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1.
Value Health ; 23(2): 139-150, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32113617

RESUMO

Healthcare resource allocation decisions made under conditions of uncertainty may turn out to be suboptimal. In a resource constrained system in which there is a fixed budget, these suboptimal decisions will result in health loss. Consequently, there may be value in reducing uncertainty, through the collection of new evidence, to make better resource allocation decisions. This value can be quantified using a value of information (VOI) analysis. This report, from the ISPOR VOI Task Force, introduces VOI analysis, defines key concepts and terminology, and outlines the role of VOI for supporting decision making, including the steps involved in undertaking and interpreting VOI analyses. The report is specifically aimed at those tasked with making decisions about the adoption of healthcare or the funding of healthcare research. The report provides a number of recommendations for good practice when planning, undertaking, or reviewing the results of VOI analyses.


Assuntos
Orçamentos , Tomada de Decisões , Técnicas de Apoio para a Decisão , Custos de Medicamentos , Desenvolvimento de Medicamentos/economia , Alocação de Recursos para a Atenção à Saúde/economia , Pesquisa sobre Serviços de Saúde/economia , Avaliação da Tecnologia Biomédica/economia , Redução de Custos , Análise Custo-Benefício , Humanos , Reembolso de Seguro de Saúde/economia , Modelos Econômicos , Modelos Estatísticos , Formulação de Políticas , Seguro de Saúde Baseado em Valor/economia , Aquisição Baseada em Valor/economia
2.
PLoS One ; 14(10): e0223129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622372

RESUMO

Implementation is a crucial component for the success of interventions in health service systems, as failure to implement well can have detrimental impacts on the effectiveness of evidence-based practices. Therefore, evaluations conducted in real-world contexts should consider how interventions are implemented and sustained. However, the complexity of healthcare environments poses considerable challenges to the evaluation of interventions and the impact of implementation efforts on the effectiveness of evidence-based practices. In consequence, implementation and intervention effectiveness are often assessed separately in health services research, which prevents the direct investigation of the relationships of implementation components and effectiveness of the intervention. This article describes multilevel decision juncture models based on advances in implementation research and causal inference to study implementation in health service systems. The multilevel decision juncture model is a theory-driven systems approach that integrates structural causal models with frameworks for implementation. This integration enables investigation of interventions and their implementation within a single model that considers the causal links between levels of the system. Using a hypothetical youth mental health intervention inspired by published studies from the health service research and implementation literature, we demonstrate that such theory-based systems models enable investigations of the causal pathways between the implementation outcomes as well as their links to patient outcomes. Results from Monte Carlo simulations also highlight the benefits of structural causal models for covariate selection as consistent estimation requires only the inclusion of a minimal set of covariates. Such models are applicable to real-world context using different study designs, including longitudinal analyses which facilitates the investigation of sustainment of interventions.


Assuntos
Pesquisa sobre Serviços de Saúde/economia , Serviços de Saúde/economia , Modelos Econômicos , Tomada de Decisões , Serviços de Saúde/normas , Pesquisa sobre Serviços de Saúde/normas , Humanos , Método de Monte Carlo , Psicoterapia/economia
3.
Bull Hist Med ; 93(3): 365-400, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631071

RESUMO

An influential policy network emerged from two overlapping developments of the 1970s and 1980s: new research programs focusing on tropical diseases and debates about how to implement the concept of primary health care at the World Health Organization. Participating actors came together in an informal network that, by the late 1980s, expanded advocacy to include the promotion and reorganization of all forms of research that might improve health in the Global South. This goal became associated with a search for new research methods for determining priorities, a quest that reached a peak in the early 1990s when the World Bank entered the picture. The bank brought money, economic analyses, and neoliberal ideology to the research advocacy movement and helped stimulate an upsurge of cost-effective forms of economic thinking in global health (GH) circles. This expanded research network provided some of the conceptual foundations and leadership for several of the most emblematic institutions of the new GH. These included new organizations to bring together and coordinate public and private actors in pursuit of common aims and new forms of economic rationality. The network's advocacy work contributed as well to a massive expansion of GH research at the turn of the century.


Assuntos
Saúde Global/história , Política de Saúde/história , Pesquisa sobre Serviços de Saúde/história , Pesquisa sobre Serviços de Saúde/economia , Pesquisa sobre Serviços de Saúde/organização & administração , História do Século XX , Humanos , Internacionalidade
5.
Cien Saude Colet ; 24(6): 2211-2220, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31269180

RESUMO

This article analyzes the profile of research conducted in the Federal District of Brazil funded through public calls for proposals issued by the Research for the SUS Program: shared health management/Federal District (PPSUS/DF) and a research support program run by the Superior School of Health Sciences, maintained by the Health Sciences Teaching and Research Foundation (ESCS/FEPECS, acronym in Portuguese). A document analysis was undertaken of all research funded by the PPSUS/DF and ESCS/FEPECS's Research Support Program between 2008 and 2017 using the following variables: year, title, research themes of the National Agenda for Health Research Priorities (ANPPS, acronym in Portuguese), implementing organization, area of application of research, and amount of funding. PPSUS/DF funded 73 projects with a total investment of approximately R$8 million, while ESCS/FEPECS funded 85 projects with a total investment of R$2.3 million. This study provides a critical analysis of the research themes supported by ESCS/FEPECS and PPSUS/DF between 2008 and 2017. It is recommended that future calls for proposals should prioritize the three leading causes of death in the Federal District and the organization and evaluation of healthcare services.


Assuntos
Tecnologia Biomédica/economia , Pesquisa sobre Serviços de Saúde/organização & administração , Programas Nacionais de Saúde/organização & administração , Brasil , Pesquisa sobre Serviços de Saúde/economia , Humanos , Invenções/economia , Programas Nacionais de Saúde/economia , Apoio à Pesquisa como Assunto
6.
Value Health ; 22(7): 816-821, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31277829

RESUMO

BACKGROUND AND OBJECTIVES: Common health state valuation methodology, such as time tradeoff (TTO) and standard gamble (SG), is typically applied under several descriptively invalid assumptions, for example, related to linear quality-adjusted life years (QALYs) or expected utility (EU) theory. Hence, the current use of results from health state valuation exercises may lead to biased QALY weights, which may in turn affect decisions based on economic evaluations using such weights. Methods have been proposed to correct responses for the biases associated with different health state valuation techniques. In this article we outline the relevance of prospect theory (PT), which has become the dominant descriptive alternative to EU, for health state valuations and economic evaluations. METHODS AND RESULTS: We provide an overview of work in this field, which aims to remove biases from QALY weights. We label this "the corrective approach." By quantifying PT parameters, such as loss aversion, probability weighting, and nonlinear utility, it may be possible to correct TTO and SG responses for biases in an attempt to produce more valid estimates of preferences for health states. Through straightforward examples, this article illustrates the effects of this corrective approach and discusses several unresolved issues that currently limit the relevance of corrected weights for policy. CONCLUSIONS: Suggestions for research addressing these issues are provided. Nonetheless, if validly corrected health state valuations become available, we argue in favor of using these in economic evaluations.


Assuntos
Custos de Cuidados de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Indicadores Básicos de Saúde , Nível de Saúde , Modelos Teóricos , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Tomada de Decisão Clínica , Análise Custo-Benefício , Pesquisa sobre Serviços de Saúde/economia , Humanos , Modelos Econômicos , Avaliação de Processos e Resultados em Cuidados de Saúde/economia , Formulação de Políticas , Resultado do Tratamento
7.
Health Res Policy Syst ; 17(1): 67, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319867

RESUMO

BACKGROUND: Healthcare research funders may undertake various roles to facilitate implementation of research findings. Their ability to enact such roles depends on several factors, knowledge of implementation being one essential requirement. However, previous studies do not assess the type or level of knowledge about implementation that research funders possess. This paper therefore presents findings from a qualitative, inductive study of the implementation knowledge of research funders. Three aspects of this knowledge are explored, namely how research funders define implementation, their level of self-assessed implementation knowledge and the factors influencing their self-assessment of implementation knowledge. METHODS: Research funders (n = 18) were purposefully selected from a sample of research funding organisations in Sweden (n = 10). In-depth semi-structured interviews were conducted, recorded and transcribed verbatim. An inductive method using a systematic coding procedure was employed to derive the findings. RESULTS: The research funders defined implementation as either an outcome or a process, with the majority believing that implementation of healthcare research results demands a process, although its complexity varied in the research funders' view. They perceived their own level of implementation knowledge as either limited or substantial, with a majority regarding it as limited. Clinical research experience, clinical experience and task relevance were singled out as the clearest factors affecting the self-assessment of their own implementation knowledge. CONCLUSIONS: This study, the first to focus on implementation knowledge of research funders, demonstrates that they are a category of policy-makers who may possess knowledge, based on their previous professional experience, that is comparable to some important findings from implementation research. Consequently, the findings not only pinpoint the relevance of professional experience, but also reveal a lack of awareness and knowledge of the results of implementation research among research funders in charge of healthcare research.


Assuntos
Pesquisa sobre Serviços de Saúde/organização & administração , Conhecimento , Apoio à Pesquisa como Assunto/organização & administração , Pesquisa Médica Translacional/organização & administração , Difusão de Inovações , Pesquisa sobre Serviços de Saúde/economia , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Suécia
8.
Can J Public Health ; 110(3): 270-274, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31062337

RESUMO

Governments around the world vastly underinvest in public health, despite ever growing evidence demonstrating its economic and social benefits. Challenges in securing greater public health investment largely stem from the necessity for governments to demonstrate visible impacts within an election cycle, whereas public health initiatives operate over the long term and generally involve prevention, statistical lives and underlying conditions. It is time for the public health community to rethink its strategies and craft political wins by building a political case for investing in public health-which extends far beyond mere economic and social arguments. These strategies need to make public health visible, account for the complexities of policymaking networks and adapt knowledge translation efforts to the appropriate policy instrument.


Assuntos
Pesquisa sobre Serviços de Saúde/economia , Política , Saúde Pública/economia , Canadá , Humanos , Investimentos em Saúde
9.
BMC Health Serv Res ; 19(1): 230, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30991999

RESUMO

BACKGROUND: Integrated knowledge translation (IKT) can optimize the uptake of research evidence into clinical practice by incorporating knowledge users as equal partners in the entire research process. Although several studies have investigated stakeholder involvement in research, the literature on partnerships between researchers and clinicians in rehabilitation and their impact on clinical practice is scarce. This study described the individual research projects, the outcomes of these projects on clinical practice and the partnership experiences of an initiative that funds IKT projects co-led by a rehabilitation clinician and a researcher. METHODS: This was a sequential explanatory mixed methods study where quantitative data (document reviews and surveys) informed the qualitative phase (focus groups with researchers and interviews with clinicians). Descriptive analysis was completed for the quantitative data and thematic analysis was used for the qualitative data. RESULTS: 53 projects were classified within multiple steps of the KTA framework. Descriptive information on the projects and outcomes were obtained through the survey for 37 of the 53 funded projects (70%). Half of the respondents (n = 18) were very satisfied or satisfied with their project's impact. Only two (6%) projects reported having measured sustainability of their projects and four (11%) measured long-term impact. A focus group with six researchers and individual interviews with nine clinicians highlighted the benefits (e.g. acquired collaborative skills, stronger networks between clinicians and academia) and challenges (e.g. measuring KT outcomes, lack of planning for sustainability, barriers related to clinician involvement in research) of participating in this initiative. Considerations when partnering on IKT projects included: the importance of having a supportive organization culture and physical proximity between collaborators, sharing motives for participating, leveraging everyone's expertise, grounding projects in KT models, discussing feasibility of projects on a restricted timeline, and incorporating the necessary knowledge users. Clinicians discussed the main outputs (scientific contribution, training and development, increased awareness of best practice, step in a larger effort) as project outcomes, but highlighted the complexity of measuring outcomes on clinical practice. CONCLUSION: The study provides a portrait of an IKT funding model, sheds light on past IKT projects' strengths and weaknesses and provides strategies for promoting positive partnership experiences between researchers and rehabilitation clinicians.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Pesquisa sobre Serviços de Saúde/organização & administração , Reabilitação/organização & administração , Pesquisa Médica Translacional/organização & administração , Canadá , Prestação Integrada de Cuidados de Saúde/economia , Pesquisa sobre Serviços de Saúde/economia , Humanos , Relações Interprofissionais , Reabilitação/economia , Pesquisadores/economia , Apoio à Pesquisa como Assunto , Inquéritos e Questionários
10.
PLoS One ; 14(4): e0207046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30986207

RESUMO

BACKGROUND: This study aimed to investigate the distribution of European Union (EU) healthcare research grants across EU countries, and to study the effect of the potential influencing factors on grant allocation. METHODS: We analysed publicly available data on healthcare research grants from the 7th Framework Programme and the Horizon 2020 Programme allocated to beneficiaries between 2007 and 2016. Grant allocation was analysed at the beneficiary-, country-, and country group-level (EU-15 versus newer Member States, defined as EU-13). The investigated country-level explanatory variables included GDP per capita, population size, overall disease burden, and healthcare research excellence. Grant amounts per 100,000 inhabitants were used as an outcome variable in the regression analyses. RESULTS: Research funds were disproportionally allocated to EU-15 versus the EU-13, as 96.9% of total healthcare grants were assigned to EU-15 countries. At the beneficiary level, EU funding was positively influenced by participating in previous grants. The average grant amount per beneficiary was higher for EU-15 organizations. In the multiple regression analysis GDP per capita (p = 0.002) and research excellence (p<0.001) had a significant positive association with EU funding. Population size had an inverted U-shaped relationship with EU funding for healthcare research, having the largest per capita funding in second and the third quartiles (p = 0.03 and p = 0.02). CONCLUSION: The uneven allocation of healthcare research funds across EU countries was influenced by GDP per capita, medical research excellence and population size. Wealthier countries with an average population size and strong research excellence in healthcare had more EU funding for healthcare research. Higher disease burden apparently was not associated with more EU research funding. While our findings are in line with analyses on previous periods, they suggest that the EU did not implement any effective policy measures to improve the unfair allocation of research grants.


Assuntos
União Europeia/economia , Organização do Financiamento/economia , Pesquisa sobre Serviços de Saúde/economia , Alocação de Recursos , Humanos
11.
BMC Health Serv Res ; 19(1): 248, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31018843

RESUMO

BACKGROUND: Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia. METHODS: Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search. RESULTS: Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders' expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare. CONCLUSION: The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.


Assuntos
Prioridades em Saúde , Pesquisa sobre Serviços de Saúde/economia , Qualidade da Assistência à Saúde , Apoio à Pesquisa como Assunto , Pessoal Administrativo , Tomada de Decisões , Países em Desenvolvimento , Humanos , Malásia , Formulação de Políticas , Projetos de Pesquisa , Alocação de Recursos
13.
J Pediatr ; 207: 123-129.e2, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30922490

RESUMO

OBJECTIVES: To analyze activities involving veteran resource parents and patients in a family partnership program; their perspectives were also explored. STUDY DESIGN: The multiple roles assumed by family stakeholders in neonatal initiatives were reviewed. Quality control questionnaires were distributed to resource parents and patients and providers who worked with them. Mixed methods were used to analyze results. RESULTS: Thirty resource parents and patients were involved in a total of 653 activities related to clinical care (n = 413), teaching (n = 31), and research (n = 209); 7 initiatives were described to illustrate the positive impact of family stakeholders on clinical care, teaching, and/or research. Resource parents and patients had different degrees and intensity of involvement: all were involved in low-risk initiatives and 9 in more complex activities. In the questionnaire, family stakeholders all described positive impacts associated with their participation and benefits to themselves, such as meaning making. Three resource parents reported traumatic memories that occurred during medical simulations. The majority of providers report that resource parents and patients improved their projects, but some also report this new collaboration is complex. CONCLUSIONS: Although stakeholder participation increasingly is recommended, practical knowledge and the impact of their participation is scarce. Having several resource parents and patients bring their contributions may be more valuable than a few "expert stakeholders." Recruiting and orienting resource parents and patients toward different types of activities should take into account the complexity and risks of the tasks. Family stakeholders are appreciated and have a positive impact on projects in which they are involved.


Assuntos
Pesquisa Comparativa da Efetividade/métodos , Educação Médica/normas , Pesquisa sobre Serviços de Saúde/normas , Unidades de Terapia Intensiva Neonatal/organização & administração , Neonatologia/organização & administração , Avaliação de Resultados da Assistência ao Paciente , Participação dos Interessados , Pesquisa sobre Serviços de Saúde/economia , Humanos , Recém-Nascido , Neonatologia/educação , Quebeque , Estudos Retrospectivos
16.
Public Health Res Pract ; 28(3)2018 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-30406260

RESUMO

BACKGROUND: Bridging the 'gap' between research evidence and the complexities of policy and practice is central to health improvement. The Translational Research Grants Scheme (TRGS) in New South Wales (NSW), Australia, is a funding scheme aimed at reducing the time between research generation and translation to policy and practice. The TRGS is also an important part of NSW Health's efforts to harness and strengthen research capacity to improve health service delivery. METHODS: A document review and interviews (n = 12) with key stakeholders were undertaken following the first round of TRGS funding in November 2016. The communications from continuing quality improvement processes over the three funding rounds have provided further insight. RESULTS AND DISCUSSION: A total of 53 projects have been funded under the scheme, with recipients across many NSW Health organisations. NSW Health has committed more than $24 million to date. Round one of the TRGS was received well by the policy makers, Local Health Districts and research stakeholders interviewed. Of particular note were: the requirement for Chief Executives to demonstrate strong support for the implementation of findings; requirements to partner with state-wide policy leads and clinical networks; and capacity-building outcomes of the scheme. The ongoing quality improvement processes indicate that the program continues to be well received, with improvements to partnership arrangements, and an acknowledgement of the challenge that arises because the scheme, by nature of its capacity-building aim, attracts proposals from a range of research experience. LESSONS LEARNT: The TRGS is filling an important gap in the research funding landscape in NSW and is well regarded by stakeholders. To ensure that the TRGS is achieving its intended aims, an evaluation of the impact of the scheme will take place during 2018-19.


Assuntos
Pesquisa sobre Serviços de Saúde/economia , Apoio à Pesquisa como Assunto , Pesquisa Médica Translacional/economia , Fortalecimento Institucional , Programas Governamentais , Humanos , Entrevistas como Assunto , New South Wales , Melhoria de Qualidade
17.
Public Health Res Pract ; 28(3)2018 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-30406264

RESUMO

OBJECTIVES: The Prevention Research Support Program (PRSP) is a New South Wales (NSW) Ministry of Health funding scheme. The scheme aims to build capability, and strengthen prevention and early intervention research that is important to the NSW public health system (NSW Health) and that leads to improved health and reduced health inequities for the people of NSW. This paper describes how PRSP funding has supported recipients to produce high-quality, policy-relevant research, and increase the impact of research on policy and practice. Type of program: The PRSP is a competitive funding program that supports NSW research organisations that conduct prevention and early intervention research that aligns with NSW Health priorities. The objectives of the PRSP are to: increase high-quality and internationally recognised prevention research in NSW; support the generation of research evidence that addresses NSW Health prevention priorities, including cross-government priorities; encourage the adoption of research evidence in relevant policies, programs and services in NSW; and build the prevention research capability of NSW Health staff and the NSW Health system. METHODS: Funding recipients provide information about their research, translation and capability building achievements in their funding applications and submit annual progress reports. Data from these sources were aggregated to illustrate trends in indicators of research excellence over time. Prior to the most recent call for applications, the program was reviewed. The review included consultations with funding recipients, policy and practice partners, and key funding stakeholders. Stakeholders' perceptions of the benefits and challenges associated with the PRSP were drawn from the consultation data. RESULTS: PRSP funding recipients demonstrate considerable increases over time on several indicators of research excellence, including peer-reviewed journal publications, grant income, and research students supervised. Recipients use a range of strategies to ensure dialogue with health system partners, and report research impacts at the local, state, national and international levels. PRSP funding also supports the development of research capability. LESSONS LEARNT: The PRSP is a unique scheme that is highly valued by both funding recipients and health system stakeholders. The continuity of funding provided under the scheme enables recipients to adopt a strategic approach to their research and develop innovative strategies to support its conduct and use.


Assuntos
Fortalecimento Institucional , Pesquisa sobre Serviços de Saúde/economia , Inovação Organizacional , Prática de Saúde Pública/economia , Apoio à Pesquisa como Assunto , Pesquisa Médica Translacional/economia , Programas Governamentais , Política de Saúde , Prioridades em Saúde , Humanos , New South Wales , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
18.
Am J Prev Med ; 55(6): 915-925, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30458950

RESUMO

INTRODUCTION: This paper provides the first detailed analysis of the NIH prevention research portfolio for primary and secondary prevention research in humans and related methods research. METHODS: The Office of Disease Prevention developed a taxonomy of 128 topics and applied it to 11,082 projects representing 91.7% of all new projects and 84.1% of all dollars used for new projects awarded using grant and cooperative agreement activity codes that supported research in fiscal years 2012-2017. Projects were coded in 2016-2018 and analyzed in 2018. RESULTS: Only 16.7% of projects and 22.6% of dollars were used for primary and secondary prevention research in humans or related methods research. Most of the leading risk factors for death and disability in the U.S. were selected as an outcome in <5% of the projects. Many more projects included an observational study, or an analysis of existing data, than a randomized intervention. These patterns were consistent over time. CONCLUSIONS: The appropriate level of support for primary and secondary prevention research in humans from NIH will differ by field and stage of research. The estimates reported here may be overestimates, as credit was given for a project even if only a portion of that project addressed prevention research. Given that 74% of the variability in county-level life expectancy across the U.S. is explained by established risk factors, it seems appropriate to devote additional resources to developing and testing interventions to address those risk factors.


Assuntos
Financiamento Governamental , Pesquisa sobre Serviços de Saúde/economia , National Institutes of Health (U.S.) , Prevenção Primária , Prevenção Secundária , Humanos , Estados Unidos
19.
Am J Prev Med ; 55(6): 926-931, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30458951

RESUMO

INTRODUCTION: To fulfill its mission, the NIH Office of Disease Prevention systematically monitors NIH investments in applied prevention research. Specifically, the Office focuses on research in humans involving primary and secondary prevention, and prevention-related methods. Currently, the NIH uses the Research, Condition, and Disease Categorization system to report agency funding in prevention research. However, this system defines prevention research broadly to include primary and secondary prevention, studies on prevention methods, and basic and preclinical studies for prevention. A new methodology was needed to quantify NIH funding in applied prevention research. METHODS: A novel machine learning approach was developed and evaluated for its ability to characterize NIH-funded applied prevention research during fiscal years 2012-2015. The sensitivity, specificity, positive predictive value, accuracy, and F1 score of the machine learning method; the Research, Condition, and Disease Categorization system; and a combined approach were estimated. Analyses were completed during June-August 2017. RESULTS: Because the machine learning method was trained to recognize applied prevention research, it more accurately identified applied prevention grants (F1 = 72.7%) than the Research, Condition, and Disease Categorization system (F1 = 54.4%) and a combined approach (F1 = 63.5%) with p<0.001. CONCLUSIONS: This analysis demonstrated the use of machine learning as an efficient method to classify NIH-funded research grants in disease prevention.


Assuntos
Financiamento Governamental/classificação , Pesquisa sobre Serviços de Saúde/economia , Aprendizado de Máquina , National Institutes of Health (U.S.) , Humanos , Prevenção Primária , Prevenção Secundária , Estados Unidos
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