RTI DEcIDE Center: Clinical and Comparative Effectiveness Research
The Effective Health Care Program
RTI International, in collaboration with several partners around the nation, operates as one of 13 members of the DEcIDE Network supported by the Agency for Healthcare Research and Quality (AHRQ). DEcIDE, "Developing Evidence to Inform Decisions about Effectiveness," is part of an AHRQ program launched in September 2005 -- the Effective Health Care (EHC) program -- to help clinicians and patients determine which drugs, devices, procedures, and other medical treatments work best for certain health conditions.
The EHC program was authorized under Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. It supports development of objective scientific information through research on the outcomes of health care services and therapies -- including drugs, methods development, and innovative health information technologies -- for conducting comparative effectiveness research. It gives particular emphasis to effectiveness information relevant to Medicare beneficiaries and older adults and, more recently, to the Medicaid and S-CHIP programs.
Of special concern are 10 priority conditions: developmental delays, attention deficit hyperactivity disorder, autism, functional limitations and disability, cancer, pulmonary disease and asthma, dementia (including Alzheimer's disease), depression and other mental health disorders, diabetes mellitus, cardiovascular disease, infectious disease (including HIV/AIDS), obesity, pregnancy and preterm birth, and substance abuse. Hallmarks of DEcIDE research include transparency, objectivity, practicality, and responsiveness to stakeholder concerns.
RTI DEcIDE Center and Its Partners
The RTI DEcIDE Center partnership includes integrated delivery systems such as Baylor Health Care System, Providence Health System, and Christiana Care Health System and other partners such as the Utah Department of Health; the University of Utah and the Salt Lake IDEAS (Informatics, Decision-Enhancement, and Surveillance) Center (a Veterans Administration program); the National Association of Health Data Organizations; and HealthInsight, the Utah-Nevada Quality Improvement Organization.
As a DEcIDE Center, RTI will
- Continue to assist AHRQ and other federal agencies with implementation of Section 1013 of the Medicare Modernization Act of 2003 (MMA)
- Provide a variety of services and products to support the development of new scientific knowledge through objective research on the use of health care interventions and their outcomes
- Develop scientific evidence and new analytic tools to assist health care providers, patients, and policymakers in arriving at informed decisions about the comparative effectiveness, appropriateness, harms, and outcomes of health technologies, particularly prescription medications and medical devices.
RTI DEcIDE Center Responsibilities
The RTI DEcIDE center carries out accelerated studies and longitudinal experiments and other projects on a wide variety of disease conditions, interventions, and policy and health care delivery questions. The aim is to conduct specific research to fill knowledge gaps about comparative effectiveness and safety of therapeutics. More generally, RTI will
- Analyze administrative, survey, and clinical databases
- Develop and use new analytic methods, instruments, and statistical applications
- Use computerized surveillance and monitoring systems
- Conduct prospective observational and interventional studies
- Convene scholarly symposia and working groups and publish proceedings from those meetings
- Provide technical assistance to AHRQ and complete other assignments as requested
In these efforts, we typically use de-identified data available through insurers, health plans, and other partner organizations to answer questions about the use, benefits, and risks of medications and other therapies. When desirable and feasible, we also collect primary data on quality of and satisfaction with care and on patient outcomes. We collaborate with the overall DEcIDE Network, AHRQ's 15 Evidence-based Practice Centers (EPCs), of which the RTI-UNC EPC is one; the Eisenberg Clinical Decisions and Communications Science Center; AHRQ's Centers for Education and Research in Therapeutics; and other elements of AHRQ's pharmaceutical outcomes portfolio.
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