Article type
Year
Abstract
Background: Medicaid, a US federal-state partnership, provides care to poor and disabled children and adults. Seventeen state Medicaid programs collaborate, as the Medicaid Evidence-based Decisions (MED) project, with the Center for Evidence-based Policy (CEBP) to produce rapid reviews (RR) to inform health policy decisions.
Objectives: To describe the methods used to produce RRs for US state policymakers.
Methods: Review of CEBP RR methods, their evolution, and current outputs.
Results: Between 2006 and 2015 the CEBP produced over 300 RRs. Initial MED evidence reports (2006-2008) were brief evidence summaries of SRs from trusted core sources such as the Cochrane Library. Reports sometimes included searches to update SRs, but critical appraisal (CA) of studies was not routine. In 2008, participating policymakers requested more complete evidence reviews, and wanted the option to add clinical practice guidelines, with CA of the guidelines, and payer coverage policies. Since 2009, CEBP has routinely incorporated the following methodology elements into RR production: refinement of topic scope and protocol with nominating state; multiple database search for SRs and update searches using PubMed; single reviewer study selection/abstraction/CA, with second reviewer validation; narrative synthesis; internal review; and proprietary publication. Optional elements, incorporated based on the topic and needs of the nominator, include: peer-reviewed search strategy; search of additional databases; industry dossiers; guidelines and payer policies; dual review of selection/abstraction/CA; external review and public dissemination. Production timeline is generally three to four months from protocol agreement.
Conclusions: Medicaid programs have successfully collaborated with the CEBP over the last decade to develop RRs to inform policy decisions. Evidence reviews alone seldom provide sufficient information for good policy formation. However, critical analyses of evidence and appraisal of the quality and concordance of guidelines and policies with that evidence can assist policymakers in making evidence-informed decisions within relevant timeframes and available resources.
Objectives: To describe the methods used to produce RRs for US state policymakers.
Methods: Review of CEBP RR methods, their evolution, and current outputs.
Results: Between 2006 and 2015 the CEBP produced over 300 RRs. Initial MED evidence reports (2006-2008) were brief evidence summaries of SRs from trusted core sources such as the Cochrane Library. Reports sometimes included searches to update SRs, but critical appraisal (CA) of studies was not routine. In 2008, participating policymakers requested more complete evidence reviews, and wanted the option to add clinical practice guidelines, with CA of the guidelines, and payer coverage policies. Since 2009, CEBP has routinely incorporated the following methodology elements into RR production: refinement of topic scope and protocol with nominating state; multiple database search for SRs and update searches using PubMed; single reviewer study selection/abstraction/CA, with second reviewer validation; narrative synthesis; internal review; and proprietary publication. Optional elements, incorporated based on the topic and needs of the nominator, include: peer-reviewed search strategy; search of additional databases; industry dossiers; guidelines and payer policies; dual review of selection/abstraction/CA; external review and public dissemination. Production timeline is generally three to four months from protocol agreement.
Conclusions: Medicaid programs have successfully collaborated with the CEBP over the last decade to develop RRs to inform policy decisions. Evidence reviews alone seldom provide sufficient information for good policy formation. However, critical analyses of evidence and appraisal of the quality and concordance of guidelines and policies with that evidence can assist policymakers in making evidence-informed decisions within relevant timeframes and available resources.