title: What comparative effectiveness research is needed? A framework for using guidelines and systematic reviews to identify evidence gaps and research priorities.
abstract: The authors developed and tested a framework for identifying evidence gaps and prioritizing comparative effectiveness research by using a combination of clinical practice guidelines and systematic reviews. In phase 1 of the project, reported elsewhere, 45 clinical questions on the management of primary open-angle glaucoma were derived from practice guidelines and prioritized by using a 2-round Delphi survey of clinicians. On the basis of the clinicians' responses, 9 questions were classified as high-priority. In phase 2, reported here, systematic reviews that addressed the 45 clinical questions were identified. The reviews were classified as at low, high, or unclear risk of bias, and evidence gaps (in which no systematic review was at low risk of bias) were identified. The following comparative effectiveness research agenda is proposed: Two of the 9 high-priority questions require new primary research (such as a randomized, controlled trial) and 4 require a new systematic review. The utility and limitations of the framework and future adaptations are discussed.
authors.affiliation: Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. tli@jhsph.edu
authors.forename: Tianjing
authors.initials: T
authors.lastname: Li
authors.forename: S Swaroop
authors.initials: SS
authors.lastname: Vedula
authors.forename: Roberta
authors.initials: R
authors.lastname: Scherer
authors.forename: Kay
authors.initials: K
authors.lastname: Dickersin
mesh_terms: D057186:Comparative Effectiveness Research / Q000592:standards*; D019317:Evidence-Based Medicine; D005902:Glaucoma, Open-Angle / Q000628:therapy; D006801:Humans; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012107:Research Design / Q000592:standards; D012196:Review Literature as Topic; D011795:Surveys and Questionnaires