Agency for Healthcare Research and Quality Evidence-based Practice Center methods provide guidance on prioritization and selection of harms in systematic reviews

Roger Chou, William L. Baker, Lionel L. Bañez, Suchitra Iyer, Evan R. Myers, Sydne Newberry, Laura Pincock, Karen A. Robinson, Lyndzie Sardenga, Nila Sathe, Stacey Springs, Timothy J. Wilt

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Objectives: Systematic reviews should provide balanced assessments of benefits and harms, while focusing on the most important outcomes. Selection of harms to be reviewed can be a challenge due to the potential for large numbers of diverse harms. Study Design and Setting: A workgroup of methodologists from Evidence-based Practice Centers (EPCs) developed consensus-based guidance on selection and prioritization of harms in systematic reviews. Recommendations were informed by a literature scan, review of Evidence-based Practice Center reports, and interviews with experts in conducting reviews or assessing harms and persons representing organizations that commission or use systematic reviews. Results: Ten recommendations were developed on selection and prioritization of harms, including routinely focusing on serious as well as less serious but frequent or bothersome harms; routinely engaging stakeholders and using literature searches and other data sources to identify important harms; using a prioritization process (formal or less formal) to inform selection decisions; and describing the methods used to select and prioritize harms. Conclusion: We provide preliminary guidance for a more structured approach to selection and prioritization of harms in systematic reviews.

Original languageEnglish (US)
Pages (from-to)98-104
Number of pages7
JournalJournal of Clinical Epidemiology
Volume98
DOIs
StatePublished - Jun 2018

Bibliographical note

Funding Information:
Disclaimer: This project was funded through contracts from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services to the following Evidence-based Practice Centers: Pacific Northwest (HHSA 290 2015 00009I); Brown (HHSA 290 2015 00002I); Connecticut (HHSA 290 2015 00012I); Duke (HHSA 290 2015 00004I); Johns Hopkins (HHSA 290 2015 00006I); Minnesota (HHSA 290 2015 00008I); RAND (HHSA 290 2015 00010I); Vanderbilt (HHSA 290 2015 00003I), and the Scientific Resource Center under Contract No. HHSA 290-2012-0004-C. The authors of this article are responsible for its content, including any clinical treatment recommendations. No statement in this article should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

Publisher Copyright:
© 2018 Elsevier Inc.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Adverse effects
  • Comparative effectiveness review
  • Harms
  • Recommendations
  • Study methodology
  • Systematic reviews

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