Clinical practice guidelines (CPGs) have become an increasingly important adjunct to the provision of up-to-date and evidence-based patient care. The development of recommendations that address preventive healthcare services, and the movement toward “population health,” where those recommendations are used to evaluate the care of very large numbers of patients, raise concerns about the generation of trustworthy, evidence-based prevention CPGs (P-CPGs). For example, how should the existing literature or evidence be interpreted and applied to large and more-diverse patient populations than those studied? What happens when the literature is sparse or contradictory, or when the effects are significant but small? Who should be involved in the development of P-CPGs (e.g., specialists, generalists, methodologists, others)? If experts or specialists in the topic area are involved in the development of guidelines, do they bring insurmountable biases that would shape the way that evidence is interpreted or applied? Concerns over biases or conflict of interest (COI) in the development of CPGs were highlighted in a recent series of articles in JAMA. This seminar will address the specific nature of COI, who should participate and how they should participate in the development of P-CPGs, specifically: the definition of COI for P-CPGs, who is an expert, who should be on committees developing P-CPGs, and how to address COI for P-CPG development in the future.
Speaker Biography - Sheldon Greenfield, M.D.
Sheldon Greenfield, M.D.
Donald Bren Professor of Medicine, Executive Co-Director, Health Policy Research Institute, University of California, Irvine
Dr. Greenfield is one of the country’s most eminent and experienced health services researchers and policy experts. He and colleagues have produced major policy relevant findings over the past 4 decades, resulting in over 35,000 citations to papers in which he was an author. He and his colleagues have opened at least 4 new fields: nurse practitioners, outcomes research, patient participation in Medical Care, and heterogeneity of treatment effects, a major focus of Patient Centered Outcomes Research Institute (PCORI) and Comparative Effectiveness Research. His principal accomplishments lie in the areas of quality of care assessment, case mix determination, enlarging the patient role in care, clinical practice guidelines and now comparative effectiveness research (CER). He has been Chair or Co-Chair of 4 recent Institute of Medicine (IOM) committees: Guidance for the National Healthcare Disparities report; Cancer Survivors: Lost in Transition; Initial Priorities for Comparative Effectiveness Research; Clinical Practice Guidelines We Can Trust; and he has been a member of a number of prior IOM committees. He is currently Co-Senior Editor (with Dr. Gene Rich) of the new Journal of Comparative Effectiveness Research, which has reached index status in Medline in a short period of 3 years. He is a current member of the California Medi-Cal Performance Advisory Committee.
Seminars are FREE and open to the public. If you can not attend, Videotapes of Public Health seminars are archived through the UC Irvine OpenCourseWare program - please visit OpenCourseWare: http://ocw.uci.edu.