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Harlan M. Krumholz - One of the best experts on this subject based on the ideXlab platform.
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How well does early-career investigators' cardiovascular Outcomes Research training align with funded Outcomes Research?
American Heart Journal, 2018Co-Authors: Matthew J Crowley, Harlan M. Krumholz, Prateeti Khazanie, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Sana M. Al-khatib, Sean M. O'brien, Eric D. PetersonAbstract:Background Outcomes Research training programs should prepare trainees to successfully compete for Research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) Outcomes Research. Methods We (1) reviewed literature to identify 13 core competency areas in CV Outcomes Research; (2) surveyed early-career investigators to understand their prior and desired training in each competency area; (3) examined recently funded grants commonly pursued by early-career Outcomes Researchers to ascertain available funding in competency areas; and (4) analyzed alignment between investigator training and funded Research in each competency area. We evaluated 185 survey responses from early-career investigators (response rate 28%) and 521 funded grants from 2010 to 2014. Results Respondents' prior training aligned with funded grants in the areas of clinical epidemiology, observational Research, randomized controlled trials, and implementation/dissemination Research. Funding in community-engaged Research and health informatics was more common than prior training in these areas. Respondents' prior training in biostatistics and systematic review was more common than funded grants focusing on these specific areas. Respondents' desired training aligned similarly with funded grants, with some exceptions; for example, desired training in health economics/cost-effectiveness Research was more common than funded grants in these areas. Restricting to CV grants (n = 132) and National Heart, Lung, and Blood Institute–funded grants (n = 170) produced similar results. Conclusions Identifying mismatch between funded grants in Outcomes Research and early-career investigators' prior/desired training may help efforts to harmonize investigator interests, training, and funding. Our findings suggest a need for further consideration of how to best prepare early-career investigators for funding success.
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Priorities for Cardiovascular Outcomes Research: A Report of the National Heart, Lung, and Blood Institute's Centers for Cardiovascular Outcomes Research Working Group.
Circulation: Cardiovascular Quality and Outcomes, 2017Co-Authors: Prateeti Khazanie, Harlan M. Krumholz, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Eric D. PetersonAbstract:The Centers for Cardiovascular Outcomes Research (CCORs) held a meeting to review how cardiovascular Outcomes Research had evolved in the decade since the National Heart, Lung, and Blood Institute 2004 working group report and to consider future directions. The conference involved representatives from governmental agencies, Outcomes Research thought leaders, and public and private healthcare partners. The main purposes of this meeting were to (1) advance collaborative high-yield, high-impact Outcomes Research; (2) identify priorities and barriers to important cardiovascular Outcomes Research; and (3) define future needs for the field. This report highlights the key topics covered during the meeting, including an examination of the recent history of Outcomes Research, an evaluation of the current academic climate, and a vision for the future of cardiovascular Outcomes Research.
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seeing through the eyes of patients the patient centered Outcomes Research institute funding announcements
Annals of Internal Medicine, 2012Co-Authors: Harlan M. Krumholz, Joe V. SelbyAbstract:The Patient-Centered Outcomes Research Institute (PCORI), with resources provided through the Patient Protection and Affordable Care Act, will invest more than $3 billion between now and 2019 in re...
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Real-world imperative of Outcomes Research.
JAMA, 2011Co-Authors: Harlan M. KrumholzAbstract:The Patient Protection and Affordable Care Act characterizes Outcomes Research as a field that determines how “diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed. . . . ” Stated another way, Outcomes Research is scientific investigation that generates knowledge to guide health care decisions and promote optimal results from preventive, diagnostic, prognostic, and therapeutic health care strategies. The goal is to increase the likelihood that patients achieve the Outcomes they desire through better information, better decisions, and better health care delivery. Toward this end, Outcomes Research uses a diverse array of study designs and data sources. It draws from clinical medicine, statistics, informatics, epidemiology, and the social sciences. Outcomes Research derives directly from real-world practice and policy. It seeks to determine what is being achieved for patients and how clinicians can do better. The emphasis is on Outcomes that patients experience, not on measurements that are surrogates for what may happen (eg, biomarkers) because those measures often fail to predict the effect of interventions. Outcomes Research purposely directs attention to effects in typical patients across a spectrum of venues with emphasis on characteristics that may influence Outcomes. Thus, it generates information about treatment patterns, risks, benefits, and costs that can be tailored to individuals. The questions and priorities of Outcomes Research ideally derive from partnerships with those (patients, clinicians, purchasers, and policy makers) who may use the results. Such relationships can bridge the gap that often exists between the published Research and the information needs of decision makers. Domains of Outcomes Research
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Emphasizing Methods in Outcomes Research
Circulation: Cardiovascular Quality and Outcomes, 2011Co-Authors: Harlan M. KrumholzAbstract:Outcomes Research focuses on the end results of health care, with emphasis on the patient experience. The field is not a singular discipline, but rather draws on a broad range of primary fields to produce knowledge that can inform decisions at the patient and health system level. Outcomes Research uses a wide spectrum of methods that include experimental and nonexperimental designs. It is distinctive in its focus on questions that are relevant to optimizing efforts to promote the health of patients and populations, with an emphasis on aligning decisions to the preferences, values and goals of those individuals. The richness of methodological approaches to Outcomes Research is apparent in the pages of Circulation: Cardiovascular Quality and Outcomes . Examples include articles that report on randomized trials,1,2 cross-sectional studies,3 observational cohort studies,4 economic analyses,5–7 meta-analyses,8 systematic reviews,9,10 prepost designs,11 simulations,12 and qualitative Research.13,14 A glance at this content quickly dispels …
Eric D. Peterson - One of the best experts on this subject based on the ideXlab platform.
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How well does early-career investigators' cardiovascular Outcomes Research training align with funded Outcomes Research?
American Heart Journal, 2018Co-Authors: Matthew J Crowley, Harlan M. Krumholz, Prateeti Khazanie, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Sana M. Al-khatib, Sean M. O'brien, Eric D. PetersonAbstract:Background Outcomes Research training programs should prepare trainees to successfully compete for Research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) Outcomes Research. Methods We (1) reviewed literature to identify 13 core competency areas in CV Outcomes Research; (2) surveyed early-career investigators to understand their prior and desired training in each competency area; (3) examined recently funded grants commonly pursued by early-career Outcomes Researchers to ascertain available funding in competency areas; and (4) analyzed alignment between investigator training and funded Research in each competency area. We evaluated 185 survey responses from early-career investigators (response rate 28%) and 521 funded grants from 2010 to 2014. Results Respondents' prior training aligned with funded grants in the areas of clinical epidemiology, observational Research, randomized controlled trials, and implementation/dissemination Research. Funding in community-engaged Research and health informatics was more common than prior training in these areas. Respondents' prior training in biostatistics and systematic review was more common than funded grants focusing on these specific areas. Respondents' desired training aligned similarly with funded grants, with some exceptions; for example, desired training in health economics/cost-effectiveness Research was more common than funded grants in these areas. Restricting to CV grants (n = 132) and National Heart, Lung, and Blood Institute–funded grants (n = 170) produced similar results. Conclusions Identifying mismatch between funded grants in Outcomes Research and early-career investigators' prior/desired training may help efforts to harmonize investigator interests, training, and funding. Our findings suggest a need for further consideration of how to best prepare early-career investigators for funding success.
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Priorities for Cardiovascular Outcomes Research: A Report of the National Heart, Lung, and Blood Institute's Centers for Cardiovascular Outcomes Research Working Group.
Circulation: Cardiovascular Quality and Outcomes, 2017Co-Authors: Prateeti Khazanie, Harlan M. Krumholz, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Eric D. PetersonAbstract:The Centers for Cardiovascular Outcomes Research (CCORs) held a meeting to review how cardiovascular Outcomes Research had evolved in the decade since the National Heart, Lung, and Blood Institute 2004 working group report and to consider future directions. The conference involved representatives from governmental agencies, Outcomes Research thought leaders, and public and private healthcare partners. The main purposes of this meeting were to (1) advance collaborative high-yield, high-impact Outcomes Research; (2) identify priorities and barriers to important cardiovascular Outcomes Research; and (3) define future needs for the field. This report highlights the key topics covered during the meeting, including an examination of the recent history of Outcomes Research, an evaluation of the current academic climate, and a vision for the future of cardiovascular Outcomes Research.
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report of the national heart lung and blood institute working group on Outcomes Research in cardiovascular disease
Circulation, 2005Co-Authors: Harlan M. Krumholz, Catarina I. Kiefe, Eric D. Peterson, John Z Ayanian, Marshall H Chin, Robert F Debusk, Lee Goldman, Neil R Powe, John S Rumsfeld, John A. SpertusAbstract:The National Heart, Lung, and Blood Institute convened a working group on Outcomes Research in cardiovascular disease (CVD). The working group sought to provide guidance on Research priorities in Outcomes Research related to CVD. For the purposes of this document, "Outcomes Research" is defined as investigative endeavors that generate knowledge to improve clinical decision making and healthcare delivery to optimize patient Outcomes. The working group identified the following priority areas: (1) national surveillance projects for high-prevalence CV conditions; (2) patient-centered care; (3) translation of the best science into clinical practice; and (4) studies that place the cost of interventions in the context of their real-world effectiveness. Within each of these topics, the working group described examples of initiatives that could serve the Institute and the public. In addition, the group identified the following areas that are important to the field: (1) promotion of the use of existing data; (2) facilitation of collaborations with other federal agencies; (3) investigations into the basic science of Outcomes Research, with an emphasis on methodological advances; (4) strengthening of appropriate study sections with individuals who have expertise in Outcomes Research; and (5) expansion of opportunities to train new Outcomes Research investigators. The working group concluded that a dedicated investment in CV Outcomes Research could directly improve the care delivered in the United States. (Circulation. 2005;111:3158-3166.)
John A. Spertus - One of the best experts on this subject based on the ideXlab platform.
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Careers in Cardiovascular Outcomes Research
Circulation, 2009Co-Authors: Mikhail Kosiborod, John A. SpertusAbstract:To best understand the field and goals of Outcomes Research, it is important to appreciate the challenges that confront our healthcare system. Although considerable advances in patient care have been made over the last several decades, patients, physicians, and payers continue to struggle with rising costs and inefficiencies, poor application of evidence to clinical care, fragmentation, misaligned incentives, disparities, suboptimal patient safety, and lack of patient-centeredness. In its seminal 2001 report, Crossing the Quality Chasm: A New Health System for the Twenty-first Century , the Institute of Medicine concluded that the US healthcare system has fallen far short of its potential to deliver care in a safe, timely, equitable, efficient, evidence-based or patient-centered manner.1 They called for a complete redesign of the way in which we currently practice and deliver care. The field of Outcomes Research is ideally positioned to address most of these challenges. Outcomes Research focuses on what is ultimately achieved by our efforts in healthcare. It seeks not only to describe the “end-result of healthcare” (patient Outcomes) and its determinants but also to develop solutions to improve the Outcomes by aligning the needs of patients with the performance of physicians and the healthcare system with the use of available resources.2,3 The field of Outcomes Research ranges from everyday clinical decision making that affects individual physicians and patients to population science, health economics, and policy. As such, Outcomes Research lies at the interface of multiple scientific disciplines, including clinical epidemiology, biostatistics, qualitative Research, behavioral science, organizational theory, ethics, decision analysis, health system economics, health policy, health informatics, and the sciences of quality improvement and implementation Research. Understanding and integrating these multiple disciplines can accelerate the pace and application of insights into practice. Therefore, to be a successful Outcomes Researcher, one should ultimately be contributing toward the …
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report of the national heart lung and blood institute working group on Outcomes Research in cardiovascular disease
Circulation, 2005Co-Authors: Harlan M. Krumholz, Catarina I. Kiefe, Eric D. Peterson, John Z Ayanian, Marshall H Chin, Robert F Debusk, Lee Goldman, Neil R Powe, John S Rumsfeld, John A. SpertusAbstract:The National Heart, Lung, and Blood Institute convened a working group on Outcomes Research in cardiovascular disease (CVD). The working group sought to provide guidance on Research priorities in Outcomes Research related to CVD. For the purposes of this document, "Outcomes Research" is defined as investigative endeavors that generate knowledge to improve clinical decision making and healthcare delivery to optimize patient Outcomes. The working group identified the following priority areas: (1) national surveillance projects for high-prevalence CV conditions; (2) patient-centered care; (3) translation of the best science into clinical practice; and (4) studies that place the cost of interventions in the context of their real-world effectiveness. Within each of these topics, the working group described examples of initiatives that could serve the Institute and the public. In addition, the group identified the following areas that are important to the field: (1) promotion of the use of existing data; (2) facilitation of collaborations with other federal agencies; (3) investigations into the basic science of Outcomes Research, with an emphasis on methodological advances; (4) strengthening of appropriate study sections with individuals who have expertise in Outcomes Research; and (5) expansion of opportunities to train new Outcomes Research investigators. The working group concluded that a dedicated investment in CV Outcomes Research could directly improve the care delivered in the United States. (Circulation. 2005;111:3158-3166.)
Ulrich Guller - One of the best experts on this subject based on the ideXlab platform.
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Surgical Outcomes Research Based on Administrative Data: Inferior or Complementary to Prospective Randomized Clinical Trials?
World Journal of Surgery, 2006Co-Authors: Ulrich GullerAbstract:The importance of surgical Research has gained new prominence over the past decades as the relevance of well designed and well conducted studies has become increasingly evident. There are two basic but diametrically different methods of conducting Research: the prospective randomized clinical trial and the retrospective surgical Outcomes study based on administrative data. Administrative databases contain data that were initially collected for purposes other than scientific Research. Whereas the prospective randomized clinical trial is familiar to most surgeons, surgical Outcomes Research based on administrative data constitutes a genre of investigation that is often unfamiliar to and even disparaged by the surgical community. In the present article, the strengths and weaknesses of both prospective randomized clinical trials and retrospective surgical Outcomes Research are discussed. Specifically, the advantages and limitations of investigations based on large administrative databases are outlined. Because both study designs play an important role in surgical Research, carefully designed and implemented surgical Outcomes Research based on administrative data should be viewed as being complementary and not inferior to prospective randomized clinical trials.
Catarina I. Kiefe - One of the best experts on this subject based on the ideXlab platform.
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How well does early-career investigators' cardiovascular Outcomes Research training align with funded Outcomes Research?
American Heart Journal, 2018Co-Authors: Matthew J Crowley, Harlan M. Krumholz, Prateeti Khazanie, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Sana M. Al-khatib, Sean M. O'brien, Eric D. PetersonAbstract:Background Outcomes Research training programs should prepare trainees to successfully compete for Research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) Outcomes Research. Methods We (1) reviewed literature to identify 13 core competency areas in CV Outcomes Research; (2) surveyed early-career investigators to understand their prior and desired training in each competency area; (3) examined recently funded grants commonly pursued by early-career Outcomes Researchers to ascertain available funding in competency areas; and (4) analyzed alignment between investigator training and funded Research in each competency area. We evaluated 185 survey responses from early-career investigators (response rate 28%) and 521 funded grants from 2010 to 2014. Results Respondents' prior training aligned with funded grants in the areas of clinical epidemiology, observational Research, randomized controlled trials, and implementation/dissemination Research. Funding in community-engaged Research and health informatics was more common than prior training in these areas. Respondents' prior training in biostatistics and systematic review was more common than funded grants focusing on these specific areas. Respondents' desired training aligned similarly with funded grants, with some exceptions; for example, desired training in health economics/cost-effectiveness Research was more common than funded grants in these areas. Restricting to CV grants (n = 132) and National Heart, Lung, and Blood Institute–funded grants (n = 170) produced similar results. Conclusions Identifying mismatch between funded grants in Outcomes Research and early-career investigators' prior/desired training may help efforts to harmonize investigator interests, training, and funding. Our findings suggest a need for further consideration of how to best prepare early-career investigators for funding success.
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Priorities for Cardiovascular Outcomes Research: A Report of the National Heart, Lung, and Blood Institute's Centers for Cardiovascular Outcomes Research Working Group.
Circulation: Cardiovascular Quality and Outcomes, 2017Co-Authors: Prateeti Khazanie, Harlan M. Krumholz, Catarina I. Kiefe, Nancy R. Kressin, Barbara L. Wells, Tracy Y. Wang, Eric D. PetersonAbstract:The Centers for Cardiovascular Outcomes Research (CCORs) held a meeting to review how cardiovascular Outcomes Research had evolved in the decade since the National Heart, Lung, and Blood Institute 2004 working group report and to consider future directions. The conference involved representatives from governmental agencies, Outcomes Research thought leaders, and public and private healthcare partners. The main purposes of this meeting were to (1) advance collaborative high-yield, high-impact Outcomes Research; (2) identify priorities and barriers to important cardiovascular Outcomes Research; and (3) define future needs for the field. This report highlights the key topics covered during the meeting, including an examination of the recent history of Outcomes Research, an evaluation of the current academic climate, and a vision for the future of cardiovascular Outcomes Research.
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report of the national heart lung and blood institute working group on Outcomes Research in cardiovascular disease
Circulation, 2005Co-Authors: Harlan M. Krumholz, Catarina I. Kiefe, Eric D. Peterson, John Z Ayanian, Marshall H Chin, Robert F Debusk, Lee Goldman, Neil R Powe, John S Rumsfeld, John A. SpertusAbstract:The National Heart, Lung, and Blood Institute convened a working group on Outcomes Research in cardiovascular disease (CVD). The working group sought to provide guidance on Research priorities in Outcomes Research related to CVD. For the purposes of this document, "Outcomes Research" is defined as investigative endeavors that generate knowledge to improve clinical decision making and healthcare delivery to optimize patient Outcomes. The working group identified the following priority areas: (1) national surveillance projects for high-prevalence CV conditions; (2) patient-centered care; (3) translation of the best science into clinical practice; and (4) studies that place the cost of interventions in the context of their real-world effectiveness. Within each of these topics, the working group described examples of initiatives that could serve the Institute and the public. In addition, the group identified the following areas that are important to the field: (1) promotion of the use of existing data; (2) facilitation of collaborations with other federal agencies; (3) investigations into the basic science of Outcomes Research, with an emphasis on methodological advances; (4) strengthening of appropriate study sections with individuals who have expertise in Outcomes Research; and (5) expansion of opportunities to train new Outcomes Research investigators. The working group concluded that a dedicated investment in CV Outcomes Research could directly improve the care delivered in the United States. (Circulation. 2005;111:3158-3166.)
