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Kane RL, Guise JM, Hartman K, et al. Presentation of Future Research Needs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Apr. (Methods Future Research Needs Reports, No. 9.)
Table 3Excerpt from “Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), or Direct Renin Inhibitors (DRI) for Treating Hypertension”
| Research area | RCT? | Meta-analysis or individual patient data analysis across RCTs? | Meta-analysis of observational studies? | New observational study? | Analysis of existing data? | Model? |
|---|---|---|---|---|---|---|
| What is the comparative effectiveness of these medications on cardiovascular and cerebrovascular events measured over several years? | Maybe: Large number of studies recently completed or ongoing in patients with other comorbidities may make new RCTs unnecessary | Maybe: If recent data is not included in original CER or if it is methodologically valid to combine studies of medication impact across different conditions (such as hypertension, ischemic heart disease, chronic kidney disease) | Maybe: If sufficient number of studies available; adjustment for confounding could be an issue | Maybe: Most direct way to address long-term outcomes; however, resource requirements for longer-term studies are potential limitations | Yes: Most efficient method for evaluating long-term outcomes given the large number of existing studies; appropriate coding for covariates an issue | Maybe: Potential role for helping determine clinically important differences |
| What is the impact of comorbidities (such as ischemic heart disease, CHF, diabetes, peripheral arterial disease, chronic kidney disease) on ACEI/ARB/DRI effectiveness or harms in patients with hypertension? | Maybe: May be feasible for common comorbidities; existing or ongoing studies might be sufficient for some | Yes: If individual patient data or separate subgroup data not reported in current trials could be obtained and pooled for analysis; would require cooperation from the multiple sponsors of RCTs in this area | Yes: If individual patient data or separate subgroup data not reported in current trials could be obtained and pooled for analysis; would require cooperation from the multiple sponsors; if available, could address less common comorbidities, long-term safety/effectiveness | Maybe: Most direct way to address less common comorbidities; allows for adjustment for confounding; sample size and resources needed for longer follow-up are potential limitations | Yes: Most efficient method for evaluating less common comorbidities over longer time frames; appropriate coding of covariates a potential limitation | No: Except for potential role in defining clinically or economically meaningful differences |
- Table 3, Excerpt from “Future Research Needs for Angiotensin-Converting Enzyme I...Table 3, Excerpt from “Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), or Direct Renin Inhibitors (DRI) for Treating Hypertension” - Presentation of Future Research Needs
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