[Federal Register Volume 62, Number 229 (Friday, November 28, 1997)]
[Notices]
[Pages 63345-63346]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-31205]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Health Care Policy and Research
Nominations of Topics for Evidence-Based Practice Centers (EPCs)
The Agency for Health Care Policy and Research (AHCPR) invites a
second round of nominations of topics for evidence reports on the
prevention, diagnosis, treatment, and management of common diseases and
clinical conditions, and where appropriate, the use of alternative/
complementary therapies, and for technology assessments of specific
medical procedures or health care technologies. AHCPR's first request
for topic nominations was published in the Federal Register on December
23, 1996 (61 FR 67554-67556).
AHCPR serves as a science partner with private-sector and other
public organizations in their efforts to improve the quality,
effectiveness, and appropriateness of health care delivery in the
United States, and to speed the translation of evidence-based research
findings into improved clinical care. AHCPR supports Evidence-based
Practice Centers (EPCs) to undertake scientific analyses and evidence
syntheses on high-priority topics. The EPCs produce science syntheses--
evidence reports and technology assessments--that provide the
scientific foundation for public and private organizations to use in
developing and implementing their own practice guidelines, performance
measures, and other tools to improve the quality of health care and
make decisions related to the effectiveness or appropriateness of
specific health care technologies.
As a result of nominations received in response to AHCPR's December
1996 Federal Register notice, EPCs are developing an evidence report or
a technology assessment on the following topics: (1) Testosterone
suppression treatment of prostatic cancer; (2) evaluation of cervical
cytology; (3) diagnosis and treatment of dysphagia/swallowing problems
in the elderly; (4) evaluation and treatment of new onset of atrial
fibrillation in the elderly; (5) diagnosis of sleep apnea; (6)
treatment of attention deficit and hyperactivity disorder; (7)
diagnosis and treatment of acute sinusitis; (8) rehabilitation of
persons with traumatic brain injury; (9) prevention and management of
urinary complications in paralyzed persons; (10) pharmacotherapy for
alcohol dependence; (11) management of stable angina; and (12)
treatment of depression with new drugs.
The process that AHCPR employs to select topics for analyses by the
EPCs is described below.
Background
Under Title IX of the Public Health Service Act, AHCPR is charged
with enhancing the quality, appropriateness, and effectiveness of
health care services and access to such services. AHCPR accomplishes
these goals through scientific research and through promotion of
improvements in clinical practice (including the prevention of diseases
and other health conditions) and improvements in the organization,
financing, and delivery of health care services (42 U.S.C. 299-299c-6
and 1320b-12). In carrying out these purposes, AHCPR, among other
activities, has, in the past, arranged for
[[Page 63346]]
the development of clinical practice guidelines and has conducted
assessments of health care technologies.
Through the creation of EPCs, AHCPR is better able to serve as a
science partner with private-sector and other public organizations in
addressing a greater number of health care topics and a broader range
of clinical conditions and health problems. The EPCs provide a strong
scientific foundation for private and public organizations to use in
their own efforts to improve clinical practice. The EPCs conduct
literature reviews and assess and synthesize scientific evidence to
produce evidence reports and technology assessments. The reports and
assessments will provide systems of care, provider societies, health
plans, public and private purchasers, States, and others with a
scientific foundation for development and implementation of their own
practice guidelines, clinical pathways, review criteria, performance
measures, and other tools to improve the quality of care in their own
settings and populations. They may also be used to inform health care
decisions, such as coverage or reimbursement policy, based on the
effectiveness or appropriateness of specific services, procedures, or
technologies.
Evidence-based Practice Centers (EPCs)
The EPCs prepare evidence reports and technology assessments on
topics for which there is significant demand by health care providers,
insurers, purchasers, health-related societies, and consumer
organizations. Such topics may include the prevention, diagnosis and/or
treatment of particular diseases or health conditions including, where
appropriate, the use of alternative/complementary therapies, as well as
the appropriate use of more commonly provided services, procedures, or
technologies. AHCPR will widely disseminate the evidence reports and
technology assessments produced by the EPCs.
Selection Criteria
Selection criteria for AHCPR evidence report and technology
assessment topics include: (1) High incidence or prevalence in the
general population or in subpopulations, including racial and ethnic
minorities and other populations; (2) significance for the needs of the
Medicare, Medicaid and other Federal health programs; (3) high costs
associated with a condition, procedure, treatment, or technology,
whether due to the number of people needing care, high unit cost of
care, or high indirect costs; (4) controversy or uncertainty about the
effectiveness or relative effectiveness of available clinical
strategies or technologies; (5) potential to inform and improve patient
or provider decisionmaking; (6) potential to reduce clinically
significant variations in the prevention, diagnosis, treatment, or
clinical management of a disease or condition, or in the use of a
procedure or technology, or in the health outcomes achieved; (7)
availability of scientific data to support the study or analysis of the
topic; and (8) potential opportunities for rapid implementation. The
topics selected also will complement AHCPR's efforts to build a
balanced portfolio of evidence reports and technology assessments.
Nomination and Selection Process
Nominations of topics for AHCPR evidence reports and technology
assessments should focus on specific aspects of prevention, diagnosis,
treatment and/or management of a particular condition, or on an
individual procedure, treatment, or technology. Potential topics should
be carefully defined and circumscribed so that within 6 to 12 months
databases can be searched, the evidence reviewed, supplemental analyses
performed, and final evidence reports or technology assessments
produced. Topics selected will not duplicate current and widely
available clinical practice guidelines or technology assessments,
unless new evidence is available that suggests the need for revisions
or updates.
Nominations should be brief (1-2 pages) and may be in the form of a
letter. For each topic nominated, nominators should provide a rationale
and any available supporting evidence reflecting the importance and
clinical relevance of the topic and should indicate the potential
usefulness of the evidence report or technology assessment within their
professional practices or organizations. Information should include:
A clearly defined topic, with specific questions to be
answered that will establish the focus and boundaries of the report.
The availability of data to study and, if available, any
information on the incidence, prevalence, and/or severity of the
particular disease or health condition including, if relevant, its
significance for the Medicare and medicaid populations; or the
frequency of use and cost of the procedure, treatment, or technology;
an indication of how the evidence report or assessment might be used
within the nominator's professional or organizational setting; and any
known currently available technology assessments, practice guidelines,
disease management protocols, or other tools or standards pertaining to
the topic and their deficiencies, if any.
References to significant differences in practice
patterns and/or results; alternative therapies and controversies.
Nominators of selected topics may have the opportunity to serve as
resources to EPCs as they develop evidence reports and technology
assessments. Nominators may also be requested to serve as peer
reviewers of draft evidence reports and assessments.
The AHCPR will review topic nominations and supporting information
and determine final topics, seeking additional information as
appropriate.
Materials Submission and Deadline
To be considered for the next group of evidence reports and
technology assessments, topic nominations should be submitted by
January 30, 1998 to: Douglas B. Kamerow, M.D., M.P.H., Director, Center
for Practice and Technology Assessment, Agency for Health Care Policy
and Research, 6000 Executive Boulevard, Willco Building, Suite 310,
Rockville, Maryland 20852.
Nominations also will be accepted on an ongoing basis at the above
address for topics for subsequent evidence reports and technology
assessments.
All responses will be available for public inspection at the Center
for Practice and Technology Assessment, telephone (301) 594-4015,
weekdays between 8:30 a.m. and 5 p.m. AHCPR will not reply to
individual responses, but will consider all nominations in selecting
topics. Topics selected will be announced, from time to time, in the
Federal Register and AHCPR press releases.
For Additional Information
Additional information about topic nominations can be obtained by
contacting: Jacqueline Besteman, EPC Project Officer, Center for
Practice and Technology Assessment, Agency for Health Care Policy and
Research, 6000 Executive Boulevard, Willco Building, Suite 310,
Rockville, Maryland 20852; telephone (301) 594-4015; E-mail address:
jbestema@ahcpr.gov.
Dated: November 21, 1997.
John M. Eisenberg,
Administrator.
[FR Doc. 97-31205 Filed 11-26-97; 8:45 am]
BILLING CODE 4160-90-M
