title: Setting priorities for comparative effectiveness research in inflammatory bowel disease: results of an international provider survey, expert RAND panel, and patient focus groups.
abstract: BACKGROUND
  Comparative effectiveness research (CER) is an emerging field that compares the relative effectiveness of alternative strategies to prevent, diagnose, or treat patients who are typical of day-to-day practice. We developed a priority list of CER topics for inflammatory bowel disease (IBD).
  
  
  METHODS
  Following the Institute of Medicine's approach, we developed and administered a survey to gastroenterologists asking for important CER topics in IBD. Two patient focus groups were convened to solicit additional CER studies. CER topics were presented to the expert panel using the RAND/UCLA methodology. Following initial ratings, the panel met to discuss and re-rate priorities. The top 10 CER topics were identified using a point-allocation system.
  
  
  RESULTS
  Responses were collated into 234 CER topics across 21 categories, of which 87 were prioritized for discussion and re-rated. Disagreement regarding priorities was observed in 5 of 87 studies. We utilized a point-allocation system to prioritize the top-10 CER topics. These related to comparing the effectiveness of: biomarkers in IBD; withdrawal of anti-tumor necrosis factor (TNF) or immunomodulators for Crohn's disease in remission; mucosal healing as an endpoint of treatment; infliximab levels versus standard infliximab dosing; anti-TNF monotherapy versus combination therapy in patients failing thiopurines; safety of long-term treatment options; anti-TNF versus thiopurines for prevention of postoperative recurrence; and treatment options for steroid-refractory UC.
  
  
  CONCLUSIONS
  We systematically developed a list of high-priority IBD topics for CER based on a survey of gastroenterologists, expert review, and patient input. This list may guide IBD research toward the most important CER studies.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. acheifet@bidmc.harvard.edu
authors.forename: A S
authors.initials: AS
authors.lastname: Cheifetz
authors.forename: G Y
authors.initials: GY
authors.lastname: Melmed
authors.forename: B
authors.initials: B
authors.lastname: Spiegel
authors.forename: J
authors.initials: J
authors.lastname: Talley
authors.forename: S M
authors.initials: SM
authors.lastname: Devlin
authors.forename: L
authors.initials: L
authors.lastname: Raffals
authors.forename: P M
authors.initials: PM
authors.lastname: Irving
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: G G
authors.initials: GG
authors.lastname: Kaplan
authors.forename: P
authors.initials: P
authors.lastname: Kozuch
authors.forename: M
authors.initials: M
authors.lastname: Sparrow
authors.forename: F
authors.initials: F
authors.lastname: Velayos
authors.forename: L
authors.initials: L
authors.lastname: Baidoo
authors.forename: B
authors.initials: B
authors.lastname: Bressler
authors.forename: C A
authors.initials: CA
authors.lastname: Siegel
mesh_terms: D000328:Adult; D000368:Aged; D057186:Comparative Effectiveness Research; D003625:Data Collection; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006292:Health Priorities; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome