Understanding EGAPP

Summary: Process for identifying, prioritizing, and selecting tests and specific clinical scenarios for systematic review.

Who is involved: EGAPP Working Group (EWG) Topics Subcommittee, full EWG, CDC-based EGAPP staff, and interested public. See process diagram below for details.

Transparency: EGAPP welcomes suggestions on potential topics for review. Those submitting suggestions are
encouraged to include information on the disorder, the specific test(s), and the specific clinical
scenario(s) in which the test will be used. EGAPP Working Group members make final topic selections. 

Products:

• List of topics
• Key questions and analytic framework for evidence reviews

Topic Selection Process

Summary: An evidence review involves many steps and is meant to synthesize available evidence on a particular disorder, test, and clinical scenario.

CDC commissions systematic evidence reviews using two strategies:

• Comprehensive Reviews are usually done in partnership with Agency for Healthcare Research and Quality Evidence-based Practice Centers (AHRQ EPCs). EPCs conduct comprehensive literature searches and evaluation, with detailed
  documentation of methods and results.
• Targeted and/or Rapid Reviews are conducted for topics with minimal literature to review and/or targeted questions to answer. These reviews are coordinated by CDC-based EGAPP staff in collaboration with technical contractors and expert core consultants.

Evidence reports, the products of these reviews, are detailed, systematic, objective assessments of the available scientific and
clinical evidence on a specific topic. Evidence reports are the basis for deliberations by the EGAPP Working Group as they develop
their Recommendation Statements.

Who is involved: CDC commissions the review, the EWG develops the key questions to be addressed, and the selected review team (e.g., EPC or other contracted group) conducts the review and produces a report. The review team establishes a Technical Expert Panel (TEP) to provide guidance, usually including topic experts and two to three EWG members.

Transparency: All EGAPP Working Group members, review team members, and consultants disclose potential conflicts of interest
for each topic considered. Evidence reports undergo external expert review. Reports or manuscripts published with CDC staff as authors may undergo CDC clearance.

Products:

Evidence reports posted on web sites (EGAPP or AHRQ)

Published summaries of evidence from the AHRQ EPCs or other contracted review group.

EGAPP EVIDENCE REVIEW PROCESS

Summary: The EGAPP Working Group (EWG) reviews the evidence report, considers contextual issues, and may consider other
sources of evidence. A draft recommendation statement is developed, peer-reviewed, and submitted for publication.

EWG Recommendation Statements are based on CDC-commissioned evidence reports, other review of evidence as needed, the quality of available data, and potential clinical and social impact of using the test in practice.

Who is involved: EWG, with support from CDC-based EGAPP staff and consultants.

Transparency: Review of comments from industry and a range of stakeholders (e.g., from professional organizations, health plans, consumer groups, and public health programs).

Products:

Peer-reviewed, published EWG Recommendation Statements

Recommendation Statement Development Process

Summary: EGAPP initiative products are disseminated to stakeholders through publications, web sites, and presentations. 

Who is involved: CDC-based EGAPP staff, EGAPP Stakeholders Group (ESG), EGAPP Working Group (EWG).

Transparency: Stakeholder peer review, CDC clearance.

Dissemination Processes for EGAPP Products and Informational Messages