Chapter 3: Roles and Responsibilities of EPC Program Collaborators
The EPC program is a collaborative effort. If the
collaboration is to work as intended, all participants—the Partners, AHRQ, the
EPCs, and the expert panels—need to understand their respective roles and the
expectations entailed in these roles.
Partners
Organizations
that nominate topics selected for EPC evidence reports assume the role of
partners of AHRQ and the EPCs. In some instances, there may be multiple
partners for a given topic. AHRQ places high value on its relationships with
partners. Partners have defined roles and responsibilities:
- Once a topic is selected, a partner must:
- Participate in conference calls to discuss the
goals and objectives for the topic with the AHRQ Task Order Officer (TOO) and
EPC assigned to the topic.
- Be available to the EPC as a source of information
and expertise as it develops the evidence report or technology assessment.
- Appoint one representative to the technical expert panel
designated for an EPC report. This partner representative will be available
for consultation on the scope of the topic and questions, literature sources,
identification of experts and, if requested by the EPC, serve as an external
peer reviewer of draft EPC report.
- Once an AHRQ evidence report is published, partners
are expected to:
- Commit to the timely translation of the EPC report into their own
quality improvement products (e.g., clinical practice guidelines, performance
measures), educational programs or coverage and reimbursement policies, as
appropriate.
- Disseminate these partner-developed products to appropriate
members, populations or other target audiences.
- Participate in efforts to measure the use and impact of the
products, programs or policies derived from EPC reports.
- Provide data regarding translation, dissemination, use and impact
measurement activities to AHRQ so that the EPC program can be assessed and
improved. AHRQ will collect and organize information about these activities
from partners through routine telephone communication.
Partners may not:
- Seek to alter the scope of work for an EPC report without
consulting the AHRQ TOO.
- Determine the composition of an EPC's technical
expert panel or manage the panel's deliberations. The technical expert panel,
of which the partner representative is an equal member, may be asked by the EPC
to provide substantive input from time to time. Consistent with its objective
search strategy and review of relevant evidence, EPCs may exclude articles that
partners may have published or cited (e.g., in their original topic
nomination).
- Communicate directly with the EPC while the project
is ongoing. All communication from the partner should go to the AHRQ TOO and
communication throughout the process is important to ensure that the report
meets the partner's needs. However, partner organizations may contract
directly with an EPC after the report has been published. This may allow
partner organizations to tap EPC content expertise as they develop guidelines,
quality measures or other products based upon the findings of the reports.
- Edit the content of the final report produced by the EPC. The
partner representative appointed to the technical expert panel may review the
draft report as a member of the larger external peer review group and provide
review comments. The EPC is responsible for considering all review comments
and modifying the final report to incorporate substantive comments, as
appropriate. AHRQ reviews peer review comments and the disposition of those
comments.
- One of the key attributes of the EPC program is ensuring that partners
plan for and actively participate in translation and dissemination of EPC
reports on their nominated topics. When AHRQ is considering whether to
designate a new topic for EPC review, it will review the past performance (if
any) of the nominating Partner with regard to translation and dissemination of
any previous EPC reports.
Federal partners
interested in evidence reports to support their activities are encouraged to
contact the EPC Program Director at AHRQ, Beth Collins Sharp, at:
Beth.CollinsSharp@ahrq.hhs.gov.
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AHRQ
AHRQ selects topics from the pool of nominated topics,
funds the EPCs, and acts as a bridge between the partners and EPCs. In
particular, these are the responsibilities of AHRQ's Center for Outcomes and
Evidence (COE). AHRQ has contractual relationships with the EPCs to produce
the evidence reports. As AHRQ contractors, the EPCs are accountable to AHRQ
under the scope and terms of these contracts. AHRQ task order officers (TOOs)
are responsible for the technical monitoring of the EPC contracts, including
facilitating communication between partners and EPCs. All Partner
communication with EPC staff is conducted through the appropriate AHRQ TOO.
Any communication not conducted directly through the AHRQ TOO should be
reported to the TOO.
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EPCs
EPCs conduct evidence reviews based on topics
nominated by partners and funded by AHRQ. They also may update prior evidence
reports, provide technical assistance to facilitate translation of reports, and
undertake methods research for the EPC program. During the course of
developing evidence reports, EPCs may do the following:
- Participate in conference calls to discuss goals and objectives of work
assignment, proposed search strategy, etc. At least one of these calls will be
conducted at the inception of a topic assignment and will include AHRQ staff
and representation from the partner organization. The EPC will submit a
summary of the discussion and decisions to the call participants.
- Submit a comprehensive protocol covering the assessment and refinement
phase, proposed literature search and review (abstracts and full text),
inclusion/exclusion criteria, criteria for evaluating the quality of studies
and rating the strength of overall body of evidence, etc.
- In consultation with the AHRQ TOO, identify a set of five to eight qualified
individuals to comprise a Key Informant group for refinement of the topic and a technical
expert panel. The EPC will consult with these individuals, as needed, in
developing its evidence report.
- Conduct a preliminary assessment of the scientific literature for
Federal partners to ascertain whether there is sufficient evidence to support a
comprehensive systematic review and analysis.
- Refine the preliminary questions and identify any necessary additional
questions.
- Systematically search, abstract, review, and analyze the scientific
evidence for each question.
- Identify peer reviewers to ensure input from a broad range of clinical
and professional interests for a particular topic, and submit a draft report to
these individuals. The EPC will invite the partner organization to review and
comment on the draft evidence report via a member of this external peer review
group.
- Produce a final evidence report and appendices in compliance with the
format provided by AHRQ.
- Engage
in translation and dissemination activities related to the reports they author,
and/or measure the impact of those reports.
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Expert Panels
- Key Informants provide
guidance to the EPCs during the topic refinement stage of the evidence review.
The Key Informant Panel is composed of five to eight members, including
patients and consumers, practicing clinicians, relevant professional and
consumer organizations, purchasers of health care and others with experience
relevant to the topic under development. These Key Informants are distinct from
the Technical Expert Panel, which is constituted to inform the scientific
processes of the full review. Key Informants provide information on the
relevance to health care practice of the questions under development.
- Technical Expert Panels
provide guidance to the EPCs throughout the evidence review process, as needed.
Typically composed of 5 to 8 members, the Technical Expert Panels usually
include one or more physicians (e.g., a primary care physician and a specialist),
professional society representative, health care purchaser representative, Partner
representative, and other content and methods experts. The size and
composition of the technical expert panel are intended to create a balance between
content and methodology expertise and the user's perspective. During
the course of developing evidence reports, Technical Expert Panels may assist
the EPCs by doing the following:
- Help to focus key questions, as needed.
- Help to focus and complete the literature search by helping to identify
search strategies and relevant grey literature.
- Help to identify inclusion/exclusion criteria to evaluate the quality of
studies and rate the strength of the overall body of evidence, etc.
- Provide peer review of the draft evidence report.
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