Great Quotes about Effectiveness Research

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Great Quotes about Effectiveness Research . Taken from presentations given at the 2013 National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Conference, London 9–10 October. Contents – selected slides from:. Dinner speech : Nifty shades of grey – that’s your HTA - PowerPoint PPT Presentation

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Taken from presentations given at the 2013 National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Conference, London 910 OctoberGreat Quotes about Effectiveness Research Contents selected slides from:Dinner speech: Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonSlides 39

Presentation: Reflections on the HTA Programme and where it is todaySir Iain Chalmers, Health Services Researcher and Coordinator of the James Lind InitiativeSlides 1011

Presentation: Comparative Effectiveness Research: Recent Developments in the USASean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USASlides 1217

Most research seems to forgetthat science serves human beings social human beings who dont fit into neat boxes, who are not the rational, linear thinking logical beings that many in the evidencebased movement assume them to be; human beings who, on the contrary, are irrational and illogical.Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonSuccesses are all about eschewing the false choices between black and white. It's about combining the two to find the right shades of grey. Its about finding deft ways to resolve the essential tensions3 that we constantly live with. How else do clinicians and policy makers arrive at complex practical decisions in the ever different circumstances that beset their daytoday practice? It's not about research or judgment, nor about RCTs or experience. It's always about both.Thomas Kuhn first used this term in this context in his influential essay on divergent and convergent thinking in science and education. Kuhn T S (1977) The Essential Tension Chicago University Press.Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonWe argue between two extremes, often taking up entrenched positions, when deep down we know that they are forced, false choices:Primary research or secondary research?RCTs or observational studies? Quantitative or qualitative? Carrots or sticks? Black or White? The answers may well not be one or the other but usually both.Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of Southamptonwith our ageing population how clinically useful are the results of nonpragmatic trials restricted to patients under 65 years of age with no comorbidity, unless clinicians mostly add gallons of clinical judgment when making decisions based on them?Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonWe still find ourselves debating whether to do:Ethnographic work on the nature of a complex intervention to see if it works No! If you don't measure it, it's not science!, or Do trials No! If you can measure it, its probably not it!Why not much more often consciously and systematically go for both? After all, both are necessary and neither is sufficient.Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonTrials, even perfectly executed pragmatic ones, are not and never could be the whole story. Pursuing the development of other methods, even of rigorous critically appraising evidence other than research evidence, may pay dividends.Nifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonGiven that peoples views of scientific findings are so coloured by their tribal allegiances [it is astute to include] a wide spectrum of different interest groups throughout the entire process, so that their views can be absorbed a suitably counterbalanced waya long list of Ps:Patients, Physicians, Professionals, Providers, Purchasers/ Payers, Public health, Policy makers, Politicians, Press, Public, and Producers of the technologies, e.g. Pharma, and also the Primary research. It is by [being] inclusive, so that differing values and interests are at least debated and negotiated if not neutralised, that ensures research actually fits its contextNifty shades of grey thats your HTAJohn Gabbay, Emeritus Professor of Public Health, University of SouthamptonReflections on the HTA Programme and where it is today

Sir Iain Chalmers, Health Services Researcher and Coordinator of the James Lind InitiativeI need permission to give a drug to half of my patients, but not to give it to them all.Richard SmithellsReflections on the HTA Programme and where it is today

Sir Iain Chalmers, Health Services Researcher and Coordinator of the James Lind InitiativeThe clinician who is convinced that a certain treatment works will almost never find an ethicist in his path, whereas his colleague who wonders and doubts and wants to learn will stumble over piles of them.Lancet Editorial 1990Comparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USAThe tipping point for comparative effectiveness research in the USA came in 207:

Better information about the costs and benefits of different treatment options, combined with new incentive structures reflecting the information.is essential to putting the country on a sounder long-term fiscal path.Peter Orszag, Congressional Budget OfficeSenate testimony, June 2007Comparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USA

Long-term fiscal gap and healthcare costsComparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USAComparative Effectiveness Research (CER) hypothesis:Gaps in evidence will be reduced with greater engagement of end users (decision makers = patients, clinicians, payers) inIdentifying most important uncertaintiesDeveloping study protocols / methodsImplementing studiesApplying evidence in context of payment reforms that reward efficiencyComparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USA

Comparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USA

Comparative Effectiveness Research: Recent Developments in the USA

Sean Tunis, Founder, President & CEO, Center for Medical Technology Policy, USA