The initiatives and resources described below are not primary care specific but are relevant for primary care audiences including researchers and clinicians.c
The Effective Health Care Program and Evidence-Based Practice Centers
The Effective Health Care (EHC) Program was started in 2003 to conduct patient-centered outcomes research and disseminate the findings widely.67 AHRQ created the Evidence-Based Practice Centers (EPCs) to produce evidence reports for the EHC Program. The EPCs, which are located at universities, medical centers, and research institutions throughout the United States, produce evidence reports to help patients and clinicians make informed healthcare decisions.68
Since it started, the EPC program has developed over 800 reports, covering a wide range of topics, including treatments for heart disease, cancer, and mental health conditions.69 People can use a Products Search feature on the EHC Program website to search for materials on a wide range of topics (including research reports, systematic reviews, technical briefs, white papers, and more). A few primary care relevant materials from the 2021–2022 period include
the following:
- AHRQ Evidence-Based Practice Center Program Research Gaps Summary: Primary Care (March 2022)
- Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication
(Systematic Review; December 2022) - Potential Harms Resulting From Patient-Clinician Real-Time Clinical Encounters Using Video-Based Telehealth: A Rapid Evidence Review (Research Protocol; December 2022)
U.S. Preventive Service Task Force
Under authorization from the U.S. Congress, AHRQ has convened and supported the U.S. Preventive Services Task Force (Task Force) since 1998. The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that makes recommendations for primary care professionals about clinical preventive services.
The Task Force recommendations are for preventive services offered in primary care settings for patients without signs or symptoms of the condition of focus, including screenings (e.g., breast cancer screening), counseling services (e.g., tobacco cessation), and preventive medications (e.g., statins to prevent cardiovascular disease)). The Task Force reviews the best available evidence, and then assesses the strength of the evidence and considers the balance of benefits and harms to make their recommendations.70,71 The full list of recommendations can be found on the Task Force website.
In collaboration with The Association for Prevention Teaching and Research (APTR), AHRQ also offers health policy residency rotations in preventive medicine for preventive medicine and primary care residents. In this rotation residents get the chance to work closely with the Task Force members and AHRQ staff. This includes participation in scoping reviews for preventive services topics, conducting research on the epidemiology and burden of relevant preventable conditions, helping with the final drafting of recommendations, and attending Task Force meeting and calls.72
Patient-Centered Outcomes Research Clinical Decision Support
One way to put patient-centered outcomes research (PCOR) evidence into practice is through clinical decision support (CDS). AHRQ supports the development of CDS tools that are patient-centered, standards-based, publicly available, and shareable.73 Some currently available AHRQ CDS tools and resources are described below.
The Clinical Decision Support Innovation Collaborative (CDSiC) produces resources and evidence to make clinical decision support more valuable and meaningful by bringing together the perspectives across a range of interested parties including patients and caregivers, clinicians, researchers, clinical decision support developers, informaticians, payers, and policymakers.74 The CDSic has the following specific aims:
- Identify PCOR-based evidence that can be implemented using CDS
- Test and evaluate patient-centered CDS in real-world applications
- Disseminate findings and work to advance the field of patient-centered CDS
CDS Connect is a web-based platform that helps people who work in clinical decision support to identify evidence-based care, translate and codify information into an interoperable health information technology standard, and leverage tools to promote a collaborative model of CDS development.75 CDS Connect includes a repository of CDS "artifacts"—meaning actionable medical knowledge (e.g., clinical practice guidelines and clinical quality measures) that have been translated into computable and interoperable decision support. These artifacts, which have been submitted by an array of organizations, are available in various forms and on a range of clinical topics.
The CEPI Evidence Discovery and Retrieval Project (CEDAR) is a standards-based application programming interface (API) that is designed to help users search, access, and use PCOR evidence across multiple repositories and programs within AHRQ’s Center for Evidence and Practice Improvement (CEPI).
Note
c. The programs described in this section were not included in the primary care research investment amounts in Section 2 Overview of AHRQ's Recent Investments in Primary Care Research.
