| Submitting Materials for Review |
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| Guidelines for Submitted Materials |
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Adopted by the Health Services Commission January 13, 2011
The Health Services Commission will consider health services topics when evidence is presented to indicate that current condition-treatment pairings may be inappropriately ranked on the Prioritized List or are in need of updating.
Situations where topics may be reviewed include:
- A new treatment that has become available, with acceptable evidence of its clinical effectiveness and/or cost-effectiveness
- A change in current practice, best supported by high quality systematic reviews and/or evidence based guidelines
- When acceptable evidence is unavailable, expert opinion alone indicating that a more effective or cost-effective treatment exists and that community standard of care differs from the current pairing will be considered
Please note that review of a topic does not necessarily lead to a change in the Prioritized List. All presenters to the Commission must provide disclosure of potential conflicts of interest.
The HSC relies heavily on high quality evidence and evidence-based guidelines in making its prioritization decisions. Lower quality evidence may be considered in situations where higher quality evidence is difficult to obtain (e.g., rare clinical conditions). Clinical judgment will still need to be used by the Commission to determine whether the available evidence is sufficient and compelling enough to affect prioritization decisions.
The following types of evidence are considered high quality:
- Systematic reviews of randomized controlled trials
- Systematic reviews of prospective cohort studies
- Evidence-based guidelines from trusted sources
Examples of Sources of high-quality evidence
The following sources are considered medium quality and are often examined by the HSC.
- Guidelines issued by professional societies and advocacy organizations (e.g. American Heart Association)
- Coverage decisions by private health plans (e.g. Aetna)
- Well-conducted, peer-reviewed individual studies (experimental or observational)
The following types of evidence are considered low quality and are rarely reviewed by the HSC
- Case reports, case series
- Unpublished studies (posters, abstracts, presentations, non-peer reviewed articles)
- Individual studies that are poorly conducted, do not appear in peer-reviewed journals, are inferior in design or quality to other relevant literature, or duplicate information in other materials under review by the Commission
The HSC Medical Director will include a summary of high quality evidence in the meeting packets, along with the documents themselves, for the Commissioners to review. Discretion will be used, with the HSC Medical Director consulting with the Health Outcomes Subcommittee Chair, to determine if medium or low quality sources will be included for Commissioner review. A listing of other materials submitted but not included for Commissioner review will also be included in the packets to acknowledge their receipt, along with the reason for their omission.
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