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Research and Reporting Methods |

Identifying Research Needs for Improving Health Care

Stephanie M. Chang, MD, MPH; Timothy S. Carey, MD, MPH; Elisabeth Uphoff Kato, MD, MRP; Jeanne-Marie Guise, MD, MPH; and Gillian D. Sanders, PhD
[+] Article and Author Information

From the Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, Rockville, Maryland; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Oregon Health & Science University, Portland, Oregon; and Duke University, Durham, North Carolina.

Disclaimer: The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Acknowledgment: The authors would like to acknowledge the work done by authors of the Future Research Needs pilot projects. They would like to particularly acknowledge those who contributed to the rich discussions among EPCs, including Karen Robinson, Robert Kane, Thomas Trikalinos, Barbara Rothenberg, Katherine Hartmann, Jeff Andrews, and Naomi Aronson. They also thank current and former AHRQ staff for their support, inspiration, and work on this effort, including Yen-Pin Chiang, Karen Siegel, Christine Chang, Supriya Janakiraman, and Shilpa Amin, and Leah Williams for her excellent editorial assistance.

Financial Support: This project was funded in part under contracts 290-2007-10056-1, 290-2007-10057-1, and 290-2007-10066-1 from the AHRQ, U.S. Department of Health and Human Services.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0732.

Corresponding Author: Stephanie M. Chang, MD, MPH, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850.

Current Author Addresses: Drs. Chang and Kato: Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850.

Dr. Carey: Cecil G. Sheps Center for Health Services Research, 725 Airport Road, Campus Box 7590, Chapel Hill, NC 27599-7590.

Dr. Guise: Oregon Evidence-based Practice Center, Oregon Health & Science University, L-466, 3181 SW Sam Jackson Park Road, Portland, OR 97239.

Dr. Sanders: Duke Clinical Research Institute (DCRI), North Pavilion, 2400 Pratt Street, Durham, NC 27705.

Author Contributions: Conception and design: S.M. Chang, T. Carey, E.U. Kato, J.M. Guise.

Analysis and interpretation of the data: S.M. Chang, E.U. Kato, J.M. Guise, G.D. Sanders.

Drafting of the article: S.M. Chang, T. Carey, J.M. Guise, G.D. Sanders.

Critical revision of the article for important intellectual content: S.M. Chang, T. Carey, E.U. Kato, J.M. Guise, G.D. Sanders.

Final approval of the article: S.M. Chang, T. Carey, E.U. Kato, J.M. Guise, G.D. Sanders.

Collection and assembly of data: S.M. Chang, T. Carey, E.U. Kato, J.M. Guise, G.D. Sanders.


Ann Intern Med. 2012;157(6):439-445. doi:10.7326/0003-4819-157-6-201209180-00515
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Insights from systematic reviews can help new studies better meet the priorities and needs of patients and communities. However, systematic reviews unfortunately have not yet achieved this position to direct and guide new research studies. The Agency for Healthcare Research and Quality's Evidence-based Practice Center Program uses systematic reviews to identify gaps in current evidence and has developed a systematic process of prioritizing these gaps with stakeholder input into clearly defined “future research needs.” Eight Evidence-based Practice Centers began to apply this effort in 2010 to various clinical and policy topics.

Gaps that prevented systematic reviewers from answering central questions of the review may include insufficient studies on subpopulations, insufficient studies with appropriate comparators, lack of appropriate outcomes measured, and methods problems. Stakeholder panels, consisting of advocacy groups, patients, researchers, clinicians, funders, and policymakers, help refine the gaps through multiple conference calls and prioritization exercises. Each report highlights a focused set of 4 to 15 high-priority needs with an accompanying description of possible considerations for study design. Identification of high-priority research needs could potentially speed the development and implementation of high-priority, stakeholder-engaged research.

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Appendix Figure.

Example of developing a research need from an evidence gap.

From reference (16). ADHD = attention-deficit/hyperactivity disorder; CER = comparative effectiveness review; CD = conduct disorder; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; KQ = key question; ODD = oppositional-defiant disorder; PICOTS = population, intervention, comparator, outcome, timing, and setting; RCT = randomized, controlled trial.

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