The Outcome of Outcomes Research at AHCPR: Final Report

In this comprehensive analysis of outcomes and effectiveness research at the Agency for Health Care Policy and Research, the Lewin Group describes accomplishments and lessons of the past decade and recommends how to increase the measurable impact of that research.

Contents

Summary
Introduction
Background
     History of the Science
     Definition of Outcomes and Effectiveness Research (OER)
     Data Sources
Framework—From Research Findings To Clinical Excellence
     Description
     Implications
Empirical Analysis: Survey of COER-Funded Investigators
     Results
Discussion
Synthesis: Progress and Accomplishments
     Conceptual Shifts
     Challenging Clinical Dogma
     Development of Research Methods and Tools
     Identifying Knowledge Gaps and Prompting Needed Studies
     Developing the Manpower for Outcomes Research
Lessons from Outcomes and Effectiveness Research
      Insights About Methods
     Recognition of Complexity of Changing Practice
      Realization that Savings are Difficult to Achieve
      Importance of the Current Quality of Evidence
Recommendations
     Set Research Priorities: Orchestrated Follow-On
     Clarify Criteria for Relevance and Importance
     Make OER Approach Responsive to Existing Quality of the Evidence
     Increase Emphasis on Problem-solving
     Promote Improvements in Strategies to Study Effectiveness
     Promote Routine Use of Outcomes Measures
      Continue Tools and Methods Development
      Create the Capacity to Build Upon and Transfer Knowledge
     Promote Clear Vision of Roles and Impact
      Increase Interaction with Major Stakeholders and Customers
Conclusion
References
Appendix 1: Survey of COER-Funded Principal Investigators: Summary
Appendix 2: Abstract: Presented at SGIM Annual Meeting, April 1998, Chicago
     Categories for findings reported by COER-funded Primary Investigators
Appendix 3: Health Status Measurement Instruments
Appendix 4: Projects on Practice Variation (1989-96)
Figure 1: Levels of Impact Resulting from Outcomes Studies
Figure 2: From Research to Clinical Excellence
Table 1: Levels of Impact and Examples
Table 2: Classification of findings from COER-funded studies