title: Prioritization in comparative effectiveness research: the CANCERGEN Experience.
abstract: BACKGROUND
  Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes.
  
  
  OBJECTIVE
  To develop and pilot test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG.
  
  
  METHODS
  We conducted a landscape analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds.
  
  
  RESULTS
  A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy makers, and community-based oncologists. We identified 9 domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and 1 test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities.
  
  
  CONCLUSIONS
  Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition, and integration with existing prioritization mechanisms.
authors.affiliation: Department of Pharmacy, University of Washington, Seattle, WA 98195, USA.
authors.forename: Rahber
authors.initials: R
authors.lastname: Thariani
authors.forename: William
authors.initials: W
authors.lastname: Wong
authors.forename: Josh J
authors.initials: JJ
authors.lastname: Carlson
authors.forename: Louis
authors.initials: L
authors.lastname: Garrison
authors.forename: Scott
authors.initials: S
authors.lastname: Ramsey
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Deverka
authors.forename: Laura
authors.initials: L
authors.lastname: Esmail
authors.forename: Sneha
authors.initials: S
authors.lastname: Rangarao
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Hoban
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Baker
authors.forename: David L
authors.initials: DL
authors.lastname: Veenstra
mesh_terms: D057186:Comparative Effectiveness Research / Q000191:economics / Q000458:organization & administration*; D005820:Genetic Testing; D006302:Health Services Research; D006801:Humans; D008389:Marketing of Health Services; D009369:Neoplasms / Q000235:genetics*; D017410:Practice Guidelines as Topic; D012106:Research