Papers by Christine Chang
Annals of internal medicine, Jan 4, 2018
Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a... more Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater ...
This report is based on research conducted by the Agency for Healthcare Research and Quality (AHR... more This report is based on research conducted by the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers' Methods Workgroup. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.
Journal of clinical epidemiology, Jan 27, 2017
Advanced analytic methods for synthesizing evidence about complex interventions continue to be de... more Advanced analytic methods for synthesizing evidence about complex interventions continue to be developed. In this paper, we emphasize that the specific research question posed in the review should be used as a guide for choosing the appropriate analytic method. We present advanced analytic approaches that address four common questions that guide reviews of complex interventions: 1) How effective is the intervention?; 2) For whom does the intervention work and in what contexts?; 3) What happens when the intervention is implemented?; and 4) What decisions are possible given the results of the synthesis? The analytic approaches presented in this paper are particularly useful when each primary study differs in components, mechanisms of action, context, implementation, timing, and many other domains.
Journal of Clinical Epidemiology, 2014
Objectives: The purpose of this Agency for Healthcare Research and Quality Evidence-based Practic... more Objectives: The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. Study Design and Setting: We performed a literature scan and conducted semistructured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions (CMCIs) or organizational leaders who implement CMCIs in health care. Results: Challenges identified include lack of consistent terminology for such interventions (eg, complex, multicomponent, multidimensional, multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from holistic to individual component analytic approaches; and incomplete and inconsistent reporting of elements critical to understanding the success and impact of multicomponent interventions, such as methods used for implementation the context in which interventions are implemented. Conclusion: We provide a framework for the spectrum of conceptual and analytic approaches to synthesizing studies of multicomponent interventions and an initial list of critical reporting elements for such studies. This information is intended to help systematic reviewers understand the options and tradeoffs available for such reviews.
Figure 2, Closing the Quality Gap series analytic framework to summarize applicable areas for each topic
Figure 1, AHRQ Effective Health Care Program: Points of stakeholder engagement for systematic reviews
This report is based on research conducted by Agency for Healthcare Research and Quality (AHRQ) E... more This report is based on research conducted by Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers' 2014 Methods Workgroup 1. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers-patients and clinicians, health system leaders, and policymakers, among others-make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients). AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies may not be stated or implied. This document is in the public domain and may be used and reprinted without permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders.
Focus on Action: Key Messages for Improving Quality
Journal of Hospital Medicine
Objective:The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Progr... more Objective:The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program conducts systematic reviews on a range of health care topics. Topics are nominated by a variety of stakeholders. Nominated topics undergo a refinement process to ensure that the Key Questions are relevant, of appropriate scope, and will ultimately yield a useful systematic review. Topic refinement investigators gather input from Key Informants, topical experts, and a literature scan to inform changes in the PICOTS (population, intervention, comparator, outcomes, timing, and setting), analytic framework and Key Questions. Evidence-based Practice Centers (EPCs) have approached the topic refinement process in similar and different ways. AHRQ convened a work group to assess current approaches and to develop recommendations for best practices; we report our findings here.
The Permanente Journal, 2013
Methods Series Topics The Closing the Quality Gap series included eight topics selected by leader... more Methods Series Topics The Closing the Quality Gap series included eight topics selected by leaders in AHRQ for their relevance to high-priority populations, settings, and processes, 4 and to provisions of the Affordable Care Act (Table 1). Selected topics were also ripe for systematic review and expected to yield
Implications for Future Evidence Reviews
Methods Series Topics The Closing the Quality Gap series included eight topics selected by leader... more Methods Series Topics The Closing the Quality Gap series included eight topics selected by leaders in AHRQ for their relevance to high-priority populations, settings, and processes, 4 and to provisions of the Affordable Care Act (Table 1). Selected topics were also ripe for systematic review and expected to yield
The information in this report is intended to help health care decisionmakers-patients and clinic... more The information in this report is intended to help health care decisionmakers-patients and clinicians, health system leaders, and policymakers, among others-make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients. This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated. Persons using assistive technology may not be able to fully access information in this report. For assistance contact EffectiveHealthCare@ahrq.hhs.gov. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.
Phenylketonuria Scientific Review Conference: State of the science and future research needs
Molecular Genetics and Metabolism, 2014
Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a... more Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater ...
PLoS Medicine, 2013
Center under contract with the Agency for Healthcare Research and Quality www.ahrq.gov (AHRQ; con... more Center under contract with the Agency for Healthcare Research and Quality www.ahrq.gov (AHRQ; contract No. HHSA290200710062I). The authors of this article are responsible for its contents. No statement in this article should be construed as an official position of AHRQ or the US Department of Health and Human Services. The funder had no role in the study design, data collection and analysis, or decision to publish.
Comparative Effectiveness Research, 2015
Background: Although there is a growing literature on the process of engaging stakeholders in med... more Background: Although there is a growing literature on the process of engaging stakeholders in medical research, there are a lack of clearly-defined measures for reporting and evaluation, which limits the ability to learn from past experience, understand the effectiveness of engagement, or identify which approaches work best. Clearly defining the benefits and challenges of engaging stakeholders in the systematic review process is an integral first step toward developing a set of criteria that can be used to evaluate the impact and effectiveness on the conduct, quality, and dissemination of systematic reviews. Methods: We utilized two complementary approaches to examine the benefits and challenges of engaging stakeholders in the systematic review process: 1) a literature scan to understand the overall state of the field; and 2) a series of key informant interviews with systematic reviewers, program/policy officials, and stakeholders. Results: We identified six main expected benefits a...
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions
Journal of Clinical Epidemiology, 2014
The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center met... more The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. We performed a literature scan and conducted semistructured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions (CMCIs) or organizational leaders who implement CMCIs in health care. Challenges identified include lack of consistent terminology for such interventions (eg, complex, multicomponent, multidimensional, multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from holistic to individual component analytic approaches; and incomplete and inconsistent reporting of elements critical to understanding the success and impact of multicomponent interventions, such as methods used for implementation the context in which interventions are implemented. We provide a framework for the spectrum of conceptual and analytic approaches to synthesizing studies of multicomponent interventions and an initial list of critical reporting elements for such studies. This information is intended to help systematic reviewers understand the options and tradeoffs available for such reviews.
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Papers by Christine Chang