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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.
The United States will certainly be subject to damaging earthquakes in the future. Some of these earthquakes will occur in highly populated and vulnerable areas. Coping with moderate earthquakes is not a reliable indicator of preparedness for a major earthquake in a populated area. The recent, disastrous, magnitude-9 earthquake that struck northern Japan demonstrates the threat that earthquakes pose. Moreover, the cascading nature of impacts-the earthquake causing a tsunami, cutting electrical power supplies, and stopping the pumps needed to cool nuclear reactors-demonstrates the potential complexity of an earthquake disaster. Such compound disasters can strike any earthquake-prone populated area. National Earthquake Resilience presents a roadmap for increasing our national resilience to earthquakes. The National Earthquake Hazards Reduction Program (NEHRP) is the multi-agency program mandated by Congress to undertake activities to reduce the effects of future earthquakes in the United States. The National Institute of Standards and Technology (NIST)-the lead NEHRP agency-commissioned the National Research Council (NRC) to develop a roadmap for earthquake hazard and risk reduction in the United States that would be based on the goals and objectives for achieving national earthquake resilience described in the 2008 NEHRP Strategic Plan. National Earthquake Resilience does this by assessing the activities and costs that would be required for the nation to achieve earthquake resilience in 20 years. National Earthquake Resilience interprets resilience broadly to incorporate engineering/science (physical), social/economic (behavioral), and institutional (governing) dimensions. Resilience encompasses both pre-disaster preparedness activities and post-disaster response. In combination, these will enhance the robustness of communities in all earthquake-vulnerable regions of our nation so that they can function adequately following damaging earthquakes. While National Earthquake Resilience is written primarily for the NEHRP, it also speaks to a broader audience of policy makers, earth scientists, and emergency managers.