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Initial National Priorities for Comparative Effectiveness Research (2009)

Chapter: Appendix D: Cardiovascular and Peripheral Vascular Cover Sheet

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Suggested Citation:"Appendix D: Cardiovascular and Peripheral Vascular Cover Sheet." Institute of Medicine. 2009. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: The National Academies Press. doi: 10.17226/12648.
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Page 199
Suggested Citation:"Appendix D: Cardiovascular and Peripheral Vascular Cover Sheet." Institute of Medicine. 2009. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: The National Academies Press. doi: 10.17226/12648.
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Page 200
Suggested Citation:"Appendix D: Cardiovascular and Peripheral Vascular Cover Sheet." Institute of Medicine. 2009. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: The National Academies Press. doi: 10.17226/12648.
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Page 201
Suggested Citation:"Appendix D: Cardiovascular and Peripheral Vascular Cover Sheet." Institute of Medicine. 2009. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: The National Academies Press. doi: 10.17226/12648.
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Page 202

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Appendix D Cardiovascular and Peripheral Vascular Cover Sheet This is one of 32 cover sheets addressing the research areas represented by the nominated topics provided to the committee to guide their prioriti- zation process. The data included the committee’s condition-level criteria pertinent to the specific research area. (n) the number in parenthesis signifies the number of conditions on the particular list X signifies condition appears on the list of the top (n) conditions Blank signifies that condition does not appear on the list of the top (n) conditions Prevalence—Number of people receiving care for selected conditions, 2006 MEPS Survey Data All age groups Age 0-1 years Ages 1-17 Condition (20) (5) years (11) 65+ years (8) Hypertension X X Hyperlipidemia X X Heart conditions X X Mortality—Number of deaths, 2005 National and Vital Statistics Report All age Age 0-1 Ages 1-14 65+ years Condition groups (20) years (8) years (6) (20) Ischemic heart X X diseases Acute myocardial X X Infarction 199

200 INITIAL NATIONAL PRIORITIES FOR CER All age Age 0-1 Ages 1-14 65+ years Condition groups (20) years (8) years (6) (20) Cerebrovascular X X diseases Heart failure X X Hypertensive heart X X disease Major cardiovascular X diseases Diseases of heart X Morbidity—Number of events for selected conditions including: Hospital outpatient or office based, Hospital inpatient, ER, Home health visits, and Prescribed medicines, 2006 MEPS Survey Data Condition All age groups (12) Ages 0-17 years (12) Hypertension X Heart conditions X Cost—Total expenses for selected conditions including: Hospital out- patient or office based, Hospital inpatient, ER, Home health visits, and Prescribed medicines, 2006 MEPS Survey Data All ages Age 0-1 years Age 1-17 years Age 65+ years Condition (10) (10) (10) (10) Heart conditions X X Hypertension X X

APPENDIX D 201 Variability—The Dartmouth Institute for Health Policy and Clinical Prac- tice Data, 2005 Variation of hospitalization for Variation in treatment for Condition procedure (11) conditions (11) Congestive heart X failure Cardiac arrhythmia X Stroke X PCI X Lower extremity X bypass Carotid X endarterectomy CABG X Condition Appears on Other Priority Lists AHRQ Effective National Health Care Healthy People Quality Cochrane Condition program (19) 2010 (32) Forum (5) (15) Cardiovascular disease, X X X including stroke and hypertension Funding Gap—Number of Trials by Sponsor Type, February 2000 to April 2009 Clinicaltrials.gov Other Federal Universities/ Condition NIH Industry Agencies Organizations Total Anticoagulant therapy 6 43 1 37 74 for myocardial infarction Anticoagulant therapy 9 43 0 44 81 for stroke Cardiac imaging 107 154 3 287 537

202 INITIAL NATIONAL PRIORITIES FOR CER Other Federal Universities/ Condition NIH Industry Agencies Organizations Total Congestive heart 87 227 35 268 537 failure Hyperlipidemia 103 365 22 257 666 Hypertension 535 1080 74 1211 2616 Stable angina pectoris   93   151    6   262   439 or acute coronary syndrome ReferenceS AHRQ (Agency for Healthcare Research and Quality). 2009. Medical Expenditure Panel Survey. http://www.meps.ahrq.gov/mepsweb/ (accessed March 10, 2009). Doyle, J., E. Waters, D. Yach, D. McQueen, A. De Francisco, T. Stewart, P. Reddy, A. M. Gul- mezoglu, G. Galea, and A. Portela. 2005. Global priority setting for Cochrane systematic reviews of health promotion and public health research. Journal of Epidemiology and Community Health 59:193-197. HHS (Department of Health and Human Services). 2000. Healthy People 2010: Understand- ing and improving health. Place Published: U.S. Government Printing Office. http://purl. access.gpo.gov/GPO/LPS4217 (accessed April 3, 2009). Kung, H.-C., D. L. Hoyert, J. Xu, S. L. Murphy, and Division of Vital Statistics. 2008. Deaths: Final data for 2005. National Vital Statistics Reports National Center for Health Statistics. NIH (National Institutes of Health). 2009. Clinicaltrials.Gov. http://www.clinicaltrials.gov/ (accessed June 5, 2009). NPP (National Priorities Partnership). 2008. National priorities and goals. Washington, DC: National Quality Forum. Wennberg, J. E. 2009 (unpublished). Recommendations to the Institute of Medicine on com- parative effectiveness research priorities. Submitted in response to a request from the Institute of Medicine Committee on Comparative Effectiveness Research Prioritization. The Dartmouth Institute for Health Policy and Clinical Practice. Whitlock, E. P., S. A. Lopez, S. Chang, M. Helfand, M. Eder, and N. Floyd. 2009. Identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the Effective Health Care Program. http://effectivehealthcare.ahrq.gov/repFiles/ 20090427IdenttifyingTopics.pdf (accessed June 5, 2009).

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Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise.

As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.

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