Beth Collins Sharp from AHRQ is answering question we, and other advocates, have about P2P. Here is our email exchange, and she reiterated those question in her #CFSAC presentation: -------------------------- Q: From my understanding, the P2P is intended to identify research gaps. Will diagnosis or treatment recommendations be a result also? A: You are right. The process is squarely focused on research and research gaps. The EPC’s research review that will inform the Panel will only make research recommendations. The text of the report will describe and summarize the evidence for each key question so that the Panel can consider the evidence for their recommendations. Based on the evidence review and the public testimony, the Panel will formulate their recommendations. That said, the key questions include research on diagnosis and treatments. So a recommendation could be made, but I’d expect it to reflect the context of the data and the public testimony. Often there are recommendations like… “More research is needed on x treatment or y diagnostic test.” Q: What role does AHRQ have? A: AHRQ is the science partner. We support the EPC Program that conducts systematic reviews for a wide variety of audiences and purposes. [Full disclosure: I used to be the Director of the EPC Program.] The EPC and a project officer attended the Expert Workgroup meeting to help them refine the questions for the systematic review and to listen to the issues so that the questions were worded in a way that was useful for systematic review purposes. Q: From my understanding, the questions listed are entirely different from that suggested by the expert working group. Why are the original questions from the experts not being used? effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1906 A: The key questions are different than the ones that are initially presented at the beginning of the Expert Working Group meeting. But they are not different than the questions that the experts identified for the EPC’s systematic review. In addition to identifying the key questions for the systematic review, the Working Group crafted the over-riding Conference questions/themes, and structured an agenda and identified potential speakers to cover those questions/themes. https://prevention.nih.gov/programs-events/pathways-to-prevention/workshop-planning/working-group So once again going back to the key questions for the systematic review, they were extracted from the initial set of questions to focus on areas where there was sufficient literature to be informative to the broader questions and themes. In areas where there were not sufficient data for a systematic review, there will be experts who speak to fill in those areas for the Panel. Q: Has the Oxford criteria been explicitly excluded in the review? You may note that the advocates invited to speak at the December IoM meeting, including myself, emphasized that any study that uses fatigue as the only requirement is not appropriate in looking at ME/CFS since it includes anyone with idiopathic fatigue or fatigue from other conditions. iom.edu/Activities/Disease/DiagnosisMyalgicEncephalomyelitisChronicFatigueSyndrome/2014-JAN-27/Videos/Patients%20and%20Advocates/11-Chapo-Kroger-Video.aspx A: Right. The Oxford criteria seem problematic to many of us. But it is not excluded from the review because an identifiable body of research has used it. Including it seems silly to those in the know, but it can be a good thing for the science ahead. It will be reviewed and left to stand or fall on its own [de]merits. The same applies to the other criteria.
Posted on: Mon, 16 Jun 2014 16:57:24 +0000
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