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Open Discussion: Working together or working apart: Cross-group cooperation in priority setting
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Open Discussion: Working together or working apart: Cross-group cooperation in priority setting


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    • 1. Working together or working apart: Cross-group collaboration in priority setting Lisa A. Bero, Ph.D. Cochrane Collaboration Steering Group US Cochrane Center University of California, San Francisco
    • 2. Disclaimer
      • Prioriti z ation / Prioriti s ation
      • Organi z ation / Organi s ation
    • 3. Cochrane Collaboration Values
      • Collaboration
      • Building on the enthusiasm of others
      • Avoiding duplication
      • Minimizing bias
      • Keeping up to date
      • Ensuring relevance
      • Ensuring access
      • Continually improving the quality of its work
      • Maintaining continuity
      • Enabling participation
    • 4. Eliminate duplication of effort!
      • Why start from scratch?
      • Example: A registry of systematic reviews
        • Internet based
        • Open access
        • Easily searchable
    • 5. Whose priorities?
      • Population
      • Local (microscopic) vs broader (the world)
      • Condition, behavior
      • Treatment, prevention
      • Clinical effectiveness vs. economic
      • Consumers, clinicians, experts, funders, on and on…..
      • “ Can’t make all of the people happy all of the time….”
    • 6.  
    • 7. Challenges (Excuses)
      • Communication
      • Timeliness / quality
      • Transparency
      • Who to support and how?
    • 8.  
    • 9. Aligned Mission Statements
      • Cochrane Mission Statement
      • The Cochrane Collaboration is an international organisation that aims to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions.
      • World Health Organization
      • WHO is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options , providing technical support to countries and monitoring and assessing health trends.
      • Agency for Healthcare Research and Quality
      • To improve the quality, safety, efficiency, and effectiveness of health care for all Americans .
    • 10. Communication
      • “I don’t know who to talk to!”
      • Working with groups that have a track record of delivering .. Working with the entire CC vs. selected groups
    • 11. Steering Group Centers Review Groups Fields Networks Methods Groups Secretariat
    • 12. What are we doing?
      • Passive activities: eg using Cochrane reviews
      • Planned collaborative activities
      • Opportunistic activity: eg individuals who happen to be involved in both organizations but are not representative
    • 13. What are we doing?
      • WHO
        • Reproductive Health Library
        • Portal to clinical trials in children
        • International Clinical Trials Registry Platform
        • EvipNet
        • Evidence Aid
        • WHO Guideline Review Committees
        • Essential Medicines list
        • Evidence and Equity
        • Advisory Committee on Health Research
      • AHRQ
        • EPCs
        • Methods
    • 14.  
    • 15. Evidence Aid
      • Evidence summaries for interventions relevant to health care in natural disasters and other healthcare emergencies, such as those following the 2004 tsunami, and more recent events in the USA and South Asia.
    • 16. Evidence Aid – Prioritization
      • Prioritised list prepared by a working party established by The Cochrane Collaboration in January 2005.
      • All Cochrane entities, the 200 people in the affected countries who are contributors to the work of The Cochrane Collaboration and members of other agencies such as WHO and Oxfam.
      • The priorities identified cover more than 200 interventions relevant to infectious diseases, injuries and wounds, rebuilding of communities and infrastructure, mental health, nutrition, rehabilitation, and pregnancy and childbirth.
    • 17. Evidence Aid - Prioritization
      • Two topic lists:
      • topics for which an up-to-date Cochrane review is available (and, where relevant, a summary has been prepared).
      • topics for which an up-to-date Cochrane review is not currently available (includes protocols and reviews that need updating).
    • 18. Where are we going?
      • Proactive / strategic vs. reactive
      • WHO example: 3 year plan for collaboration
    • 19. Timeliness
      • Quality vs. relevance
        • Peer review process
        • Editor, standardizing processes
      • “Rapid response team”
    • 20. Transparency
      • Question formulation
      • Methods
      • Review processes
      • Publication
    • 21. Transparency
      • Stakeholder input vs.
      • “ Sponsorship of a Cochrane review by any commercial source or sources is prohibited.”
        • “ any for-profit manufacturer or provider of health care, or any other for-profit source with a real or potential vested interest in the findings of a specific review.”
        • http://
    • 22. Who to support and how
      • “ We just don’t know how to fund you … we just don’t have a mechanism”
      • “ Cochrane is a primarily volunteer organization”
      • Let me count the ways….
        • Product specific (e.g., reviews, registries)
        • Methods research
        • Infrastructure
        • Combination of commissioned and investigator initiated
    • 23.  
    • 24.  
    • 25. “What will you do for me?”
      • WHO struggles with consumer involvement – Cochrane can help
      • Cochrane struggles with developing country involvement – WHO can help
      • AHRQ struggles with ……..
    • 26. “ We don’t know what to call you”
      • WHO: Proposal to establish the Cochrane Collaboration as a Non-Governmental Organization (NGO) in Official Relations with the World Health Organization (WHO)
      • AHRQ: ??, Center, Collaborating Center, AHRQCCCC…
    • 27. Challenges (Solutions)
      • Communication
        • Leadership – responsible for identifying relevant contacts + local contacts
        • Know what you have and where you are going (eg, registry of systematic reviews)
      • Timeliness / quality
        • Align and standardize processes
        • Rapid response team
    • 28. Challenges (Solutions)
      • Transparency
        • Maintain incoming and outgoing
        • Don’t confuse transparency with funding source
      • Who to support and how?
        • Different products will meet different priorities
        • Mix of commissioned and investigator initiated
    • 29. I’m just too tired to wave
    • 30.