Practice-Based Evidence Study Design for Comparative Effectiveness Research

@article{Horn2007PracticeBasedES,
  title={Practice-Based Evidence Study Design for Comparative Effectiveness Research},
  author={Susan D. Horn and Julie Gassaway},
  journal={Medical Care},
  year={2007},
  volume={45},
  pages={S50-S57}
}
Objectives:To describe a new, rigorous, comprehensive practice-based evidence for clinical practice improvement (PBE-CPI) study methodology, and compare its features, advantages, and disadvantages to those of randomized controlled trials and sophisticated statistical methods for comparative effectiveness research. Research Design:PBE-CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It uses the knowledge of… 
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248 Citations
Highly Influential Citations
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Background Citations
74
Methods Citations
28
Results Citations
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248 Citations

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Citation Type

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TLDR
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It is argued that practice-based evidence (PBE) study designs include features that address limitations inherent in both randomized trials and traditional observational studies, and also reduce the need for instrumental variables and propensity scores methods.
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This research paradigm strengthens the final step in clinical research that should follow the traditional demonstration of efficacy and reemphasizes the potentially important role of observational and retrospective investigations in establishing effectiveness of efficacious procedures in actual application to individual patients.
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The inclusion of substantial PBE in Community Guide reviews suggests that evidence of adequate rigor to inform practice is being produced, and should increase stakeholders' confidence that The Community Guide provides recommendations with real-world relevance.
The Use of Patient-reported Outcomes (PRO) Within Comparative Effectiveness Research: Implications for Clinical Practice and Health Care Policy
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The recommendations presented for incorporating PROs in CER are intended to provide a guide to researchers, clinicians, and policy makers to ensure that information derived from PROs is applicable and interpretable for a given CER context.
Interrupted Time Series Design: A Useful Approach for Studying Interventions Targeting Participation
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This work proposes the use of interrupted time series (ITS) quasi-experimental design for its potential application in determining the effectiveness of participation-focused interventions, ascertaining its advantages and limitations.
Emerging Methods in Comparative Effectiveness and Safety: Symposium Overview and Summary
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Conference papers covered numerous points about ways to structure both interventional and database-oriented studies, particularly those concerned with adverse drug events, to avoid bias in those studies, and to apply advanced statistical tools to exploit the information from these studies to their fullest.
Comparative effectiveness and implementation research: Directions for Neurology
TLDR
Neuroscientists and neuroscientists should understand the scope and objectives of comparative effectiveness and implementation research, their range of methodological approaches, and existing research resources relevant to research for neurological conditions, to close the well‐documented evidence‐to‐practice gap.
Practice based research in dentistry: an alternative to deal with clinical questions.
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This review sought to present PBR studies as alternative designs to answer clinical questions, but not replacing randomized clinical trials.
A Tipping Point for Measurement-Based Care.
OBJECTIVE Measurement-based care involves the systematic administration of symptom rating scales and use of the results to drive clinical decision making at the level of the individual patient. This…
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References

SHOWING 1-10 OF 39 REFERENCES
Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy.
TLDR
Increasing the supply of pragmatic or practical clinical trials will depend on the development of a mechanism to establish priorities for these studies, significant expansion of an infrastructure to conduct clinical research within the health care delivery system, more reliance on high-quality evidence by health care decision makers, and a substantial increase in public and private funding forThese studies.
Practice-Based Research
TLDR
This paper defines practice evaluation research, identifies strategies for its implementation, and describes a framework for creating a “research friendly” culture; it further describes the implementation of such an innovative program in both a hospital and a mental health agency setting.
Results of a collaborative quality improvement program on outcomes and costs in a tertiary critical care unit.
TLDR
A focused quality improvement program in the ICU can have a beneficial impact on care and simultaneously reduce costs.
Formulary limitations and the elderly: results from the Managed Care Outcomes Project.
TLDR
Positive, significant associations were found between the independent variable formulary limitations in drug class and the dependent variables measuring resource utilization, sometimes significantly greater for elderly patients after controlling for severity of illness and other variables.
Applying the clinical practice improvement approach to stroke rehabilitation: methods used and baseline results.
TLDR
This article outlines methods used in the PSROP, provides an overview of participating IRFs, describes the database, and summarizes key characteristics to enable readers of subsequent articles to better interpret study findings and determine generalizability.
Causal effects in clinical and epidemiological studies via potential outcomes: concepts and analytical approaches.
TLDR
An approach to making inferences about the causal effects of treatments or agents via potential outcomes is reviewed, where the causal effect is defined as a comparison of results from two or more alternative treatments, with only one of the results actually observed.
Treatment of Depression in Older Primary Care Patients in Health Maintenance Organizations
TLDR
Psychotropic medication management is an important target for improving quality of care for older patients with depression in HMOs and decreasing inefficient minor tranquilizer use and increasing use of newer antidepressant medications may lead to improved outcomes for older depressed adults.
Newness of Drugs and Use of HMO Services by Asthma Patients
TLDR
Greater use of newer asthma drugs was associated with significantly lower drug costs and fewer PCP visits; associations with hospitalization rates and ED visits, although lower, were not significant.
Development of a pediatric age- and disease-specific severity measure.
TLDR
The age- and disease-specific pediatric CSI score correlates highly with LOS, cost, and mortality in hospitalized children and can help determine the best clinical practices for specific diseases and adjust for differences in severity of illness across providers.
Effect of practice variation on resource utilization in infants hospitalized for viral lower respiratory illness.
TLDR
Institutional differences in care practices for children with VLRI were not explained by differences in patient severity and did not affect the children's recovery but correlated significantly with hospital costs and LOS.
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