertsH ( 0޽h ? - 0L0 P,U(  , , 0a P T"Application of Inclusion Criteria ##(a , 0Oa   Assessment of studies based on key questions Populations / Indications Interventions (drugs) Outcome measures Study designs Dual Assessment reduces risk, increases reliability6-O4-O4H , 0޽h ? H  0 `H(    0a  `}  a   08a  ` a H  0޽h ? 80___PPT10.}H  0 PH(    0\.a   `  a   0Fa  ` a H  0޽h ? 80___PPT10.u H  0 pH(    0\D  `}  D   0 D  ` D H  0޽h ? 80___PPT10.H   0 H(    0D  `}  D   0D  `  D H  0޽h ? 80___PPT10.0Y  0 80` (      08hD   0Oregon Evidence-based Practice Center Oregon Health & Science University 3181 SW Sam Jackson Park Road Portland, OR 97239 Drug Effectiveness Review Project www.ohsu.edu/drugeffectiveness 6# # H   0޽h ? D0 0 p(  ^ S RT   D # l3D f f#" 0e C8  D .Marian McDonagh, Oregon Evidence-based Practice Center for the Drug Effectiveness Review Project; presentation to the Citizens Health Care Working Group, Portland, OR, September 23, 2005, on the topic  Methods for Comparative Evidence Reviews. &      H  0.k ? ̙33 0 &(  ^  S XK   D  c $YD M)  D  Health Resources Commission Remit to Oregon Evidence-based Practice Center H  0.k ? ̙3380___PPT10.hp-nB 0 R(  ^  S XK     c $Pu M)   H4 Key Question Development H  0.k ? ̙3380___PPT10.h*}<< 0 L(  ^  S XK     c $( M)   B. Search for Literature H  0.k ? ̙3380___PPT10.hT= 0 d(  ^  S XK     c $XЕ M)   ZF Application of Inclusion Criteria H  0.k ? ̙3380___PPT10.hා6 0 F(  ^  S XK     c $D M)   <( Quality Assessment H  0.k ? ̙3380___PPT10.h0J 0 Z(  ^  S XK     c $$~ M)   P< Data Collection and Analysis H  0.k ? ̙3380___PPT10.h0h˗  0 0(  ^  S XK     c $ M)   & Reports H  0.k ? ̙3380___PPT10.h*}  0 0(  ^  S XK     c $ M)   & Updates H  0.k ? ̙3380___PPT10.hN; 0  (  ^  S XK     c $ M)   eAddress of organization: 3181 SW Sam Jackson Park Road, Portland, OR; www.ohsu.edu/drugeffectiveness.F H  0.k ? ̙3380___PPT10.h0?@ABDEFGHIJLMNOPQRURoot EntrydO)Current UserKSummaryInformation(9PowerPoint Document(&pDocumentSummaryInformation8C