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Methods to Prioritize Systematic Reviews: The Guide to Community Preventive Services Shawna L. Mercer, M.Sc., Ph.D. Director The Guide to Community Preventive Services National Center for Health Marketing Centers for Disease Control and Prevention (CDC)
Presentation Structure ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Community Guide is: ,[object Object],[object Object],[object Object],[object Object],[object Object]
The  Clinical Guide  and  Community Guide  Are Complementary
The Clinical and Community Guides Are Complementary  Individual level Clinical settings Delivered by healthcare providers Screening, Counseling, etc. Group level Health system changes Insurance/benefits coverage Access to/provision of services Community, population-based Informational ( Group Education, Media) Behavioral, Social Environmental & Policy Change   Community Guide (TFCPS  Recommendations ) Clinical Guide  (USPSTF  Recommendations)
Community Guide (CG) Topics Settings Social Environment The Environment Worksites Schools Specific Conditions Risk Behaviors Vaccine-Preventable Disease Pregnancy Outcomes Violence Motor Vehicle Injuries Depression Cancer Diabetes Oral Health Obesity Tobacco Use Alcohol Abuse/Misuse Other Substance Abuse Poor Nutrition Inadequate Physical Activity Unhealthy Sexual Behaviors
Community Guide Outputs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Brief History of the Community Guide  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Task Force on Community Preventive Services (Task Force) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Community Guide: Intended Uses ,[object Object],[object Object],[object Object],[object Object],[object Object]
Community Guide’s Approach to Developing and Disseminating Evidence Based Recommendations  ,[object Object]
So Whose Participation Do We Seek in our Systematic Reviews? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Participants in the Community Guide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Official Federal Agency Liaisons  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Official Organizational Liaisons  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Official Organizational Liaisons (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Participants in the Community Guide ,[object Object],[object Object],[object Object],[object Object],[object Object]
Participants in Individual Reviews ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prioritization of  Community Guide Work
Priority List - 1998 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Priority List - 1998 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Note on Task Force Deliberations ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Guide Process:  From Topic to Intervention Review(s) Topic is  Selected Task  Force
The Guide Process: The Team Topic is  Selected Staff  Recruits Teams  Task  Force Coordination Team Consultation Team
The Guide Process:  Team Decisions Topic is  Selected Staff  Recruits Teams  Task  Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach  Team Develops Priority List of Interventions
The Guide Process:  Task Force Input Topic is  Selected Staff  Recruits Teams  Task  Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach  Team Develops Priority List of Interventions Team  Presents To Task Force
Prioritization 2006ff: Our Ultimate Goal is a Work List… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
We Remain Open to Funded Review Opportunities   Priority Work List Funded Review
We Have to Update Existing Reviews   Priority Work List Funded Review ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Task Force Retains a Place for Special Projects   Priority Work List Funded Review ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
We Also Need a Priority List of New and Continued Public Health Topics   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Funded Review ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Step 1: Stakeholder Survey ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Responses from Stakeholders  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Step 2: Compile List of Candidate Topics ,[object Object],[object Object],[object Object]
Challenges Moving Forward ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenges Moving Forward ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenges Moving Forward ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Product of Step 2 ,[object Object],Notes Source Focused Topic Overall Topic Topic Number Grouping:  Addressing social, environmental, and ecosystem challenges New; DNPAO,NCIPC Stakeholders Land use planning and policy 71 New; DNPAO,NCIPC Stakeholders, Guide staff Built environment 70 . . .
Step 3: Compile Information to Enable Ranking of Topics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
a) Information Compiled for Each Topic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
b) CDC Program Directors Questionnaire ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
b) CDC Program Directors’ Questionnaire ,[object Object],[object Object],[object Object],[object Object]
b) CDC Program Directors’ Questionnaire ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Re-Prioritization of Topics:  Task Force Meeting, Fall 2006 ,[object Object],[object Object],[object Object]
Initial Plan Total List of  Considered Topics (n=111) Additional Information High Priority Tier of  Topics (n=~25) Medium Priority Tier of Topics (n=~50) Low Priority Tier of Topics (rest) Initial Vote Consensus Discussion Rank Vote Within High Priority Tier Final  Consensus
Mid-Course Modifications Initial Vote 111 Topics 1  …… 2  …… 3  …… 4  …… 5  …… . . . . 111 Preliminary Rank Order for all 111 topics Agree on criteria for voting
Key Criteria Agreed Upon for Voting ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Voting   Process; Resulting Rankings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Rank Order Led to (Lots and Lots of!!!) Consensus Discussion Initial Vote 1 …… 2 …… .  …… .  …… 25 or so 1  …… 2  …… 3  …… 4  …… 5  …… . . . . 111 26 ish 27 …… 28 …… .  …… 50 or so 51 …… 62 …… .  …… .  ……  111
We Alerted Task Force During Consensus Discussion of… ,[object Object],[object Object],[object Object],[object Object],[object Object]
Consensus Discussion 1 …… 2 …… .  …… .  …… 25 or so 26 ish 27 …… 28 …… .  …… 50 or so 51 …… 62 …… .  …… .  ……  111 Move lower ranked  Topics Up Move higher ranked  Topics Down Consider to exclude from further discussion? Consider if wish to group focused topics, exclude too broad topics
End of Task Force Meeting High Priority Tier of Topics 25 or so ‘ Loosely ranked’ Medium Priority Tier of Topics Low Priority Tier of Topics
Subsequent Steps ,[object Object],[object Object],[object Object]
Prioritization of Interventions for Systematic Review within Topics Topic is  Selected Staff  Recruits Teams  Task  Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach  Team Develops Priority List of Interventions Team  Presents To Task Force
Prioritization of Interventions for Systematic Review within a Topic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
For More Information ,[object Object],[object Object],[object Object],The findings and conclusions in this presentation are those of the presenter and do not necessarily represent the views of CDC.

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Centers for Disease Control & Prevention Community Guide

  • 1. Methods to Prioritize Systematic Reviews: The Guide to Community Preventive Services Shawna L. Mercer, M.Sc., Ph.D. Director The Guide to Community Preventive Services National Center for Health Marketing Centers for Disease Control and Prevention (CDC)
  • 2.
  • 3.
  • 4. The Clinical Guide and Community Guide Are Complementary
  • 5. The Clinical and Community Guides Are Complementary Individual level Clinical settings Delivered by healthcare providers Screening, Counseling, etc. Group level Health system changes Insurance/benefits coverage Access to/provision of services Community, population-based Informational ( Group Education, Media) Behavioral, Social Environmental & Policy Change Community Guide (TFCPS Recommendations ) Clinical Guide (USPSTF Recommendations)
  • 6. Community Guide (CG) Topics Settings Social Environment The Environment Worksites Schools Specific Conditions Risk Behaviors Vaccine-Preventable Disease Pregnancy Outcomes Violence Motor Vehicle Injuries Depression Cancer Diabetes Oral Health Obesity Tobacco Use Alcohol Abuse/Misuse Other Substance Abuse Poor Nutrition Inadequate Physical Activity Unhealthy Sexual Behaviors
  • 7.
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  • 19. Prioritization of Community Guide Work
  • 20.
  • 21.
  • 22.
  • 23. The Guide Process: From Topic to Intervention Review(s) Topic is Selected Task Force
  • 24. The Guide Process: The Team Topic is Selected Staff Recruits Teams Task Force Coordination Team Consultation Team
  • 25. The Guide Process: Team Decisions Topic is Selected Staff Recruits Teams Task Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach Team Develops Priority List of Interventions
  • 26. The Guide Process: Task Force Input Topic is Selected Staff Recruits Teams Task Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach Team Develops Priority List of Interventions Team Presents To Task Force
  • 27.
  • 28. We Remain Open to Funded Review Opportunities Priority Work List Funded Review
  • 29.
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  • 37.
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  • 41.
  • 42.
  • 43.
  • 44.
  • 45. Initial Plan Total List of Considered Topics (n=111) Additional Information High Priority Tier of Topics (n=~25) Medium Priority Tier of Topics (n=~50) Low Priority Tier of Topics (rest) Initial Vote Consensus Discussion Rank Vote Within High Priority Tier Final Consensus
  • 46. Mid-Course Modifications Initial Vote 111 Topics 1 …… 2 …… 3 …… 4 …… 5 …… . . . . 111 Preliminary Rank Order for all 111 topics Agree on criteria for voting
  • 47.
  • 48.
  • 49. Initial Rank Order Led to (Lots and Lots of!!!) Consensus Discussion Initial Vote 1 …… 2 …… . …… . …… 25 or so 1 …… 2 …… 3 …… 4 …… 5 …… . . . . 111 26 ish 27 …… 28 …… . …… 50 or so 51 …… 62 …… . …… . …… 111
  • 50.
  • 51. Consensus Discussion 1 …… 2 …… . …… . …… 25 or so 26 ish 27 …… 28 …… . …… 50 or so 51 …… 62 …… . …… . …… 111 Move lower ranked Topics Up Move higher ranked Topics Down Consider to exclude from further discussion? Consider if wish to group focused topics, exclude too broad topics
  • 52. End of Task Force Meeting High Priority Tier of Topics 25 or so ‘ Loosely ranked’ Medium Priority Tier of Topics Low Priority Tier of Topics
  • 53.
  • 54. Prioritization of Interventions for Systematic Review within Topics Topic is Selected Staff Recruits Teams Task Force Coordination Team Consultation Team Team Decides Breadth vs Depth Team Develops Conceptual Approach Team Develops Priority List of Interventions Team Presents To Task Force
  • 55.
  • 56.