METHODOLOGICAL CHALLENGES AND INNOVATIONS IN PATIENT OUTCOMES RESEARCH

Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcom es Research Teams (PORTs). These large, complex projects form the cent erpiece of the first generation of research under the Medical Treatmen t Effectiveness Program. In carrying out their individual 5-year resea rch plans, and through collaborative work of six Inter-PORT Work Group s, PORTs have contributed to methodological advances related to their specific clinical focus and to outcomes research in general. Each of t he PORTs has followed a standard research model, involving the applica tion of: systematic literature review, measurement of outcomes, analys is of cost and claims data, decision analysis, and strategies for diss eminating findings. This article reports what has been learned by indi vidual PORTS, and by AHCPR, regarding the usefulness of each of these methodologies, both for the ongoing projects and for the next generati on of effectiveness research. Examples from individual PORTs and work groups illustrate some of the methodological gains that have been made in effectiveness research and provide a glimpse of the work that rema ins to be done.