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West SL, Gartlehner G, Mansfield AJ, et al. Comparative Effectiveness Review Methods: Clinical Heterogeneity [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Sep.

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Comparative Effectiveness Review Methods: Clinical Heterogeneity [Internet].

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Table 16Clinical heterogeneity variables specified in key questions for AHRQ comparative effectiveness reviews

CER TopicKey Question and Specific Clinical Heterogeneity Variables
Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in AdultsKQ 4. What are the comparative benefits and harms of drug therapies for rheumatoid arthritis and psoriatic arthritis in subgroups of patients based on stage of disease, history of prior therapy, demographics, concomitant therapies, or comorbidities?
Comparative Effectiveness of Percutaneous Coronary Bypass Grafting for Coronary Artery DiseasesKQ 2. Is there evidence that the comparative effectiveness of PCI and CABG varies based on:
  • Age, sex, race, or other demographic risk factors?
  • Coronary disease risk factors, diabetes, or other comorbid disease?
  • Angiographic-specific factors including, but not limited to, the number of diseased vessels amenable to bypass or stenting, vessel territory of stenoses (e.g., left main or anterior descending coronary arteries, right coronary artery, circumflex coronary artery), diffuse vs. focal stenoses, left ventricular function, or prior revascularization procedures?
  • CABG-specific factors including, but not limited to, cardiopulmonary bypass mode (normothermic vs. hypothermic), type of cardioplegia used (blood vs. crystalloid), or use of saphenous vein grafts, single or bilateral internal mammary artery grafts, or other types of bypass grafts?
  • Clinical presentation (e.g., stable angina or unstable angina based on New York Heart Association functional class I–IV, acute coronary syndrome, cardiogenic shock, acute myocardial infarction with or without ST elevation, or silent ischemia)?
  • Adjunctive medical therapies, such as short-term intravenous or oral antiplatelet drugs, or long-term use of oral antiplatelet drugs?
  • Process characteristics such as provider volume, hospital volume, and setting (e.g., academic vs. community)?
  • Prior PCI or CABG revascularization procedures?
Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult DepressionKQ 3. Do medications or combinations of medications (including tricyclics in combination) used to treat depression differ in their efficacy or effectiveness for treating accompanying symptoms, such as anxiety, insomnia, and neurovegetative symptoms?
  • Do medications differ in their efficacy and effectiveness in treating the depressive episode?
  • Do medications differ in their efficacy and effectiveness in treating the accompanying symptoms?
KQ 5. How do the efficacy, effectiveness, or harms of treatment with antidepressants for a depressive syndrome differ for the following subpopulations?
  • Elderly or very elderly patients;
  • Other demographic groups (defined by age, ethnic or racial groups, and sex);
  • Patients with medical comorbidities (e.g., ischemic heart disease, cancer);
  • Patients with psychiatric and behavioral comorbidities (e.g., substance abuse disorders); and
  • Patients taking other medications

CABG=coronary artery bypass grafting; PCI=percutaneous coronary intervention.

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