Finding What Works in Health Care

Finding What Works in Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-07-20

Total Pages: 267

ISBN-13: 0309164257

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Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.


Fostering Integrity in Research

Fostering Integrity in Research

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-01-13

Total Pages: 327

ISBN-13: 0309391253

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The integrity of knowledge that emerges from research is based on individual and collective adherence to core values of objectivity, honesty, openness, fairness, accountability, and stewardship. Integrity in science means that the organizations in which research is conducted encourage those involved to exemplify these values in every step of the research process. Understanding the dynamics that support â€" or distort â€" practices that uphold the integrity of research by all participants ensures that the research enterprise advances knowledge. The 1992 report Responsible Science: Ensuring the Integrity of the Research Process evaluated issues related to scientific responsibility and the conduct of research. It provided a valuable service in describing and analyzing a very complicated set of issues, and has served as a crucial basis for thinking about research integrity for more than two decades. However, as experience has accumulated with various forms of research misconduct, detrimental research practices, and other forms of misconduct, as subsequent empirical research has revealed more about the nature of scientific misconduct, and because technological and social changes have altered the environment in which science is conducted, it is clear that the framework established more than two decades ago needs to be updated. Responsible Science served as a valuable benchmark to set the context for this most recent analysis and to help guide the committee's thought process. Fostering Integrity in Research identifies best practices in research and recommends practical options for discouraging and addressing research misconduct and detrimental research practices.


Government Auditing Standards - 2018 Revision

Government Auditing Standards - 2018 Revision

Author: United States Government Accountability Office

Publisher: Lulu.com

Published: 2019-03-24

Total Pages: 234

ISBN-13: 0359536395

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Audits provide essential accountability and transparency over government programs. Given the current challenges facing governments and their programs, the oversight provided through auditing is more critical than ever. Government auditing provides the objective analysis and information needed to make the decisions necessary to help create a better future. The professional standards presented in this 2018 revision of Government Auditing Standards (known as the Yellow Book) provide a framework for performing high-quality audit work with competence, integrity, objectivity, and independence to provide accountability and to help improve government operations and services. These standards, commonly referred to as generally accepted government auditing standards (GAGAS), provide the foundation for government auditors to lead by example in the areas of independence, transparency, accountability, and quality through the audit process. This revision contains major changes from, and supersedes, the 2011 revision.


Engaging Schools

Engaging Schools

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-12-21

Total Pages: 303

ISBN-13: 0309084350

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When it comes to motivating people to learn, disadvantaged urban adolescents are usually perceived as a hard sell. Yet, in a recent MetLife survey, 89 percent of the low-income students claimed "I really want to learn" applied to them. What is it about the school environmentâ€"pedagogy, curriculum, climate, organizationâ€"that encourages or discourages engagement in school activities? How do peers, family, and community affect adolescents' attitudes towards learning? Engaging Schools reviews current research on what shapes adolescents' school engagement and motivation to learnâ€"including new findings on students' sense of belongingâ€"and looks at ways these can be used to reform urban high schools. This book discusses what changes hold the greatest promise for increasing students' motivation to learn in these schools. It looks at various approaches to reform through different methods of instruction and assessment, adjustments in school size, vocational teaching, and other key areas. Examples of innovative schools, classrooms, and out-of-school programs that have proved successful in getting high school kids excited about learning are also included.


Identifying the Culprit

Identifying the Culprit

Author: National Research Council

Publisher: National Academies Press

Published: 2015-01-16

Total Pages: 212

ISBN-13: 0309310628

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Identifying the Culprit: Assessing Eyewitness Identification makes the case that better data collection and research on eyewitness identification, new law enforcement training protocols, standardized procedures for administering line-ups, and improvements in the handling of eyewitness identification in court can increase the chances that accurate identifications are made. This report explains the science that has emerged during the past 30 years on eyewitness identifications and identifies best practices in eyewitness procedures for the law enforcement community and in the presentation of eyewitness evidence in the courtroom. In order to continue the advancement of eyewitness identification research, the report recommends a focused research agenda.


The Future of Nursing

The Future of Nursing

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-02-08

Total Pages: 700

ISBN-13: 0309208955

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The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.


Clinical Practice Guidelines We Can Trust

Clinical Practice Guidelines We Can Trust

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-06-16

Total Pages: 217

ISBN-13: 030921646X

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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.


Science for Environmental Protection

Science for Environmental Protection

Author: National Research Council

Publisher: National Academies Press

Published: 2012-12-21

Total Pages: 188

ISBN-13: 0309264898

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In anticipation of future environmental science and engineering challenges and technologic advances, EPA asked the National Research Council (NRC) to assess the overall capabilities of the agency to develop, obtain, and use the best available scientific and technologic information and tools to meet persistent, emerging, and future mission challenges and opportunities. Although the committee cannot predict with certainty what new environmental problems EPA will face in the next 10 years or more, it worked to identify some of the common drivers and common characteristics of problems that are likely to occur. Tensions inherent to the structure of EPA's work contribute to the current and persistent challenges faced by the agency, and meeting those challenges will require development of leading-edge scientific methods, tools, and technologies, and a more deliberate approach to systems thinking and interdisciplinary science. Science for Environmental Protection: The Road Ahead outlines a framework for building science for environmental protection in the 21st century and identified key areas where enhanced leadership and capacity can strengthen the agency's abilities to address current and emerging environmental challenges as well as take advantage of new tools and technologies to address them. The foundation of EPA science is strong, but the agency needs to continue to address numerous present and future challenges if it is to maintain its science leadership and meet its expanding mandates.


The Belmont Report

The Belmont Report

Author: United States. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

Publisher:

Published: 1978

Total Pages: 614

ISBN-13:

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The Health Effects of Cannabis and Cannabinoids

The Health Effects of Cannabis and Cannabinoids

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-03-31

Total Pages: 487

ISBN-13: 0309453070

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Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.