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Center for Evidence-Based Practice
September 12, 2006, Volume 53, No. 3

UPHS launched a new “Center for Evidence-Based Practice” in July. Its purpose is to provide, throughout the entire health system, recommendations—based on scientific methodology—on clinical practices and policies. The center will evaluate drugs, as well as non-drug technologies like medical devices and equipment, and processes of care by examining research findings and drawing on the expertise of clinicians and industry experts.

“We wanted to create a forum to develop clinical practices and policies that would span the whole health system. The ultimate goal with this new center is to significantly improve patient safety and clinical outcomes and to reduce occurrences,” said Dr. P.J. Brennan, chief medical officer at UPHS, who will oversee the new center. “We want to take a proactive approach to evaluate new drugs on the market and the processes we use—to have the evidence to support its use. We will methodically examine the data using scientific standards of analysis, and allow a rigorous review, to bring us to a logical conclusion.”

Once a specific medical issue is identified, the center will form a task force consisting of clinician experts from within UPHS to work alongside the center to examine the issue. The review process may last up to a few months for each issue, with multiple reviews occurring simultaneously. The process of review will start with a comprehensive search and evaluation of the world’s medical literature on the issue at hand. Then, the task force will obtain further input from thought leaders, institutional experts, and industry as appropriate.

When all of the evidence is analyzed, the task force will develop a set of recommended guidelines, which will be disseminated to each hospital’s chief medical officer for further review and application. This effort includes all of UPHS.

Dr. Brennan added, “The recommendations these task forces make will stem from a language and process that the medical community at Penn knows and respects. The intention here is to create a center that gathers, examines, and analyzes evidence and then brings clinical experts and industry into the process for their input. It’s a way to honestly analyze what we’re using and doing here at Penn. I know of no other center like this in existence at an academic medical center. We will directly apply evidence to clinical practice.”

Dr. Kendal Williams and Dr. Craig Umscheid, both assistant professors in the department of medicine with formal training in public health and epidemiology respectively, will serve as the center’s co-directors. 

“Our main mission is to apply the best research findings from around the globe to our patient population. Penn has the ability to do this well,” said Dr. Williams. “With this new center, we’re also tackling the important issue of clinician-industry relations and quality of care. Often many ‘special interests’ involved in patient care are in-line with our goals as health care professionals, but not always. It is the responsibility of a health system to promote the health and protect the safety of its patients. The health system leadership is showing, through this new center, that they take this duty very seriously.”

Dr. Williams views the center as a way to create a proactive, collaborative, patient-centered relationship between the health system and the pharmaceutical and medical device industry, based on science.

“This will encourage more scientific dialogue with industry rather than marketing dialogue,” added Dr. Umscheid. “We want to be a resource to help our physicians to make decisions and practice medicine based on findings from valid clinical studies. The topic of our first review is the use of Aprotinin, a drug used by anesthesiologists during cardiac surgery to reduce blood loss. Recently, its safety has come into question. We assembled a group of clinical experts from within Penn to help us conduct a clinically relevant, systematic review of the pertinent studies on the topic and we hope to recommend guidelines for its use within the next month.”

See www.uphs.upenn.edu/cep/index.html for more information.


Almanac - September 12, 2006, Volume 53, No. 3