Notice Number: NOT-HS-16-016

Key Dates
Release Date: August 29, 2016

Issued by
Agency for Healthcare Research and Quality (http://www.ahrq.gov/)

Purpose

The mission of the Agency for Healthcare Research and Quality (AHRQ) is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used. AHRQ achieves this mission by supporting evidence synthesis, translation, and implementation of evidence into practice.

This Special Emphasis Notice (SEN) informs the research community that AHRQ intends to support research designed to develop innovative systematic review methods that address the opportunities and challenges of the current era of data abundance, and make systematic reviews both more efficient and salient. Systematic reviews transform individual studies into a form of evidence that can be used to underpin guidelines, quality indicators, patient decision aids, and other products that shape patient care. Innovative systematic review methods may increase the speed and power of systematic reviews, increasing their value to the health care system and the patients it serves.

Areas of Interest

This SEN is intended to generate new methods for systematic review that address the opportunities and challenges of the current era of data abundance and that facilitate the integration of systematic reviews into healthcare decisions. In the past, much of the work in systematic review methodology focused on developing the basic tools of systematic review, especially reliable and standardized approaches to scoping, searching, assessing, synthesizing, and grading the evidence. There are now widely shared standards for how to conduct a high quality systematic review. The next challenge is developing novel or improved methods that optimize the efficiency, comprehensiveness, and predictive value of systematic reviews. Some potential areas of interest are described below:

Efficiency. Traditional systematic review approaches may not be sustainable given the ever increasing volume of studies and increasing demand for timely synthesized evidence. Faster techniques, without sacrificing validity and reliability, are increasingly valuable. Possible approaches include automation, incorporation of existing systematic reviews, predictors of marginal return, continuous updates and data reduction techniques.

New forms of data. We are on the verge of having access to large data sets both observational data and individual patient data from randomized controlled trials and patient registries. Tapping directly into this data could greatly enhance the power of systematic reviews and reduce the lag between knowledge generation and implementation. Possible approaches might include Bayesian stepwise analysis, informative priors, data linkage, subgroup analysis, etc. How best to incorporate qualitative data into systematic reviews would be of interest as well.

Predictive value. Systematic review methodology is highly detailed for processes, but much less developed regarding outcomes. Now that a substantial number of systematic reviews have been completed and indexed, it may be possible to empirically examine how accurately different reviews predict future research findings and to use this information to develop more robust methods. Managing the tradeoff between Type I and Type II error is of particular concern.

Complex interventions. There has been an increase in the number of requests from stakeholders to synthesize evidence regarding effectiveness and harms of complex multicomponent health care interventions. However, because of their complexity, conducting reviews on multicomponent interventions is often challenging. AHRQ is interested in novel techniques or application of methods for synthesizing evidence for complex questions in systematic reviews, such as those related to implementation, multiple components, and context. Examples include but are not limited to qualitative comparative analysis and finite mixture models.

Stakeholder engagement. AHRQ is interested in determining the most effective way to incorporate stakeholder engagement into the systematic review process. Although AHRQ has particular interest in engaging patients and patient advocates, stakeholders also include guideline developers, policy- makers, etc. Studies which will identify types of activities, the optimal amount of engagement, and how much value stakeholder engagement adds to systematic reviews are encouraged.

These are just a few areas of methodological innovation of interest to AHRQ. We welcome innovative applications addressing systematic review methods and issues not mentioned above. Applicants should describe the significance of their proposed research to enhancing the speed, power, predictive value, or otherwise advancing the utility of systematic reviews.

Further Guidance

Priority Populations. Systematic review methods may be applied to primary research involving all populations regardless of age, gender, ethnicity, or socio-ethnic backgrounds. However, some populations are often underrepresented in clinical trials and therefore methods that address the issues discussed above in the context of priority populations are areas of interest to AHRQ. For purposes of this SEN, priority populations include low-income patients, the under- and uninsured, children, women, elderly, racial and ethnic minorities, and individuals with special health care needs.

Use of Funding Mechanism. AHRQ will use the standing R03 grant mechanism to support applications submitted in response to this notice. The standing R03 FOA, PA-15-147, can be found at https://grants.nih.gov/grants/guide/pa-files/PA-15-147.html.

Application Submission. Applicants should consider this SEN active for only three award cycles. These cycles have due dates on October 16, 2016, February 16, 2017, and June 16, 2017. AHRQ will provide updates of new developments and research priorities as research budget information becomes available. Applications will be reviewed by AHRQ's standing study sections. We strongly encourage applicants to indicate in their applications that they are responding to this notice by including the title and number of this SEN (NOT-HS-16-XXX) in their Specific Aims page.

Inquiries

Please direct all inquiries to:

Lionel L. Ba ez, M.D.
Agency for Healthcare Research and Quality (AHRQ)
Center for Evidence and Practice Improvement
Telephone: 301-427-1514
Email: [email protected]