|
Showing 1 - 6 of
6 matches in All Departments
When is it appropriate to return individual research results to
participants? The immense interest in this question has been
fostered by the growing movement toward greater transparency and
participant engagement in the research enterprise. Yet, the risks
of returning individual research results?such as results with
unknown validity?and the associated burdens on the research
enterprise are competing considerations. Returning Individual
Research Results to Participants reviews the current evidence on
the benefits, harms, and costs of returning individual research
results, while also considering the ethical, social, operational,
and regulatory aspects of the practice. This report includes 12
recommendations directed to various stakeholders?investigators,
sponsors, research institutions, institutional review boards
(IRBs), regulators, and participants?and are designed to help (1)
support decision making regarding the return of results on a
study-by-study basis, (2) promote high-quality individual research
results, (3) foster participant understanding of individual
research results, and (4) revise and harmonize current regulations.
Table of Contents Front Matter Summary 1 Introduction 2 Principles
for the Return of Individual Research Results: Ethical and Societal
Considerations 3 Laboratory Quality Systems for Research Testing of
Human Biospecimens 4 Processes to Enable Appropriate Decision
Making Regarding the Return of Individual Research Results 5
Advancing Practices for Returning Individual Research Results 6
Reshaping the Legal and Regulatory Landscape to Support Return of
Individual Research Results Appendix A: Study Approach and Methods
Appendix B: Public Agendas Appendix C: Analysis of Legal and
Regulatory Landscape Relevant to Return of Individual Results
Generated from Biospecimens in Research Appendix D: The Return of
Individual-Specific Research Results from Laboratories:
Perspectives and Ethical Underpinnings Appendix E: Biographical
Sketches of Committee Members, Consultants, and Staff
|
Medications for Opioid Use Disorder Save Lives (Paperback)
National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Committee on Medication-Assisted Treatment for Opioid Use Disorder; Edited by Michelle Mancher, …
|
R1,429
Discovery Miles 14 290
|
Ships in 12 - 17 working days
|
The opioid crisis in the United States has come about because of
excessive use of these drugs for both legal and illicit purposes
and unprecedented levels of consequent opioid use disorder (OUD).
More than 2 million people in the United States are estimated to
have OUD, which is caused by prolonged use of prescription opioids,
heroin, or other illicit opioids. OUD is a life-threatening
condition associated with a 20-fold greater risk of early death due
to overdose, infectious diseases, trauma, and suicide. Mortality
related to OUD continues to escalate as this public health crisis
gathers momentum across the country, with opioid overdoses killing
more than 47,000 people in 2017 in the United States. Efforts to
date have made no real headway in stemming this crisis, in large
part because tools that already exist?like evidence-based
medications?are not being deployed to maximum impact. To support
the dissemination of accurate patient-focused information about
treatments for addiction, and to help provide scientific solutions
to the current opioid crisis, this report studies the evidence base
on medication assisted treatment (MAT) for OUD. It examines
available evidence on the range of parameters and circumstances in
which MAT can be effectively delivered and identifies additional
research needed. Table of Contents Front Matter Summary 1
Introduction 2 The Effectiveness of Medication-Based Treatment for
Opioid Use Disorder 3 Treatment with Medications for Opioid Use
Disorder in Different Populations 4 Medications for Opioid Use
Disorder in Various Treatment Settings 5 Barriers to Broader Use of
Medications to Treat Opioid Use Disorder Appendix A: Study Approach
and Methods Appendix B: Public Workshop Agenda Appendix C:
Biographical Sketches of Committee Members
The 2014?2015 Ebola epidemic in western Africa was the longest and
most deadly Ebola epidemic in history, resulting in 28,616 cases
and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola
virus has been known since 1976, when two separate outbreaks were
identified in the Democratic Republic of Congo (then Zaire) and
South Sudan (then Sudan). However, because all Ebola outbreaks
prior to that in West Africa in 2014?2015 were relatively isolated
and of short duration, little was known about how to best manage
patients to improve survival, and there were no approved
therapeutics or vaccines. When the World Heath Organization
declared the 2014-2015 epidemic a public health emergency of
international concern in August 2014, several teams began
conducting formal clinical trials in the Ebola affected countries
during the outbreak. Integrating Clinical Research into Epidemic
Response: The Ebola Experience assesses the value of the clinical
trials held during the 2014?2015 epidemic and makes recommendations
about how the conduct of trials could be improved in the context of
a future international emerging or re-emerging infectious disease
events. Table of Contents Front Matter Summary 1 Introduction 2
Conducting Clinical Research During an Epidemic 3 Assessment of
Therapeutic Trials 4 Assessment of Vaccine Trials 5 Strengthening
Capacity for Response and Research 6 Engaging Communities in
Research and Response 7 Facilitating International Coordination and
Collaboration Appendix A: Study Approach and Methods Appendix B:
Clinical Trial Designs Appendix C: Ethical Principles for Research
with Human Subjects Appendix D: Biographical Sketches of Committee
Members and Staff
|
Clinical Practice Guidelines We Can Trust (Paperback, New)
Committee on Standards for Developing Trustworthy Clinical Practice Guidelines, Board on Health Care Services, Institute of Medicine; Edited by Robin Graham, Michelle Mancher, …
|
R1,564
Discovery Miles 15 640
|
Ships in 12 - 17 working days
|
Advances in medical, biomedical and health services research have
reduced the level of uncertainty in clinical practice. Clinical
practice guidelines (CPGs) complement this progress by establishing
standards of care backed by strong scientific evidence. CPGs are
statements that include recommendations intended to optimize
patient care. These statements are informed by a systematic review
of evidence and an assessment of the benefits and costs of
alternative care options. Clinical Practice Guidelines We Can Trust
examines the current state of clinical practice guidelines and how
they can be improved to enhance healthcare quality and patient
outcomes.
Clinical practice guidelines now are ubiquitous in our healthcare
system. The Guidelines International Network (GIN) database
currently lists more than 3,700 guidelines from 39 countries.
Developing guidelines presents a number of challenges including
lack of transparent methodological practices, difficulty
reconciling conflicting guidelines, and conflicts of interest.
Clinical Practice Guidelines We Can Trust explores questions
surrounding the quality of CPG development processes and the
establishment of standards. It proposes eight standards for
developing trustworthy clinical practice guidelines emphasizing
transparency; management of conflict of interest; systematic
review--guideline development intersection; establishing evidence
foundations for and rating strength of guideline recommendations;
articulation of recommendations; external review; and updating.
Clinical Practice Guidelines We Can Trust shows how clinical
practice guidelines can enhance clinician and patient
decision-making by translating complex scientific research findings
into recommendations for clinical practice that are relevant to the
individual patient encounter, instead of implementing a one size
fits all approach to patient care. This book contains information
directly related to the work of the Agency for Healthcare Research
and Quality (AHRQ), as well as various Congressional staff and
policymakers. It is a vital resource for medical specialty
societies, disease advocacy groups, health professionals, private
and international organizations that develop or use clinical
practice guidelines, consumers, clinicians, and payers.
Health care in the United States is more expensive than in other
developed countries, costing $2.7 trillion in 2011, or 17.9 percent
of the national gross domestic product. Increasing costs strain
budgets at all levels of government and threaten the solvency of
Medicare, the nation's largest health insurer. At the same time,
despite advances in biomedical science, medicine, and public
health, health care quality remains inconsistent. In fact,
underuse, misuse, and overuse of various services often put
patients in danger. Many efforts to improve this situation are
focused on Medicare, which mainly pays practitioners on a
fee-for-service basis and hospitals on a diagnoses-related group
basis, which is a fee for a group of services related to a
particular diagnosis. Research has long shown that Medicare
spending varies greatly in different regions of the country even
when expenditures are adjusted for variation in the costs of doing
business, meaning that certain regions have much higher volume
and/or intensity of services than others. Further, regions that
deliver more services do not appear to achieve better health
outcomes than those that deliver less. Variation in Health Care
Spending investigates geographic variation in health care spending
and quality for Medicare beneficiaries as well as other
populations, and analyzes Medicare payment policies that could
encourage high-value care. This report concludes that regional
differences in Medicare and commercial health care spending and use
are real and persist over time. Furthermore, there is much
variation within geographic areas, no matter how broadly or
narrowly these areas are defined. The report recommends against
adoption of a geographically based value index for Medicare
payments, because the majority of health care decisions are made at
the provider or health care organization level, not by geographic
units. Rather, to promote high value services from all providers,
Medicare and Medicaid Services should continue to test payment
reforms that offer incentives to providers to share clinical data,
coordinate patient care, and assume some financial risk for the
care of their patients. Medicare covers more than 47 million
Americans, including 39 million people age 65 and older and 8
million people with disabilities. Medicare payment reform has the
potential to improve health, promote efficiency in the U.S. health
care system, and reorient competition in the health care market
around the value of services rather than the volume of services
provided. The recommendations of Variation in Health Care Spending
are designed to help Medicare and Medicaid Services encourage
providers to efficiently manage the full range of care for their
patients, thereby increasing the value of health care in the United
States.
Interim Report of the Committee on Geographic Variation in Health
Care Spending and Promotion of High-Value Health Care: Preliminary
Committee Observations is designed to provide the committee's
preliminary observations for the 113th Congress as it considers
further Medicare reform. This report contains only key preliminary
observations related primarily to the committee's commissioned
analyses of Medicare Parts A (Hospital Insurance program), B
(Supplementary Medical Insurance program) and D (outpatient
prescription drug benefit), complemented by other empirical
investigations. It does not contain any observations related to the
committee's commissioned analyses of the commercial insurer
population, Medicare Advantage, or Medicaid, which will be
presented in the committee's final report after completion of
quality-control activities. This interim report excludes
conclusions or recommendations related to the committee's
consideration of the geographic value index or other payment
reforms designed to promote highvalue care. Additional analyses are
forthcoming, which will influence the committee's deliberations.
These analyses include an exploration of how Medicare Part C
(Medicare Advantage) and commercial spending, utilization, and
quality vary compared with, and possibly are influenced by,
Medicare Parts A and B spending, utilization, and quality. The
committee also is assessing potential biases that may be inherent
to Medicare and commercial claims-based measures of health status.
Based on this new evidence and continued review of the literature,
the committee will confirm the accuracy of the observations
presented in this interim report and develop final conclusions and
recommendations, which will be published in the committee's final
report. Table of Contents Front Matter Interim Report REFERENCES
Appendix A: Glossary Appendix B: Statement of Task
|
You may like...
Loot
Nadine Gordimer
Paperback
(2)
R398
R330
Discovery Miles 3 300
Morbius
Jared Leto, Matt Smith, …
DVD
R179
Discovery Miles 1 790
Ab Wheel
R209
R149
Discovery Miles 1 490
|