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医疗保健领域声明的科学评估与审查(SEaRCH):一种用于确定医疗保健中“有效方法”的简化、系统、分阶段方法。

Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining "What Works" in Healthcare.

作者信息

Jonas Wayne B, Crawford Cindy, Hilton Lara, Elfenbaum Pamela

机构信息

1 Samueli Institute , Alexandria, VA.

2 RAND Corporation , Santa Monica, CA.

出版信息

J Altern Complement Med. 2017 Jan;23(1):18-25. doi: 10.1089/acm.2016.0291. Epub 2016 Dec 27.

Abstract

BACKGROUND

Answering the question of "what works" in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias.

METHODS

SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods-CAP, REAL, and EP-can be integrated into a strategic approach to help answer the question "what works in healthcare?" and what it means in a comprehensive way.

DISCUSSION

SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and wellness.

摘要

背景

回答医疗保健领域“什么有效”的问题可能很复杂,需要精心设计并按顺序应用系统方法。在过去十年中,萨缪利研究所与多个合作伙伴共同开发了一种简化的、系统的、分阶段的方法来处理这个过程,称为医疗保健索赔的科学评估与审查(SEaRCH™)。SEaRCH过程提供了一种方法,能够以最小的偏差,严谨、高效且透明地就研究和实践中的医疗保健索赔做出基于证据的决策。

方法

SEaRCH采用三种方法以协调的方式结合使用,以帮助确定医疗保健领域中什么有效。第一种方法是索赔评估概况(CAP),旨在阐明医疗保健索赔和问题,以及在其实施背景下进行评估的能力。第二种方法是文献快速证据评估(REAL),这是一个简化的系统综述过程,用于确定证据的数量、质量和强度以及治疗措施的风险/益处。第三种方法涉及专家小组(EP)的结构化运用。根据目的和需求,有几种类型的专家小组。这三种方法——CAP、REAL和EP——可以整合为一种战略方法,以全面回答“医疗保健领域中什么有效?”以及这意味着什么的问题。

讨论

SEaRCH是一种系统、严谨的方法,用于以高效且逐步的方式评估疗法、实践、项目或产品的医疗保健索赔。它提供了一个迭代的、由协议驱动的过程,该过程针对干预措施、消费者和背景进行定制。包括参与卫生服务和政策制定的多个群体都可以从这个有组织的框架中受益,确保基于证据的原则决定哪些最有前景的医疗保健实践用于改善公众的健康和福祉。

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