ORIGINAL ARTICLE AHRQ Series Paper 3: Identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the Effective Health-Care program Evelyn P. Whitlock a,b, * , Sarah A. Lopez c , Stephanie Chang d , Mark Helfand a,e , Michelle Eder a,b , Nicole Floyd a,c a Oregon Evidence-based Practice Center, Portland, OR 97227 USA b Kaiser Permanente Center for Health Research, Portland, OR 97227, USA c Oregon Health & Science University, Portland, OR 97239, USA d Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, MD 20850, USA e Portland Veterans Affairs Medical Center, Portland, OR 97239, USA Accepted 10 March 2009 Abstract Objective: This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality’s Effective Health Care (EHC) program. Study Design and Setting: The EHC program seeks to align its research topic selection with the overall goals of the program, impar- tially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. Results: A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are ‘‘appropriate’’) to determine how ‘‘important’’ topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the ‘‘potential value and impact’’ of a comparative effectiveness systematic review. Conclusion: As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthe- sized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness. Ó 2010 Elsevier Inc. All rights reserved. Keywords: Comparative effectiveness; Evidence-based practice; Systematic review; Priority setting; Methods; Decision making 1. Introduction Globally, people are struggling with the reality of limited resources to address the breadth of health and health care needs. Evidence has been recognized as the ‘‘new anchor for medical decisions’’ [1], and many consider systematic reviews to be the best source of information for making clinical and health policy decisions [2]. These translational research prod- ucts rigorously summarize existing research studies so that health and health care decisions by practitioners, policy makers, and patients are more evidence based. Yet, dollars for researchdwhether for systematic reviews, trials, or observational studiesdare constrained, and are likely to be into the future. Effective prioritization is clearly necessary to identify the most important topics for synthesized research investment that may help the US health care system realize powerful and meaningful improvements in health status. This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Qual- ity’s (AHRQ) Effective Health Care (EHC) program, which has been described in more detail elsewhere [3]. Briefly, AHRQ’s EHC program was authorized in 2003 by the US Congress to conduct and support research on outcomes, com- parative clinical effectiveness, and appropriateness of phar- maceuticals, devices, and health care services. This program uses the AHRQ Evidence-based Practice Center (EPC) pro- gram, with 14 designated centers throughout North America that conduct comparative effectiveness systematic reviews, among other research products of the program. AHRQ has designated a Scientific Resource Center (SRC) currently housed at the Oregon EPC to support the EHC program as * Correspondingauthor. Tel.: þ1-503-335-6787; fax: þ1-503-335-2424. E-mail address: evelyn.whitlock@kpchr.org (E.P. Whitlock). 0895-4356/10/$ e see front matter Ó 2010 Elsevier Inc. All rights reserved. doi: 10.1016/j.jclinepi.2009.03.008 Journal of Clinical Epidemiology 63 (2010) 491e501