OHSU

Past Topics

Below are the topics previously discussed by the E2I Journal Club. If you would like to see the slides from a particular meeting, please email ICE.

Publication Bias 

  • McGauran, N., et al., Reporting bias in medical research - a narrative review. Trials, 2010. 11: p. 37.
  • Hopewell, S., et al., Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database Syst Rev, 2009(1): p. MR000006.
  • Hopewell, S., et al., Time to publication for results of clinical trials. Cochrane Database Syst Rev, 2007(2): p. MR000011.
  • Jefferson, T., et al., Ensuring safe and effective drugs: who can do what it takes? BMJ, 2011. 342: p. c7258.

Synthesizing evidence related to harms 

  • Chou, R., et al., AHRQ series paper 4: assessing harms when comparing medical interventions: AHRQ and the effective health-care program. J Clin Epidemiol, 2010. 63(5): p. 502-12.
  • Juni, P., et al., Risk of cardiovascular events and rofecoxib: cumulative meta-analysis. Lancet, 2004. 364(9450): p. 2021-9.
  • Loke, Y.K., D. Price, and A. Herxheimer, Systematic reviews of adverse effects: framework for a structured approach. BMC Med Res Methodol, 2007. 7: p. 32.

RCTs versus observational studies and methodology for observational studies in comparative effectiveness research

  • Lindenauer, P.K., et al., Association of corticosteroid dose and route of administration with risk of treatment failure in acute exacerbation of chronic obstructive pulmonary disease. JAMA, 2010.
  • Dreyer, N.A., et al., Why observational studies should be among the tools used in comparative effectiveness research. Health Aff (Millwood), 2010. 29(10): p. 1818-25.
  • Brookhart, M.A., et al., Confounding control in healthcare database research: challenges and potential approaches. Med Care, 2010. 48(6 Suppl): p. S114-20.

Use of propensity scores for controlling confounding in non-randomized research 

  • D'Agostino, R.B., Jr., Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med, 1998. 17(19): p. 2265-81.
  • Austin, P.C. and M.M. Mamdani, A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use. Stat Med, 2006. 25(12): p. 2084-106.
  • Stukel, T.A., et al., Analysis of observational studies in the presence of treatment selection bias: effects of invasive cardiac management on AMI survival using propensity score and instrumental variable methods. JAMA, 2007. 297(3): p. 278-85.

Instrumental variables 

  • Brookhart, M.A., J.A. Rassen, and S. Schneeweiss, Instrumental variable methods in comparative safety and effectiveness research. Pharmacoepidemiol Drug Saf, 2010. 19(6): p. 537-54.
  • Brooks, J.M., et al., Effect of dialysis center profit-status on patient survival: a comparison of risk-adjustment and instrumental variable approaches. Health Serv Res, 2006. 41(6): p. 2267-89.
  • Rassen, J.A., et al., Instrumental variables I: instrumental variables exploit natural variation in nonexperimental data to estimate causal relationships. J Clin Epidemiol, 2009. 62(12): p. 1226-32.

Patient preferences and medical decision making 

  • Covey, J., A meta-analysis of the effects of presenting treatment benefits in different formats. Med Decis Making, 2007. 27(5): p. 638-54.
  • Zikmund-Fisher, B.J., et al., The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. Med Decis Making, 2010. 30(5 Suppl): p. 20S-34S.

Practice Variation: A prelude to visiting Professor, John Wennberg (March 23rd, noon, OHSU Auditorium).  

  • Fisher, E.S., et al., The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med, 2003. 138(4): p. 273-87.
  • Wennberg, J.E., E.S. Fisher, and J.S. Skinner, Geography and the debate over Medicare reform. Health Aff (Millwood), 2002. Suppl Web Exclusives: p. W96-114.

The contribution of qualitative research to comparative effectiveness 

  • Noyes, J. and J. Popay, Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta-synthesis. J Adv Nurs, 2007. 57(3): p. 227-43.
  • Popay, J. and G. Williams, Qualitative research and evidence-based healthcare. J R Soc Med, 1998. 91 Suppl 35: p. 32-7.

Review of clinical guidelines 

  • Parmelli, E., et al., Updating clinical recommendations for breast, colorectal and lung cancer treatments: an opportunity to improve methodology and clinical relevance. Ann Oncol, 2011. 22(1): p. 188-94.
  • Shekelle, P., et al., When should clinical guidelines be updated? BMJ, 2001. 323(7305): p. 155-7.

Practiced-based Research and CER 

  • Mold, J.W. and K.A. Peterson, Primary care practice-based research networks: working at the interface between research and quality improvement. Ann Fam Med, 2005. 3 Suppl 1: p. S12-20.
  • Westfall, J.M., J. Mold, and L. Fagnan, Practice-based research--"Blue Highways" on the NIH roadmap. JAMA, 2007. 297(4): p. 403-6.

Assessing and applying trial results to individual patients 

  • Kent, D.M. and R.A. Hayward, Limitations of applying summary results of clinical trials to individual patients: the need for risk stratification. JAMA, 2007. 298(10): p. 1209-12.
  • Kent, D.M., et al., Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal. Trials, 2010. 11: p. 85.

Shared Decision-Making 

  • Kaimal, A.J. and M. Kuppermann, Understanding risk, patient and provider preferences, and obstetrical decision making: approach to delivery after cesarean. Semin Perinatol, 2010. 34(5): p. 331-6.
  • O'Connor, A.M., et al., Toward the 'tipping point': decision aids and informed patient choice. Health Aff (Millwood), 2007. 26(3): p. 716-25.

When is comparative effectiveness actually “Comparative Effectiveness Research”? A discussion of non-traditional applications of CER 

  • Helfand, M. and H. Balshem, AHRQ series paper 2: principles for developing guidance: AHRQ and the effective health-care program. J Clin Epidemiol, 2010. 63(5): p. 484-90.
  • McGaghie, W.C., et al., Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med, 2011. 86(6): p. 706-11.
  • Volpp, K.G. and A. Das, Comparative effectiveness--thinking beyond medication A versus medication B. N Engl J Med, 2009. 361(4): p. 331-3.

Communicating with patients about overused healthcare strategies 

  • The business of healing hearts: cardiac care is a money-making machine that too often favors profit over science. Consum Rep, 2011. 76(9): p. 26-36.
  • Chan, P.S., et al., Appropriateness of percutaneous coronary intervention. JAMA, 2011. 306(1): p. 53-61.
  • Hackam, D.G., et al., Influence of noninvasive cardiovascular imaging in primary prevention: systematic review and meta-analysis of randomized trials. Arch Intern Med, 2011. 171(11): p. 977-82.
  • Lauer, M.S., Pseudodisease, the next great epidemic in coronary atherosclerosis?: comment on "Impact of coronary computed tomographic angiography results on patient and physician behavior in a low-risk population". Arch Intern Med, 2011. 171(14): p. 1268-9.
  • McEvoy, J.W., et al., Impact of coronary computed tomographic angiography results on patient and physician behavior in a low-risk population. Arch Intern Med, 2011. 171(14): p. 1260-8.
  • Sprenger, A., J. Kane, and E.S. Adair, Health Actions Not to Do: Lessons for consumer decision-making, in AHRQ Internal Publication. 2011.

Multimorbidity in CER 

  • Tinetti, M.E. and S.A. Studenski, Comparative effectiveness research and patients with multiple chronic conditions. N Engl J Med, 2011. 364(26): p. 2478-81.
  • Tooth, L., et al., Weighted multimorbidity indexes predicted mortality, health service use, and health-related quality of life in older women. J Clin Epidemiol, 2008. 61(2): p. 151-9.

Stakeholder Engagement 

  • Chalkidou, K., et al., Comparative effectiveness research priorities: identifying critical gaps in evidence for clinical and health policy decision making. Int J Technol Assess Health Care, 2009. 25(3): p. 241-8.
  • Hoffman, A., et al., How best to engage patients, doctors, and other stakeholders in designing comparative effectiveness studies. Health Aff (Millwood), 2010. 29(10): p. 1834-41.

Prognosis, Prediction, and Prophesies, Oh My: The use of risk assessment tools in CER 

  • Brady, A.R., et al., Assessment and optimization of mortality prediction tools for admissions to pediatric intensive care in the United kingdom. Pediatrics, 2006. 117(4): p. e733-42.
  • Cook, N.R. and P.M. Ridker, Advances in measuring the effect of individual predictors of cardiovascular risk: the role of reclassification measures. Ann Intern Med, 2009. 150(11): p. 795-802.
  • Hemingway, H., Prognosis research: why is Dr. Lydgate still waiting? J Clin Epidemiol, 2006. 59(12): p. 1229-38.

A Framework for Using Systematic Reviews in Designing Primary Studies 

  • Atkins, D., et al., Assessing applicability when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol, 2011. 64(11): p. 1198-207.
  • Thompson, M., et al., A Framework to Facilitate the Use of Systematic Reviews and Meta-Analyses in the Design of Primary Research Studies. 2011.

A Metabias: Single vs Multi-Center Trials 

  • Bellomo, R., S.J. Warrillow, and M.C. Reade, Why we should be wary of single-center trials. Crit Care Med, 2009. 37(12): p. 3114-9.
  • Dechartres, A., et al., Single-center trials show larger treatment effects than multicenter trials: evidence from a meta-epidemiologic study. Ann Intern Med, 2011. 155(1): p. 39-51.

Indirect comparisons in comparative effectiveness reviews 

  • Chou, R., et al., Initial highly-active antiretroviral therapy with a protease inhibitor versus a non-nucleoside reverse transcriptase inhibitor: discrepancies between direct and indirect meta-analyses. Lancet, 2006. 368(9546): p. 1503-15.
  • Psaty, B.M., et al., Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA, 2003. 289(19): p. 2534-44.
  • Song, F., et al., Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews. BMJ, 2009. 338: p. b1147.

Issues pertaining to deferral of informed consent in acute care CER 

  • Brasel, K.J., et al., Hypertonic resuscitation: design and implementation of a prehospital intervention trial. J Am Coll Surg, 2008. 206(2): p. 220-32.
  • Kasner, S.E., et al., Community views on neurologic emergency treatment trials. Ann Emerg Med, 2011. 57(4): p. 346-354 e6.
  • Nelson, M.J., et al., Local media influence on opting out from an exception from informed consent trial. Ann Emerg Med, 2010. 55(1): p. 1-8.

Cost effectiveness and CER

  • Neumann, P.J. and M.C. Weinstein, Legislating against use of cost-effectiveness information. N Engl J Med, 2010. 363(16): p. 1495-7.
  • Ollendorf, D.A. and S.D. Pearson, An integrated evidence rating to frame comparative effectiveness assessments for decision makers. Med Care, 2010. 48(6 Suppl): p. S145-52.
  • Owens, D.K., et al., High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions. Ann Intern Med, 2011. 154(3): p. 174-80.

Integrating CER into clinical practice: physician opinion and concerns for autonomy

  • Keyhani, S., M. Woodward, and A.D. Federman, Physician views on the use of comparative effectiveness research: a national survey. Ann Intern Med, 2010. 153(8): p. 551-2.
  • Chou, R., et al., Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med, 2011. 155(11): p. 762-71.

CER and Implementation Science

  • Kessler, R. and R.E. Glasgow, A proposal to speed translation of healthcare research into practice: dramatic change is needed. Am J Prev Med, 2011. 40(6): p. 637-44.
  • Brownson, R.C., G.A. Colditz, and E.K. Proctor, Dissemination and implementation research in health : translating science to practice. 2012, Oxford: Oxford University Press. p. (Chapter 4)

Quality Improvement vs Research: Ethics and IRB Issues

  • Kass, N., et al., Controversy and quality improvement: lingering questions about ethics, oversight, and patient safety research. Jt Comm J Qual Patient Saf, 2008. 34(6): p. 349-53.
  • Dokholyan, R.S., et al., Regulatory and ethical considerations for linking clinical and administrative databases. Am Heart J, 2009. 157(6): p. 971-82.

Observational Data and CER: Always? Never? Sometimes? When?

  • Alemayehu, D., et al., Statistical issues with the analysis of nonrandomized studies in comparative effectiveness research. J Manag Care Pharm, 2011. 17(9 Suppl A): p. S22-6.
  • Norris, S.L., et al., Observational studies in systemic reviews of comparative effectiveness: AHRQ and the Effective Health Care Program. J Clin Epidemiol, 2011. 64(11): p. 1178-86.