Disclosing adverse events to patients.

Background: The rationale for, and recommended approaches to, disclosing adverse events to patients are examined on the basis of the experience of the Veterans Health Administration (VHA). The VHA's National Ethics Committee endorses a general policy requiring the routine disclosure of adverse events to patients and offers practical recommendations for implementation.

Practical Approaches To Disclosing Adverse Events: Disclosure is required when the adverse event (1) has a perceptible effect on the patient that was not discussed in advance as a known risk; (2) necessitates a change in the patient's care; (3) potentially poses an important risk to the patient's future health, even if that risk is extremely small; (4) involves providing a treatment or procedure without the patient's consent.

Alternative methods for formal literature review and meta-analysis in AHCPR Patient Outcomes Research Teams. Agency for Health Care Policy and Research.

Formal literature review and synthesis is an important component of Patient Outcomes Research Teams (PORTs) and the development of clinical practice guidelines supported by the Agency for Health Care Policy and Research (AHCPR). Investigators face unresolved methodological issues and practical problems in carrying out this work because the use of such systematic reviews is relatively new in medicine. In addition, standard meta-analytic methods may not readily be applied to the literature pertinent to most PORTs.

Methodological challenges and innovations in patient outcomes research.

Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying out their individual 5-year research plans, and through collaborative work of six Inter-PORT Work Groups, PORTs have contributed to methodological advances related to their specific clinical focus and to outcomes research in general.

The national medical effectiveness research initiative. The search for what really works in treating common clinical conditions.

In 1989, Congress established the Agency for Health Care Policy and Research within the U.S. Public Health Service and gave it the lead in a national effort to produce reliable evidence of which medical treatments are effective and which are not.

Medical treatment effectiveness research. A view from inside the Agency for Health Care Policy and Research.

The Medical Treatment Effectiveness Program (MEDTEP) is an intradepartmental federal program of the Department of Health and Human Services, for which the Agency for Health Care Policy and Research (AHCPR) has lead responsibility. This article presents a staff perspective on the conceptual framework for the MEDTEP research agenda and on the opportunity to address empirically the relationships between particular health care services and patient outcomes. It reviews programmatic priorities and identifies active MEDTEP research projects, with descriptions of 11 patient outcomes research team projects.