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The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute

Pacific Northwest Evidence-based Practice Center (PNW EPC)

The Pacific Northwest Evidence-based Practice Center (PNW EPC) conducts systematic reviews, meta-analyses, and network meta-analyses on health care topics for federal and state agencies, professional associations and foundations. PNW EPC projects bring together investigators across the three partner institutions: Oregon Health & Science University (lead; http://www.ohsu.edu/xd/research/centers-institutes/evidence-based-practice-center/about/index.cfm), the University of Washington CHOICE Institute, and Aggregate Analytics, Inc. Beth Devine is the UW-site principal investigator and Assistant Director of the PNW EPC who coordinates participation of UW investigators in a variety of evidence synthesis projects.

The EPC program is funded by the Agency for Healthcare Research and Quality (ARHQ; https://www.ahrq.gov/research/findings/evidence-based-reports/index.html) as part of the Effective Healthcare Program. Under the EPC program, AHRQ awards 5-year contracts to selected institutions in the United States and Canada. These designated EPCs review the scientific literature on a wide spectrum of topics. The resulting reports inform policy decisions, guideline development, educational materials, reimbursement and coverage policies, clinical practice, and future research agendas. The EPCs support the work of the United States Preventive Services Task Force (USPSTF) and also conduct research to advance methodology in the field of evidence synthesis. The AHRQ EPC initiative was launched in 1997 and is now in its sixth cycle (EPC VI). In, 2003, with passage of the Medicare Prescription Drug, Improvement, and Modernization Act, the EPCs were placed under the banner of AHRQ’s Effective Healthcare Program. OHSU has been part of the EPC network since 1997, first under the directorship of Mark Helfand, MD, MPH, and now under the leadership of Dr. Roger Chou.

The UW joined the EPC program in 2013 (EPC IV), and, to date has participated in fourteen projects ranging in scope from imaging for hepatocellular cancer to pharmacologic and non-pharmacologic treatments for schizophrenia. In EPC V, CHOICE investigators led a project synthesizing the use of telehealth modalities for acute and chronic consultation that incorporated the use of decision modeling to estimate the outcomes of specific telehealth interventions. Combining evidence synthesis with decision modeling was a new undertaking for AHRQ in their EPC V program and, with modeling expertise from CHOICE faculty member Ryan Hansen, the PNW EPC was awarded the first of these contracts.

In EPC VI, Dr. Devine recently served as a member of the methods group that updated the 2010 AHRQ Methods Guide for Comparative Effectiveness Reviews that provides guidance for the inclusion of nonrandomized studies of intervention effectiveness in systematic reviews.1 Together, Dr. Devine and former CHOICE post-doctoral fellow, Dr. Noah Hammarland, championed inclusion of the section on causal inference methods. A summary of the AHRQ Report was published in the Journal of Clinical Epidemiology,2 accompanied by an Editor´s Choice designation with companion commentaries by the Cochrane Collaboration, the Campbell Collaboration, and the GRADE Working Group.3

Additional CHOICE and UW faculty from other departments have led and participated in PNW EPC projects. These investigators represent a broad range of interests and disciplines including diagnostic imaging, comparative effectiveness, evidence-based informatics, and Health Services Research.  

List of PNW EPC projects in which UW has Participated

  EPC V Projects UW Investigators
1 Medication-Assisted Treatment Programs Beth Devine, Paul Kraegel
2 Treatments for Adults with Schizophrenia Beth Devine, Paul Kraegel, Sarah Kopelovich, Maria Monroe-DeVita
3 Non-Pharmacological Treatment for Pain Beth Devine, Paul Kraegel, Janna Friedly, Judy Turner, Sean Rundell
4 Telehealth for Acute and Chronic Consultation Ryan Hansen, Beth Devine, Paul Kraegel,  Jesse Fann, Marc Avery, Cara Towle, Joseph Babigumira, Justin Robertson
5 and 6 USPSTF Breast Cancer Medications and BRCA-Related Cancer Beth Devine, Paul Kraegel, Larissa Korde, Elizabeth Swisher, Rachel Yung
   
  EPC IV Projects
7 Imaging for Hepatocellular Cancer Sean Sullivan, Paul Kraegel, Carlos Cuevas, Beth Devine, Brian Bresnahan
8 The Effectiveness and Risks of Long-term Opioid Treatment of Chronic Pain Sean Sullivan, Judith Turner, Jerry Jarvik, Ryan Hansen, Beth Devine, Paul Kraegel
9 Imaging Techniques for Metastatic Breast Cancer Sean Sullivan, Laurie Gold, Christoph Lee, Beth Devine, Paul Kraegel, Scott Ramsey
10 Bladder Cancer Sean Sullivan, John Gore, Paul Kraegel
11 Health Information Exchange Beth Devine, Sean Sullivan, Paul Kraegel
12 Pain Management Injection Therapies for Low-Back Pain Sean Sullivan, Jerry Jarvik, Janna Fridley, Paul Kraegel
13 Abridged Topic Development of Patient Centered Outcomes Research Institute (PCORI) Research Topics Josh Carlson, Larry Kessler, Dave Grembowski, Laurie Gold, Paul Kraegel
14 Noninvasive Treatment for Low Back Pain Sean Sullivan, Janna Fridley, Paul Kraegel

CHOICE Institute, School of Pharmacy;

USPSTF = United States Preventive Services Task Force

UW-EPC Publications

AHRQ Reports

  1. McDonagh MS, Dana T, Selph S, Devine EB, Cantor A, Bougatsos C, Blazina I, Grusing S, Fu R, Kopelovich SL, Monroe-DeVita M, Haupt DW. Treatments for Adults with Schizophrenia: A Systematic Review <Report Series Name in Title Caps No.> <#>. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. HHSA290201500009I.) AHRQ Publication No. XX-EHCXXX-EF. Rockville, MD: Agency for Healthcare Research and Quality. <Month Year>. https://www.ahrq.gov/research/findings/index.html.
  1. Chou R, Korthuis PT, Weimer M, Bougatsos C, Blazina I, Zakher B, Grusing S, Devine B, McCarty D. Medication-Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings. Technical Brief No. 28. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 16(17)-EHC039- EF. Rockville, MD: Agency for Healthcare Research and Quality. December 2016. https://www.ahrq.gov/research/findings/index.html.
  1. Hersh W, Totten A, Eden K, Devine B, Gorman P, Kassakian S, Woods SS, Daeges M, Pappas M, McDonagh MS. Health Information Exchange. Evidence Report/Technology Assessment No. 220. (Prepared by the Pacific Northwest Evidence-based Practice Center Under Contract No. 290-2012-00014-I.) AHRQ Publication No. 15 (16)-E002-EF. Rockville, MD: Agency for Healthcare Research and Quality; December 2015. https://www.ahrq.gov/research/findings/index.html.
  1. Gold LS, Lee CI, Devine B, Nelson H, Chou R, Ramsey S, Sullivan SD. Imaging Techniques for Treatment Evaluation for Metastatic Breast Cancer. Technical Brief No. 17. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 2902012-00014-I.) AHRQ Publication No. 14-EHC044-EF. Rockville, MD: Agency for Healthcare Research and Quality; October 2014. https://www.ahrq.gov/research/findings/index.html.
  1. Chou R, Deyo R, Devine B, Hansen R, Sullivan S, Jarvik JG, Blazina I, Dana T, Bougatsos C, Turner J. The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain. Evidence Report/Technology Assessment No. 218. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2012-00014-I.) AHRQ Publication No. 14-E005-EF. Rockville, MD: Agency for Healthcare Research and Quality; September 2014. https://www.ahrq.gov/research/findings/index.html.
  1. Chou R, Cuevas C, Fu R, Devine B, Wasson N, Ginsburg A, Zakher B, Pappas M, Graham E, Sullivan S. Imaging Techniques for the Diagnosis and Staging of Hepatocellular Carcinoma. Comparative Effectiveness Review No. 143. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2012-00014-I.) AHRQ Publication No. 14-EHC048-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2014. https://www.ahrq.gov/research/findings/index.html.

Journal Articles

  1. Devine EB, Hersh W, Totten A, Eden K, , Gorman P, Kassakian S, Woods S, Daeges M, Pappas M, McDonagh M. Use of health information exchange. In press at eGEMS, August 2017
  1. Korthuis PT, McCarty D, Weimer M, Bougatsos C, Blazina I, Zakher B, Grusing S, Devine B, Chou R. Primary Care-Based Models for the Treatment of Opioid Use Disorder: A Scoping Review. Ann Intern Med. 2017 Feb 21;166(4):268-278. doi: 10.7326/M16-2149. Epub 2016 Dec 6.
  1. Eden KB, Totten AM, Kassakian SZ, Gorman PN, McDonagh MS, Devine B, Pappas M, Daeges M, Woods S, Hersh WR. Barriers and facilitators to exchanging health information: a systematic review. Int J Med Inform 2016 Apr;88:44-51
  1. Hersh WR, Totten AM, Eden KB, Devine B, Gorman P, Kassakian SZ, Woods SS, Daeges M, Pappas M, McDonagh MS. Outcomes from health information exchange: Systematic review and future research needs. JMIR Med Inform. 2015 Dec 15;3(4):e39. doi: 10.2196/medinform.5215.
  1. Chou R, Cuevas C, Fu R, Devine B, Wasson N, Ginsburg A, Zakher B, Pappas M, Graham E, Sullivan SD. Imaging techniques for the diagnosis of hepatocellular carcinoma: a systematic review. Ann Intern Med 2015;162:697-711. doi:10.7326/M14-2509
  1. Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, Dana T, Bougatsos C, Deyo RA. The Effectiveness and Risks of Long-Term Opioid Therapy for Chronic Pain: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015 Jan 13. doi: 10.7326/M14-2559

AHRQ Methods Development for the Field of Evidence Synthesis

Complex Interventions (2015-2017)

  1. Viswanathan M, McPheeters ML, Murad MH, Butler ME, Devine EB, Dyson MP, Guise JM, Kahwati LC, Miles JNV, Morton SC. AHRQ series on complex intervention systematic reviews-paper 4: selecting analytic approaches. J Clin Epidemiol. 2017 Jul 15. pii: S0895-4356(17)30639-X. doi: 10.1016/j.jclinepi.2017.06.014. [Epub ahead of print]
  1. Pigott T, Noyes J, Umscheid CA, Myers E, Morton SC, Fu R, Sanders-Schmidler GD, Devine B, Murad MH, Kelly MP, Fonnesbeck C, Kahwati L, Beretvas SN. AHRQ series on complex intervention systematic reviews-paper 5: advanced analytic methods. J Clin Epidemiol. 2017 Jul 15. pii: S0895-4356(17)30640-6. doi: 10.1016/j.jclinepi.2017.06.015. [Epub ahead of print]

 

Footnotes

  1. Saldanha IJ, Skelly AC, Vander Ley K, Wang Z, Berliner E, Bass EB, Devine B, Hammarlund N, Adam GP, Duan-Porter D, Bañez LL, Jain A, Norris SL, Wilt TJ, Leas B, Siddique SM, Fiordalisi CV, Patino-Sutton C, Viswanathan M. Inclusion of Nonrandomized Studies of Interventions in Systematic Reviews of Intervention Effectiveness: An Update. Methods Guide for Comparative Effectiveness Reviews. (Prepared by the Scientific Resource Center under Contract No. 290-2017-00003-C.) AHRQ Publication No. 22-EHC033. Rockville, MD: Agency for Healthcare Research and Quality; September 2022. DOI: https://effectivehealthcare.ahrq.gov/products/nonrandomized-studies/methods
  2. Saldanha IJ, Adam GP, Bañez LL, et al. Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: Updated guidance from the Agency for Healthcare Research and Quality Effective Healthcare Program. J Clin Epidemiol. 2022 Sept 19. [Epub ahead of print.] PMID: 36245131.
  3. David Tovey D, Tugwell P. Editors´Choice. J Clin Epi. 2022;152:A1-A3