Center for Care Delivery and Outcomes Research

Minneapolis Evidence Synthesis Core

Background: The Minneapolis VA is an international leader in conducting and disseminating systematic reviews to assist health care users provide evidence-based care. Our Minneapolis VA Evidence Synthesis Core is comprised of clinicians and researchers collaborating across topics and methods. The Minneapolis VA Evidence Synthesis and Dissemination Center (MEDIC) is co-led by Timothy Wilt, MD, MPH and Denise Duan-Porter, MD, PhD. The core receives funding through the multiple sources including the VA Health Services Research and Development Evidence Synthesis Program (ESP) to conduct systematic reviews of the effectiveness and comparative effectiveness and harms of high impact healthcare topics for VA. Our Evidence Synthesis Center also conducts evidence reports funded by national medical societies development of clinical practice guidelines and is a designated American College of Physicians Center for Evidence Reviews (ACP-CER). We are partners with the University of Minnesota School of Public Health as the AHRQ-funded Minnesota Evidence-based Practice Center (EPC). Additional evidence synthesis and methods work is often conducted in collaboration with investigators in urologic diseases through Cochrane Urology, Philipp Dahm, MD, MSC, Coordinating Editor (Urology Section). Additionally, Drs. Dahm and Shahnaz Sultan, MD, MSC are international leaders in evidence review methodology. They are members of the US Grading of Recommendations Assessment, Development and Evaluation (GRADE) Network that provides national training, mentorship, education and collaboration in systematic reviews and evidence-based health care.

Highlights:

• We published a report Assessing the Effectiveness of Complex Interventions to Meet the Needs of VA Stakeholders in a Medical Care supplement on Evidence Synthesis in a Learning Health Care System.
• Our ESP reports on Implementation of evidence-based psychotherapies for pain; Use of Medical Scribes in Emergency, Cardiology and Orthopedic Departments as well as Nursing Home Staffing Models have informed practice and policy within VA, were presented as VA Cyberseminars and included in Inspector General Reports.
• Ongoing ESP reviews include: Hypofractionation Therapies for Cancer, Neuroimaging for Mental Health Disorders and Virtual Reality for Pain.
• Our VA-ESP conducted COVID-19 reviews on remdesivir for adults with COVID-19 (used by the ACP for guidance statements) and published in Annals of Internal Medicine (AIM), Post-Acute COVID-19 Major Organ Damage and Long-COVID. These were presented to VA clinical and operations leadership.
• We are collaborators on the VA-Long COVID Integrated Patient Team Workstream, National Research Action Plan and the MVAMC Practice Based Research Network.
• Our ACP-CER report on Testosterone Therapy for Age Related Hypogonadism was published in AIM and used for ACP clinical guidelines. Our review and network meta-analysis is examining effectiveness/cost-effectiveness of newer anti-diabetes drugs.
• We conducted an evidence review evaluating medical and surgical therapies for benign prostatic hyperplasia to inform American Urological Association clinical guidelines.
• Ongoing AHRQ-EPC reports include: Nutritional Interventions for Cancer Patients with or at risk for Malnutrition, Gynecologic Syndromes of Menopause, Patient and System Interventions to Reduce Racial Ethnic Health Disparities and Trauma Informed Care.
• Workshops and manuscripts by members of the US GRADE network, Minnesota AHRQ-EPC and Minneapolis VA-ESP have advanced state-of-the art methodology for evidence synthesis and guideline development and expanded the number of individuals trained-in, conducting and using evidence-based health care.

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