Rachel Richardson, Research Fellow, NHS Centre for Reviews and Dissemination

The NHS Centre for Reviews and Dissemination (CRD) was established in 1994 and aims to provide the NHS with important information on the effectiveness and cost-effectiveness of treatments and the delivery and organisation of healthcare.

Those delivering care, managing health services or making healthcare policy will know that keeping up to date with the best research evidence is a problem because:

  • It is dispersed over many types of publications
  • It may be inconsistently indexed and recorded
  • It varies greatly in quality and reliability.

By offering rigorous and systematic reviews of research on selected topics, a database of quality-assessed published reviews, and a dissemination service, CRD is helping to promote the use of research-based knowledge in healthcare.

Within the NHS R&D programme, CRD is the sibling organisation of the UK Cochrane Centre and plays an important role in disseminating the contents of Cochrane reviews to the NHS.

CRD produces systematic reviews both in-house and by collaborating with other academics and healthcare professionals. Reviews cover the effectiveness of healthcare interventions relevant to the NHS.

An expert panel of consultants is recruited for each review to advise and help ensure the accuracy and relevance of the reviews to the NHS.

Reviews currently underway at CRD include the effectiveness of interventions used in the treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis (ME) in adults and children.

CRD also seeks to raise the general standard of reviews of health research through the publication of guidelines for undertaking systematic reviews and by supporting others carrying out reviews for the NHS.

CRD is one of the agencies commissioned to undertake evidence-based technology appraisals of significant new and existing interventions on behalf of the National Institute for Clinical Excellence (NICE).

CRD has already completed several appraisals, including assessing the prophylactic removal of impacted third molars, and the use of taxanes for ovarian and breast cancer.

Over the past 4 years, CRD has been involved in a major programme to improve quality and coordination of care in those cancers identified as major service priorities (breast, colorectal, lung, gynaecological and upper gastrointestinal).

The National Cancer Guidance Group has had responsibility for developing high quality guidance on these site-specific cancers for commissioners of cancer services. CRD has provided input into the project and has been responsible for reviewing the research evidence (including commissioning relevant reviews) and writing the manual and evidence documents.

The majority of CRD's dissemination activities focus on raising awareness of key messages from research, and providing key research intelligence in easily accessible and usable forms.

The core dissemination products used by CRD are the Effective Health Care and Effectiveness Matters bulletins. Effectiveness Matters is particularly targeted at primary care. Recent topics include 'Treating head lice and scabies' and 'Drug treatment of essential hypertension in older people'.

Both bulletins are distributed widely to relevant audiences throughout the NHS. CRD utilises a targeted approach to dissemination, a key element of which is the maintenance of active links with key individuals (single contact points) in health authorities and trusts. Similar approaches for targeting primary care are currently being explored.

Both Effective Health Care and Effectiveness Matters are available free via the internet.

In addition to the core dissemination process, summary articles relating to each Effective Health Care bulletin are published in a variety of healthcare journals. Other specialist and professional publications are targeted on a bulletin-by-bulletin basis.

It is also important for users of NHS services to know about the latest research evidence, and CRD works with voluntary organisations to raise awareness of its publications. The relevant lay and professional media are contacted and press releases sent out. CRD also works closely with CHAIN (Contacts, Help, Advice and Information Network) to disseminate messages to targeted audiences.

In addition to printed reports, three freely available databases are maintained by CRD:

  • Database of Abstracts of Reviews of Effectiveness (DARE)
  • NHS Economic Evaluation Database (NHS EED)
  • Health Technology Assessment Database.

DARE is a collection of abstracts of high quality research reviews of the effectiveness of healthcare interventions, and the management and organisation of health services.

Trained reviewers and information staff within CRD identify systematic reviews from research published throughout the world, and evaluate them according to a set of quality criteria.

Reviews that meet the quality criteria receive detailed structured abstracts that explain the aims of the reviews, their main findings and a critical commentary of the methods used.

More than 1000 structured abstracts of systematic reviews are currently held on DARE and cover a wide spectrum of healthcare topics of relevance to a broad range of professions and disciplines.

The NHS Economic Evaluation Database contains abstracts of published economic evaluations of healthcare interventions. Commissioned health economists evaluate published cost-benefit analyses, cost-effectiveness analyses and cost-utility analyses from a variety of sources.

Records normally include a structured summary and an assessment of the quality of the studies, together with details of any practical implications for the NHS.

The Health Technology Assessment Database contains author abstracts of technology assessments published by agencies around the world, as well as records of ongoing projects.

These databases are available free of charge and can be accessed in a variety of ways, including via the internet (http://nhscrd.york.ac.uk/welcome.html). All three databases are also available as part of The Cochrane Library.

CRD provides an information and enquiry service to help answer specific questions on reviews and cost-effectiveness studies in healthcare and the delivery and organisation of healthcare.

This service is available to anyone and can be accessed by telephone (01904 433707 9.00am–5.15pm Mon to Fri), email (nhscrd-info@york.ac.uk), or fax (01904 433661).

It is important to recognise that the development of a knowledge-based health service is dependent primarily on the use and application of high quality research evidence by those making clinical, managerial and policy decisions. However, this can only occur if sound information is made easily available to the appropriate audiences.

Through its various activities, CRD is helping to ensure the provision of good research evidence to health service professionals and decision-makers in the NHS.

NHS Centre for reviews and dissemination

Set up 1994
Aim To provide the NHS with important information on the effectiveness and cost-effectiveness of treatments and the delivery and organisation of healthcare
Funding Majority from the Department of Health
Key personnel
Research Fellow:
Rachel Richardson
 
Research Fellow:
Paul Wilson
 
Publications Manager:
Frances Sharp
Contact details
Address:
NHS CRD, University of York, York, YO10 5DD
 
Tel (general enquiries):
01904 433634
 
Fax:
01904 433661
 
Publications:
01904 433648
 
E-mail (general enquiries):
revdis@york.ac.uk
 
E-mail (information service):
nhscrd-info@york.ac.uk
 
Website:
http://www.york.ac.uk/inst/crd

 

Guidelines in Practice, December 2000, Volume 3
© 2000 MGP Ltd
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