The Scientific Resource Center is a coordinating center for a large, multi-center federal program that collectively aims to synthesize evidence
to inform medical decisionmaking. We are a centralized resource for scientific, medical, editorial, and technical expertise to promote scientific rigor,
and consistency within the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program.
Primary functions
We support the production of EPC evidence reviews from conception, through production, and into publication and dissemination.
We work with medical decision makers to transform their decisional dilemmas into research questions and assist AHRQ in prioritizing those research questions for funding.
We help to ensure methodological consistency and rigor across EPCs by facilitating workgroups, and we promote collaboration and expansion of skills by hosting program-wide
meetings. We develop templates and resources to promote consistency across the EPCs. We are essential in the editorial oversight of EPC evidence reviews, both by providing
direct editorial input and managing the recruitment and activities of peer reviewers. Working with our partners at Academy Health, we have assembled a panel of leaders
from health systems and academia in order to broaden the audience for—and quicken the uptake of—medical evidence from the program as well as to ensure that program products are developed to better
meet the information needs of clinicians, health systems, policymakers, and others. We also have innovated and piloted a more modern web-based presentation for EPC reviews
("NxGen") and are assisting AHRQ in the implementation of this new report format.
The SRC is located at the Portland Veterans Administration Hospital campus in beautiful, sunny Portland, Oregon. It was created and contracted in 2005 at the request of
AHRQ. We can be reached by email at AHRQSRC@va.gov.
In addition to AHRQ and the EPCs, we work with a variety of stakeholders in the field of evidence-based medicine, including guideline developers,
federal partners, clinicians, and patient advocacy groups, as well as health systems and practices, particularly learning health systems. We also support those who come to our
program with medical decisional dilemmas, working to ensure they are provided with evidence products designed to inform their decisions. We work to collaborate with external experts
in the field of evidence reviews to ensure EPC reports are using the most up-to-date and rigorous methodology so end-users of AHRQ EPC products can trust in the findings.
Recently, the SRC and our partners at AcademyHealth have worked with AHRQ to assemble a group of key stakeholders, experts in health policy, communication, and systems.
The panel is co-led by Drs. Lucy Savitz, a recognized expert in promoting the uptake and adoption of evidence in health systems, Mark Helfand
(the SRC principal investigator and internationlly recognized expert in comparative effectiveness methodologies), and Lisa Simpson, M.B., B.Ch, M.P.H., FAAP,
President and CEO of AcademyHealth.
The work of the Stakeholder Panel is intended to enhance the reach and impact of AHRQ's EPC products, thereby supporting improvements in the quality and outcomes of care, with a strong focus on equity.
Stakeholder Panel members will be asked to provide thoughts, insight, and feedback, on:
- Topic nominations
- Adoption and use of evidence
- EPC evidence reviews and tools
- Implementation of EPC program or contractor-developed tools in practice
Additionally, the SRC—in partnership with AcademyHealth—facilitates a meeting series "Grand Rounds" to promote and facilitate the use of EPC evidence reports
in healthcare. These meetings feature presentations from EPC report authors followed by discussions with stakeholders to explore EPC report findings. More information on these
meetings can be found on AHRQ's Effective Health Care website: https://effectivehealthcare.ahrq.gov/about/webinars
The SRC can be reached by email at AHRQSRC@va.gov.
The evidentiary and information needs of health systems are evolving alongside innovative research designs for causal inference, new tools and technologies for
evidence synthesis, and creative mechanisms for scientific communication not bound by academic publishing. The COVID-19 pandemic further highlighted challenges in developing methods
to complete rigorous, useful, targeted, and up to date evidence synthesis products. Today's context presents exciting opportunities for the role of methodological work within the EPC
Program. In this context, the SRC's role is to create a collaborative infrastructure within which a diverse cohort of EPCs have structured opportunities to share knowledge and
experiences, embrace the complexity of challenges and specialization of skills, reframe failures as opportunities for growth, and collaborate with the broader evidence synthesis
community in the global effort to advance evidence synthesis methodology.
Through this effort to improve the transparency, consistency, and scientific rigor of the work of the Effective Health Care (EHC) Program, the SRC has worked collaboratively with
the Agency for Healthcare Research and Quality (AHRQ) and the Evidence-based Practice Centers (EPCs) to develop a Methods Guide for Comparative Effectiveness Reviews. That guide can
be found on AHRQ's Effective Health Care site: https://effectivehealthcare.ahrq.gov/products/collections/cer-methods-guide
As further empiric evidence develops and our understanding of methods improves, updates are made and additional chapters are added, such that this Methods Guide is a living
document. The more recent methods guidance publications are listed on our publications page.
The SRC can be reached by email at AHRQSRC@va.gov.
The SRC topic development team evaluates all proposed evidence synthesis topics using criteria that include appropriateness, importance,
absence of duplication, feasibility, impact, and value of a proposed evidence review. Based on these assessments, the SRC makes recommendations to the EPC Program. The outputs
of the topic selection/development process include Topic Briefs and Adapted Topic Briefs.
Most topic nominations come from the topic nomination portal on AHRQ's Effective
Health Care website. Using an iterative process, the SRC engages topic nominators to formulate Key Questions and PICOTS (Population, Intervention, Comparator, Outcomes,
Timing, and Setting) that address the decisional dilemma(s) faced by the nominator. Priority ranking is based on expert assessment of the importance and feasibility of the nominated
topics. The Topic Brief encapsulates this work and the expert assessment; Topic Briefs are posted on the AHRQ Effective Health Care website.
Adapted Topic Briefs serve two purposes: 1) to assess the nomination using established EPC Program selection criteria, as with traditional briefs; and 2) to provide
additional information, such as tables of data abstracted from the studies matching the Key Questions/PICOTS or more advanced visualizations, that are relevant and useful to the
stakeholder.
The SRC can be reached by email at AHRQSRC@va.gov.
The SRC also supports the EPC program by providing Peer Review Management and coordinating aspects of internal review by managing the Associate Editor (AE) group.
The SRC has configured third-party software to support the specialized needs of AHRQ EPC peer review. We have customized inputs and outputs to the system in order to meet
program needs and to provide a "paper trail" to document steps and support continuous quality improvement.
Before reports are released for peer and public review, they are assessed by an Associate Editor—an EPC leader unassociated with the author EPC. More information on the
AE group and the editorial process is available on the AHRQ Effective Health Care website.
The SRC can be reached by email at AHRQSRC@va.gov.
The SRC has led the effort at AHRQ's EPC Program website to make program reports easier to use and understand by adding
data visualizations and other improvements to the web-based display. Called "NxGen," this technical update began implementation in 2022. The philosophy and practical considerations
defining this work are outline in our publication: "NxGen Evidence: Redesigning the Agency for Healthcare Research and
Quality (AHRQ) Effective Health Care website to promote engagement, interactivity and usability of systematic reviews." This effort is ongoing.
We created NxGen as a method for both broadening the reach of EPC reports and improving access to EPC report findings. In a years-long stakeholder-driven effort to
make EPC report findings easier to locate and understand, we established the following basic elements of NxGen:
- Main Points
- Abstract
- Visual Dashboard
- Report Snapshot
- Summary of Findings
- Key Questions
- Related Findings
- Clinical and Policy Implications
- Limitations and Future Research
- Citations (Journal and Report)
- Downloads (Separate elements in PDF form—including the full report—so that users can pick and choose among report elements)
The key elements are the Visual Dashboard and the Report Snapshot. The Visual Dashboards provide an interactive image that shows users the "big picture" painted by the data while enabling them to interact with the data to focus on
interventions-comparisons-outcomes of interest. Users can hover over any included study to learn more about it and, in some cases, link to the study in Pubmed (if the link to
Pubmed is not available in the visualization, it will be available in the Report Snapshot).
The Report Snapshot is a tabbed tool with the tab sections noted above. The Summary of Findings tab is intended to focus on the findings of greatest interest/most importance.
and provides these data in a tabular format.
1.
Antipsychotics for the Prevention and Treatment of Delirium
2.
Treatment of Depression in Children and Adolescents
3.
Interventions To Decrease Hospital Length of Stay
4.
Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain
5.
Antibody Response Following SARS-CoV-2 Infection and Implications for Immunity: A Living Rapid Review
6.
Malnutrition in Hospitalized Adults
7.
Management of Primary Headaches in Pregnancy
8.
Management of Infantile Epilepsies
9.
Partial Breast Irradiation for Breast Cancer
The SRC can be reached by email at AHRQSRC@va.gov.
The Scientific Resource Center (SRC) publishes and presents on issues relevant to the content, methods, and presentation of systematic and comparative effectiveness review.
A listing of our most recent and most important work follows:
Highlighted Publications (6)
1.
Saldanha I, Adam G, Bañez L, et al. Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance
from the Agency for Health Care Research and Quality Effective Health Care program
Journal of Clinical Epidemiology
2.
Reid E, Guise JM, Fiordalisi, et al. NxGen Evidence: Redesigning the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care website to
promote engagement, interactivity and usability of systematic reviews
Research Synthesis Methods
3.
Gerrity M, Fiordalisi C, Pillay J, et al. Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews
4.
Murad MH, Chang SM, Fiordalisi C, et al. Improving the Utility for Healthcare Decisionmakers of Evidence Synthesis in the Face of Insufficient Evidence
Journal of Clinical Epidemiology
5.
Mind the Gap: Putting Evidence into Practice in the Era of the Learning Health System
Journal of General Internal Medicine
6.
Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in Conferring Immunity Following SARS-CoV-2 Infection
Annals of Internal Medicine
1.
Holmer HK, Mackey K, Fiordalisi CV, Helfand M. Major Update 2: Antibody Response and Risk for Reinfection After SARS-CoV-2 Infection—Final Update of a Living, Rapid Review
Annals of Internal Medicine
2.
Antibody Response After SARS-CoV-2 Infection and Implications for Immunity: A Rapid Living Review
Annals of Internal Medicine
3.
Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in
Conferring Immunity Following SARS-CoV-2 Infection
Annals of Internal Medicine
4.
Adam GP, Balk EM, Jap J, et al. AHRQ EPC Series on improving translation of evidence: Web-based interactive presentation of systematic review reports.
Joint Commission Journal on Quality and Patient Safety
5.
Barclay C, Viswanathan M, Ratner S, et al. AHRQ EPC Series on implementing evidence-based screening and counseling for unhealthy alcohol use with
Epic-based electronic health record tools.
Joint Commission Journal on Quality and Patient Safety
6.
Borsky AE, et al. AHRQ EPC Series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems
Panel.
Joint Commission Journal on Quality and Patient Safety
7.
Fiordalisi C, et al. AHRQ EPC Series on improving translation of evidence into practice for the learning health system: introduction.
Joint Commission Journal on Quality and Patient Safety
8.
Flores EJ, Jue JJ, Giradi G, et al. AHRQ EPC Series on improving translation of evidence: Use of a clinical pathway for c. difficile treatment to facilitate
the translation of research findings into practice.
Joint Commission Journal on Quality and Patient Safety
9.
Guise, JM, et al. AHRQ EPC Series on improving translation of evidence: Progress and promise in supporting learning health systems.
Joint Commission Journal on Quality and Patient Safety
10.
White CM, Coleman CI, Jackman K, et al. AHRQ EPC series on improving translation of evidence: Linking evidence reports and performance measures to help
learning health systems use new information for improvement.
Joint Commission Journal on Quality and Patient Safety
11.
Retention Strategies for Medications for Addiction Treatment in Adults with Opioid Use Disorder: A Rapid Review
Journal of Addiction Medicine
12.
Agency for Healthcare Research and Quality Evidence-based Practice Center methods provide guidance on prioritization and selection of harms in systematic
reviews
Journal of Clinical Epidemiology
13.
Murad MH, Chang SM, Fiordalisi C, et al. Improving the Utility for Healthcare Decisionmakers of Evidence Synthesis in the Face of Insufficient Evidence
Journal of Clinical Epidemiology
14.
Paynter RA, Featherstone R, Stoeger E, et al. A Prospective Comparison of Evidence Synthesis Search Strategies
Developed With and Without Text-Mining Tools
Journal of Clinical Epidemiology
15.
Recommendations for assessing the risk of bias in systematic reviews of health-care interventions
Journal of Clinical Epidemiology
16.
Lin JS, Murad MH, Leas B, et al. A Narrative Review and Proposed Framework for Using Health System Data with Systematic
Reviews to Support Decision-making.
Journal of General Internal Medicine
17.
Mind the Gap: Putting Evidence into Practice in the Era of the Learning Health System
Journal of General Internal Medicine
18.
Murad MH, Fiordalisi C, Pillay J., et al. Making Narrative Statements to Describe Treatment Effects
Journal of General Internal Medicine
19.
Reid E, Guise JM, Fiordalisi, et al. NxGen Evidence: Redesigning the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care website to
promote engagement, interactivity and usability of systematic reviews
Research Synthesis Methods
20.
Gartlehner G, Wagner G, Lux L, et al. Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
Systematic Reviews
21.
Gates A, Guitard S, Pillay J, et al. Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of
three tools.
Systematic Reviews
22.
Saldanha I, Adam G, Bañez L, et al. Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance
from the Agency for Health Care Research and Quality Effective Health Care program
Journal of Clinical Epidemiology
1.
Holmer HK, Mackey K, Fiordalisi CV, Armstrong C, Gean E, Arkhipova-Jenkins I, Helfand M. Antibody Response Following SARS-CoV-2 Infection and Implications
for Immunity: Final Update of a Rapid, Living Review
2.
Hickam DH, Gordon CJ, Armstrong CE, Coen MJ, Paynter R, Helfand M. Efficacy of Dental Services for Reducing Adverse Events in Those Receiving Chemotherapy
for Cancer. AHRQ Rapid Evidence Product.
3.
Hickam DH, Gordon CJ, Armstrong CE, Paynter R. Efficacy of Dental Services for Reducing Adverse Events in Those Undergoing Insertion of Implantable Cardiovascular
Devices. AHRQ Rapid Evidence Product.
4.
Gartlehner G, Wagner G, Lux L, Affengruber L, Dobrescu A, Kaminski-Hartenthaler A, Viswanathan M. Assessing the Accuracy of Machine-Assisted Abstract
Screening With DistillerAI: A User Study. Methods Research Report. AHRQ Publication No. 19(20)-EHC026-EF. Rockville, MD: Agency for Healthcare Research and Quality.
5.
Gates A, Guitard S, Pillay J, Elliott SA, Dyson MP, Newton AS, Hartling L. Performance and Usability of Machine Learning for Screening in Systematic
Reviews: A Comparative Evaluation of Three Tools. (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-2015-00001-I) AHRQ
Publication No. 19(20)-EHC027-EF Rockville, MD: Agency for Healthcare Research and Quality.
6.
Lin J, Murad H, Leas B, et al. Integrating Health System Data with Systematic Reviews: A Framework for When and How Unpublished Health System Data Can Be
Used with Systematic Reviews to Support Health System Decision Making.
7.
Michel J, Flores E, Mull N, Tsou AY. Translation of a Clinical Pathway for C. Difficile Treatment Into a Machine-Readable Clinical Decision Support
Artifact Prototyped for Electronic Health Record Integration.
8.
Michel J, Flores E, Mull N, Tsou AY. Translation of a Clinical Pathway for C. Difficile Treatment Into a Machine-Readable Clinical Decision Support
Artifact Prototyped for Electronic Health Record Integration.
9.
Saldanha IJ, Senturk B, Smith BT, Robinson, KA. Pilot to Promote Entry of Structured Data Into the Systematic Review Data Repository.
10.
Saldanha IJ, Senturk B, Smith BT, Robinson, KA. Pilot to Promote Entry of Structured Data Into the Systematic Review Data Repository.
1.
Assessing the Risk of Bias in Systematic Reviews of Health Care Interventions
2.
Prioritization and selection of harms for inclusion in systematic reviews
3.
Quantitative Synthesis—An Update
4.
Inclusion of Nonrandomized Studies of Interventions in Systematic Reviews of Intervention Effectiveness: An Update
1.
A Framework for Conceptualizing Evidence Needs of Health Systems
2.
Fiordalisi C, Borsky A, Chang S. Improving Health Systems' Access to High-Quality Evidence: AHRQ EPC 2018 Pilot Projects Summary.
3.
Gerrity M, Fiordalisi C, Pillay J, et al. Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews
4.
Hartling L, Gates A, Pillay J, et al. Development and Usability Testing of EPC Evidence Review Dissemination Summaries for Health Systems Decisionmakers.
5.
Lin JS, Rubenstein LV, Beil TL, et al. Linking Evidence Reviews to Organizational Guideline Planning: A Pilot Test of an Interactive, Web-Based
Presentation and Discussion of Evidence.
6.
Morrow AS, Butler M, Murad MH. Facilitating the Implementation of EPC Reports in Learning Health Systems Engaged in Quality Initiatives: an EPC
Pilot Project on ADHD.
7.
Morrow AS, Whiteside SP, Sim L, et al. EPC Pilot Project: A Dual Approach To Facilitate Health Systems Uptake of Evidence Synthesis Reports.
8.
Murad MH, Chang SM, Fiordalisi C, et al. Improving the Utility for Healthcare Decisionmakers of Evidence Synthesis in the Face of Insufficient Evidence
9.
Paynter RA, Fiordalisi C, Stoeger E, et al. A Prospective Comparison of Evidence Synthesis Search Strategies Developed With and Without
Text-Mining Tools
10.
Robinson KA. Disseminating Findings From EPC Reports: Pilot Project of Three Products.
11.
Understanding Health-Systems' Use of and Need for Evidence to Inform Decision-making
The SRC can be reached by email at AHRQSRC@va.gov.
The Scientific Resource Center (SRC) is centered in the Portland VA Research Foundation (PVARF)
and located at the Portland Veterans Administration Hospital campus in beautiful, sunny Portland, Oregon.
The SRC was created and contracted in 2005 at the request of the Agency for Healthcare Research and Quality (AHRQ) to support its
Evidence-based Practice Center (EPC) program.
The ultimate goal of EPC work is to present the "state of the science" on a given topic in a manner that can be directly applied to decisions made by users of health
care information. The EPC Program leads the nation in engaging stakeholders, review authors, methodologists, and the public in identifying information needs,
critically appraising the world's literature, and reporting what is and is not known in health care. EPCs conduct research on methods to enhance the scientific rigor
and consistency of systematic reviews, develop White Papers on systematic review methods that describe the current understanding of the state of the science of
emerging methods issues, and have produced methods guidance for conducting systematic reviews.
Investigative Staff and Program Officers
Mark Helfand, MD, MPMH
Professor of Medicine at the Oregon Health & Science University, Dr. Helfand is board-certified in Internal Medicine and practices hospital medicine at the Portland VA Medical Center.
He directs the VA Evidence-Based Synthesis Program Coordinat-ing Center, and the AHRQ Scientific Resource Center for the Effective Health Care Program. He is a founding member
of the steering committee of the Health Experiences Research Network, the US branch of Dipex International.
Lisa Winterbottom, MD, MPH, FACP
Dr. Lisa M. Winterbottom is an internist in Portland, Oregon. She re-ceived her medical degree from
The Warren Alpert Medical School of Brown University and has been in practice for more than 20 years. She also serves as an Associate Professor of Medicine with the VA Portland
Healthcare System and serves as a clinical advisor for the SRC topics team.
Haley Holmer, PhD, MPH
Dr. Holmer is an investigator on the Methods team at the SRC.
Devan Kansagara, MD, MCR
Professor of Medicine, Division of General Internal Medicine and Geriatrics at OHSU, Dr. Kansagara
practices internal medicine in the VA and has an interest in evidence based medicine and the use of evidence to guide health policy. Devan works with the SRC on adaptive
topics.
David Hickam, MD, MPH
David is a general internist who formerly was a senior investigator in the Oregon EPC and led health
services research programs at the Portland VAMC. From 2012 to 2020 he directed the Clinical Effectiveness Program at PCORI. In 2021 he re-turned to Portland to serve as a
clinician investigator in the VA's Evidence Synthe-sis Program Coordinating Center. In 2023 he joined the SRC to work on rapid re-views and topic development activities.
He is a professor in the OHSU Department of Medical Informatics and Clinical Epidemiology.
Celia Fiordalisi, MS, BS
Program Manager for the SRC, Celia has been with the SRC since 2016 when she joined as a research assistant and has
experience with research methodology.
We can be reached by email at AHRQSRC@va.gov.