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Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
When it comes to motivating people to learn, disadvantaged urban adolescents are usually perceived as a hard sell. Yet, in a recent MetLife survey, 89 percent of the low-income students claimed "I really want to learn" applied to them. What is it about the school environmentâ€"pedagogy, curriculum, climate, organizationâ€"that encourages or discourages engagement in school activities? How do peers, family, and community affect adolescents' attitudes towards learning? Engaging Schools reviews current research on what shapes adolescents' school engagement and motivation to learnâ€"including new findings on students' sense of belongingâ€"and looks at ways these can be used to reform urban high schools. This book discusses what changes hold the greatest promise for increasing students' motivation to learn in these schools. It looks at various approaches to reform through different methods of instruction and assessment, adjustments in school size, vocational teaching, and other key areas. Examples of innovative schools, classrooms, and out-of-school programs that have proved successful in getting high school kids excited about learning are also included.
The integrity of knowledge that emerges from research is based on individual and collective adherence to core values of objectivity, honesty, openness, fairness, accountability, and stewardship. Integrity in science means that the organizations in which research is conducted encourage those involved to exemplify these values in every step of the research process. Understanding the dynamics that support â€" or distort â€" practices that uphold the integrity of research by all participants ensures that the research enterprise advances knowledge. The 1992 report Responsible Science: Ensuring the Integrity of the Research Process evaluated issues related to scientific responsibility and the conduct of research. It provided a valuable service in describing and analyzing a very complicated set of issues, and has served as a crucial basis for thinking about research integrity for more than two decades. However, as experience has accumulated with various forms of research misconduct, detrimental research practices, and other forms of misconduct, as subsequent empirical research has revealed more about the nature of scientific misconduct, and because technological and social changes have altered the environment in which science is conducted, it is clear that the framework established more than two decades ago needs to be updated. Responsible Science served as a valuable benchmark to set the context for this most recent analysis and to help guide the committee's thought process. Fostering Integrity in Research identifies best practices in research and recommends practical options for discouraging and addressing research misconduct and detrimental research practices.
Despite many advances, 20 American workers die each day as a result of occupational injuries. And occupational safety and health (OSH) is becoming even more complex as workers move away from the long-term, fixed-site, employer relationship. This book looks at worker safety in the changing workplace and the challenge of ensuring a supply of top-notch OSH professionals. Recommendations are addressed to federal and state agencies, OSH organizations, educational institutions, employers, unions, and other stakeholders. The committee reviews trends in workforce demographics, the nature of work in the information age, globalization of work, and the revolution in health care deliveryâ€"exploring the implications for OSH education and training in the decade ahead. The core professions of OSH (occupational safety, industrial hygiene, and occupational medicine and nursing) and key related roles (employee assistance professional, ergonomist, and occupational health psychologist) are profiled-how many people are in the field, where they work, and what they do. The book reviews in detail the education, training, and education grants available to OSH professionals from public and private sources.
TRB Special Report 295, The Federal Investment in Highway Research, 2006-2009: Strengths and Weaknesses assesses how well the investments that Congress made in research programs through the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users comply with the principles articulated in the preface to the act's research title. The book contains findings and recommendations about specific research programs and calls for reliance on competition and merit review in awarding funds through the Federal Highway Administration and in selecting institutions for the University Transportation Centers program of the Research and Innovative Technology Administration.
Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Calling the Shots examines the basic strategies that finance the national immunization system in the current health care climate. It is a comprehensive volume, rich with data and highlighted examples, that explores: The evolution of the system in light of changing U.S. demographics, development of new vaccines, and other factors. The effectiveness of public health and health insurance strategies, with special emphasis on the performance of the "Section 317" program. The condition of the infrastructure for control and prevention of infectious disease, surveillance of vaccines rates and safety, and efforts to sustain high coverage. Calling the Shots will be an indispensable resource to those responsible for maintaining our nation's vaccine vigilance.
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In recent years, the instrumentation needs of the nation's research communities have changed and expanded. The need for particular instruments has become broader, crossing scientific and engineering disciplines. The growth of interdisciplinary research that focuses on problems defined outside the boundaries of individual disciplines demands more instrumentation. Instruments that were once of interest only to specialists are now required by a wide array of scientists to solve critical research problems. The need for entirely new types of instrumentsâ€"such as distributed networks, cybertools, and sensor arraysâ€"is increasing. Researchers are increasingly dependent on advanced instruments that require highly specialized knowledge and training for their proper operation and use. The National Academies Committee on Science, Engineering, and Public Policy Committee on Advanced Research Instrumentation was asked to describe the current programs and policies of the major federal research agencies for advanced research instrumentation, the current status of advanced mid-sized research instrumentation on university campuses, and the challenges faced by each. The committee was then asked to evaluate the utility of existing federal programs and to determine the need for and, if applicable, the potential components of an interagency program for advanced research instrumentation.