Improving The Utility Of Evidence Synthesis In The Face Of Insufficient Evidence
Healthcare decision makers strive to operate on the best available evidence. The Agency for Healthcare Research and Quality Evidence-based Practice Center (EPC) Program aims to support health care decision makers by producing evidence reviews that rate the strength of evidence. The evidence base, however, is often sparse or heterogeneous, or otherwise results in a high degree of uncertainty and insufficient evidence ratings. A workgroup comprising EPC Program members convened throughout 2020. Its members conducted interative discussions considering information from three data sources: a literature review for relevant publications and frameworks; a review of a convenience sample of past systematic reviews conducted by the EPCs; and an audit of methods used in past EPC technical briefs. Researchers concluded that throughout early scoping, protocol development, review conduct, and review presentation, authors should consider five possible strategies to supplement potential insufficient findings of benefit or harms. When there is no evidence available for a specific outcome, reviewers should use a statement such as "no studies" instead of "insufficient." The main reasons for insufficient evidence rating should be explicitly described. A White Paper can be obtained at https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/improving-utility-evidence-synthesis-white-paper.pdf.
Implementing High-Quality Primary Care
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan from the National Academies Press with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs. The document can be obtained at https://www.nap.edu/login.php?record_id=25983&page=https%3A%2F%2Fwww.nap.edu%2Fdownload%2F25983.
Primary Care In The COVID-19 Pandemic
In a new report edited by authors from the Harvard Medical School Center for Primary Care, produced with support from the Milbank Memorial Fund and the CareQuest Institute for Oral Health, dozens of leading thinkers document and analyze the trends in primary care over the course of the pandemic, and make recommendations to primary care clinical team members, health care industry leaders, and policy experts. The authors: describe access to high-quality primary care during the COVID-19 pandemic in the United States and other parts of the world; determine opportunities for accelerating transitions to new payment and delivery models; and identify the care strategies, including anti-racist policies, that can best advance primary care equity. Care strategies focused on vulnerable populations can be adapted to logistical challenges if providers focus on an integrated experience delivered across multiple diverse disciplines through the same clinic infrastructure. The perspectives in this report are, therefore, ultimately optimistic, demonstrating that the resilience of populations to this pandemic and future ones can be bolstered by flexible, coordinated, and dedicated primary care providers. The report can be obtained at https://www.milbank.org/wp-content/uploads/2021/04/Book_Primary_Care_During_COVID_ebook_4-27-21.pdf.
More May 2021 TRENDS Articles
MINISCULE CREATURES OF HUGE IMPORTANCE
is a discussion on how declines in the population of insects on earth can have major negative impacts on the health status of humans. Read More
A MAJOR FOCUS ON GOVERNMENT SPENDING
describes early attempts to appropriate funds for the upcoming next fiscal year, the return of “earmarks,” and key hearings on Capitol Hill regarding COVID-19. Read More
HEALTH REFORM DEVELOPMENTS
refers to how overuse of tests and procedures in the Medicare program contributes to wasteful spending; Biden administration efforts to reverse policies of the previous administration; and expansion of some provisions of the Affordable Care Act. Read More
DEVELOPMENTS IN HIGHER EDUCATION
is about the financial impact of lockdowns on colleges and universities; the effect on students of remote instead of in-class learning; and proposed legislation on student loan tax elimination. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Emergency Departments For Bicycle-Related TBIs: United States, 2009-2018
Medicare, Medicaid, Children’s Health Insurance Program Enrollment: 2020
Ventilating The Rectum To Support Respiration Opening A Window Into Alzheimer's Disease Read More
OBTAINABLE RESOURCES
Improving The Utility Of Evidence Synthesis In The Face Of Insufficient Evidence
Implementing High-Quality Primary Care
Primary Care In The COVID-19 Pandemic Read More
IMPACT OF MARRIAGE, DIVORCE, AND WIDOWHOOD ON HEALTH STATUS
indicates reasons why the so-called “golden years” associated with old age can be particularly disruptive in the lives of women in the U.S. Read More
COGNITIVE EPIDEMIOLOGY, INTELLIGENCE, HEALTH, AND DEATH
pertains to how an understanding of the association between intelligence and health/mortality has been refined with the advent of new, population-scale data and genetic tools. Read More Read More