1. Topic Selection for the AHRQ Effective Health Care Program Evelyn P. Whitlock, MD, MPH Associate Director Oregon Evidence-based Practice Center Oregon Health & Science University Center for Health Research, Kaiser Permanente Northwest Baltimore, MD July 10, 2008

10. Principle 2: Engage Stakeholders in Topic Selection for the EHC Program Oregon EPC Convened EHC Program Stakeholder Panel and Program Priorities Work Group

11. Topic Selection Process: From Ideas Important Research Topics Ideas/ Nominations Important Research Topics

12. EHC Program Principle 3 Define Selection Criteria (18 criteria) 3 criteria 7 criteria 1 criterion 1 criterion 6 criteria Same criteria considered for every nomination in a structured, hierarchical manner

14. Experience to Date: 2008 Nominations Received by Priority Condition

15. Selection Criteria Nomination: IV Catheter-Associated Bloodstream Infection Prevention Criterion 2b : Is of high public interest; affects health care decision-making, outcomes, or costs for a large proportion of the US population or for a priority population in particular Example : Yes, topic is of high public interest and affects health care decision-making for 200,000 US patients annually. The high public interest is evident through the recent recognition of this topic by the Joint commission, the Institute of Medicine (IOM), Centers for Medicare & Medicaid Services (CMS), and the Institute for Healthcare Improvement (IHI). CMS will soon stop paying hospitals for eight hospital-acquired conditions that have evidence-based prevention guidelines, including catheter-associated infections . The decision by CMS to not reimburse hospitals for the additional cost of treating patients who acquire a vascular catheter-associated infection during their hospitalization has made infection prevention even more of a priority.

16. Selection Criteria Nomination : Over-the-Counter (OTC) Cold Remedies for Children Criterion 3 : Would not be redundant (i.e., the proposed topic is not already covered by available or soon-to-be available high-quality systematic review by AHRQ or others) Example : Topic would be redundant given the Cochrane review published in 2008. This review looked at the limited amount of data available for this topic and concluded that the evidence does not support the effectiveness of over-the-counter preparations for children with acute cough .

17. Selection Criteria Nomination : 17-OH Progesterone Criterion 4 : Effectively utilizes existing research and knowledge by considering: 1) adequacy (type and volume) of research for conducting a systematic review, and 2) newly available evidence (particularly for updates or new technologies) Example : The most recent review was published in 2006 and had a last search date of 2004. Given that the search dates for this review are somewhat dated, we conducted a brief feasibility scan to determine whether a new systematic review would be useful at this time. In our brief scan we found there to be several trials, case series, and observational studies published between 2005 and 2008. There are several ongoing and recruiting trials for this topic listed on clinicaltrials.gov and the NICHD website.

18. Selection Criteria Nomination : Preconception Programs Criterion 5e : Addresses inequities, vulnerable populations (including issues for patient subgroups) Example : Yes, this nomination addresses inequities including access to preconception and interconception care for low-income women and addresses vulnerable populations including pregnant women and infants.

20. 2008 nominations: Results to date

26. Comments & Questions Oregon EPC