Excerpt

The 2009 comparative effectiveness review (CER) on the effectiveness of medications to reduce the risk of primary breast cancer in women without preexisting cancer demonstrated the efficacy of two SERMs, tamoxifen citrate (RR, 0.70; 95% CI, 0.59 to 0.82; 4 trials) and raloxifene (RR, 0.44; CI, 0.27 to 0.71; 2 trials). However, the CER also outlined many adverse effects and unknowns about the medications. The objective of this pilot project was to engage stakeholders to develop and prioritize a list of research questions to address the research gaps related to the CER. First, our goal was to provide sufficient detail—including population, intervention, comparator, and outcome (PICO)—for researchers and funders to use in the development of research proposals and solicitations, respectively. Second, this project was intended to identify a feasible and effective approach to identify and prioritize future research from systematic reviews in general.

Contents

• Preface
• Executive Summary
  • Background
  • Methods
  • Results
  • Conclusions
  • Executive Summary References
• Background
  • Research Gaps
  • Objective
• Methods
  • Identification and Recruitment of Stakeholders
  • Disclosure and Evaluation of Conflicts of Interest
  • Questionnaire Development and Refinement
  • Webinar and Questionnaire Administration
  • Analysis
  • Identification of Ongoing Studies
• Results
  • Stakeholders
  • Research Priorities
• Discussion
  • Discussion of Process Issues or Recommendations
  • Framework for Future Research and Reflections on CERs
  • Future Research Study Designs
• Conclusions
• References
• Abbreviations
• Appendixes
  • Appendix A CER Section on Future Research Needs
  • Appendix B Future Research Agenda Questionnaire I: Consumer/Policymaker
  • Appendix C Future Research Agenda Questionnaire II: Clinician/Research Funder/Researcher
  • Appendix D Search Strategy for Ongoing Studies

Acknowledgments: First, we thank the stakeholders who devoted their time to this project and whose participation made this report possible. We thank our colleagues at the Oregon Evidence-based Practice Center, David Buckley, MD, MPH, Evelyn Whitlock, MD, MPH, and Carrie Heitzler, PhD, MPH, for drafting the initial proposal of this project. The authors also thank Lillian Nail, RN, PhD, FAAN, Heidi Nelson, MD, MPH, and Xiangshu Xiao, PhD, MS, for their expertise and thoughtful contributions during informational interviews. We acknowledge the contributions of AHRQ Task Order Officer, Christine Chang, MD, MPH and Scientific Resource Center Research Associate, Howard Balshem, MS. We would like to thank Leah Williams, B.S., for editorial support and Sasha Walia, B.S., for administrative support. Finally, we thank Mark Helfand, MD, MPH for his insights, editorial review and continued support.

AHRQ Contacts: Carolyn M Clancy, MD, Director, Agency for Healthcare Research and Quality; Stephanie Chang, MD, MPH, Director, Evidence-based Practice Center Program, Agency for Healthcare Research and Quality; Jean Slutsky, PA, MSPH, Director, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality; Christine Chang, MD, MPH, Medical Officer, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Contract No. 290-2007-10057-I. Prepared by: Oregon Evidence-based Practice Center, Portland, OR

Suggested citation:

Guise J-M, Nakamoto EK, LaBrant L, Relevo R, O’Haire C, Cottrell EK, Most C, Graham E. Future Research Needs To Reduce the Risk of Primary Breast Cancer in Women. Future Research Needs Paper No. 5. (Prepared by Oregon Evidence-based Practice Center under Contract No. 290-2007-10057-I.) AHRQ Publication No. 10-EHC073-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10057-I). The findings and conclusions in this document are those of the author(s), 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 researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

This report may be used, in whole or in part, as the basis for research design or funding opportunity announcements. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This information does not represent and should not be construed to represent a determination or policy of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

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