Table 2. Levels II-IV: Impact on Policies, Clinical Practice and Health Outcomes

NameLevel II
(Policies)		Level III
(Clinical Practice)		Level IV
(Outcomes)
Lau
(7782)
  • Evidence-based guidelines for non-diabetic renal disease (National Kidney Foundation's Kidney Disease Outcomes Quality Initiative).
  • Clinical trials checklist (Working Group on Recommendations for the Reporting of Clinical Trials in the Biomedical Literature).
  • Clinical trial registries resulting from this work were contributed to key collaborative review groups in the areas of congestive heart failure and hypertension.
  • Shift in treatment patterns toward single-dose treatment with aminoglycosides for serious infection.
 
Ray
(7768)
  • Guidelines for the management of osteoarthritis of the hip and knee.
  
Berman
(7816)
  • Guidelines for Otitis Media for Colorado Medicaid.
  • Program to evaluate OM outcomes (AMA).
  • Interactive training Web site, and workshop (American Academy of Pediatrics).
  • HEDIS measures (NCQA).
  
Soumerai
(7631)
  • Policies on appropriate use of beta-blockers (NCQA, AMA, major HMOs).
  • Increased rates of prescription of beta-blockers.
  • Reduction in mortality associated with heart attacks.
Moore
(7809)
  • HIV/AIDS-related policies (FDA, HRSA's HIV AIDS Bureau, Infectious Disease Society of America, the HIV Care Association and several pharmaceutical companies).
  • Findings on the value of combination therapy relative to monotherapy resulted in significant shift in treatment patterns.
  • Demonstrated the value of long-term safety of adjunctive corticosteroids.
  • Increased treatment of opportunistic diseases.
  • Change in natural history of HIV/AIDS resulting from combination therapy.
Garrard
(7772)
  • Plan and provider awareness of cost and treatment issues associated with depression among the elderly (HealthPartners HMO).
  
Strickland
(7813)
  • Health plan provider education and guidelines related to Lyme disease diagnosis, testing and treatment.
  • Decline in rate of use of expensive antibiotics and over-treatment of tick bites in HMO (Delmarva Health Plan, MD).
 
Gardner
(8217)
  • Study confirmed value of co-payment structure for prescription drug in a state health insurance program (Oregon Public Employees Retirement System), and demonstrated to the program the value of linking claims and clinical information to enhance quality and cost-effectiveness.
  

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Page last reviewed October 2001
Internet Citation: Table 2. Levels II-IV: Impact on Policies, Clinical Practice and Health Outcomes. October 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/final-reports/pharmaceutical-outcomes-research/table2.html