[Federal Register Volume 76, Number 39 (Monday, February 28, 2011)]
[Pages 10900-10902]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-4130]



Agency for Healthcare Research and Quality

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Agency for Healthcare Research and Quality, HHS.

ACTION: Notice.


SUMMARY: This notice announces the intention of the Agency for 
Healthcare Research and Quality (AHRQ) to request that the Office of 
Management and Budget (OMB) approve the proposed information collection 
project: ``Comparative Effectiveness Research--Continuing Education.'' 
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3521, 
AHRQ invites the public to comment on this proposed information 

DATES: Comments on this notice must be received by April 29, 2011.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
    Copies of the proposed collection plans, data collection 
instruments, and specific details on the estimated burden can be 
obtained from the AHRQ Reports Clearance Officer.

Clearance Officer, (301) 427-1477, or by e-mail at 


Proposed Project

Comparative Effectiveness Research--Continuing Education

    Previous dissemination efforts in health care research and evidence 
through comparative effectiveness funded by the Federal Government have 
largely been focused in academic settings, rather than among physicians 
and clinicians in health care delivery settings. This project 
implements and evaluates methods that extend beyond the academic 
setting to engage the target audiences in the health care environment 
where decisions are typically made.
    Most clinicians are required to complete continuing medical 
education (CME) accepted by accrediting organizations recognized by 
State medical boards. Over sixty boards require anywhere from 12 CME 
credits to 50 CME credits per year for a clinician to retain their 
State licensure. (State Medical Licensure Requirements and Statistics, 
2010, http://www.ama-assn.org/ama1/pub/upload/mm/40/table16.pdf.) AHRQ 
currently provides CME credits on some of its comparative effectiveness 
research reviews; however, these CME credits are applicable to 
physicians only and AHRQ is not conducting any follow-up surveys with 
physicians on these CME activities to ascertain the impact on physician 
behavior. AHRQ is expanding its continuing education to include nurses, 
nurse practitioners, physician assistants, medical assistants, 
pharmacists, respiratory therapists, and other allied health 
professionals, as well as physicians. In addition, AHRQ wants to assess 
the impact continuing education has on clinician behavior, its 
perceived value, and whether or not education on comparative 
effectiveness research made a difference in a clinician's confidence in 
applying comparative effectiveness research in practice, understanding 
the application of such research, and improved ability to counsel 
patients on treatment and management alternatives.
    Dissemination of clinical and research findings to clinicians 
varies in approach, methods and by target audience. Highly technical 
and scientific publications are peer reviewed and serve to validate the 
methods, calculations, analysis and conclusions of studies and 
research. Typically, scientific journals have a narrowly defined 
readership and information regarding clinical application of findings 
is not part of the criteria for manuscript acceptance and publication. 
AHRQ complies with the journal guidelines when submitting manuscripts 
regarding comparative effectiveness research (CER) information for 
publication in the Annals of Internal Medicine. However, it is nearly 
impossible to discern whether the manuscript was read, its effect on 
the reader, and the likelihood that the reader will utilize the 
    Accredited education is widely accepted as a method for 
dissemination of research findings and is provided in various ways, 
including online, on site, and through audio and video presentations. 
To earn credit for participation, clinicians must provide contact 
information, allowing the possibility of follow-up data collections 
regarding behaviors, attitudes and performance information about the 
participant. AHRQ has also provided accredited education as a method to 
disseminate CER findings, and with this project, has reaffirmed the 
value of CME in dissemination of CER findings and expanded the 
commitment to provide

[[Page 10901]]

accredited education for multiple health care disciplines.
    The goal of this project is to enhance awareness of comparative 
effectiveness research among clinicians and measure the value and 
impact of these efforts.
    This study is being conducted by AHRQ through its contractor, PRIME 
Education, Inc., pursuant to AHRQ's statutory authority to conduct and 
support research on healthcare and on systems for the delivery of such 
care, including activities with respect to: the quality, effectiveness, 
efficiency, appropriateness and value of healthcare services; quality 
measurement and improvement; and clinical practice. 42 U.S.C. 
299a(a)(1), (2) and (4).

Method of Collection

    To achieve this project's goal, the following activities and data 
collections will be implemented:
    1. Provide continuing medical education (CME) or continuing 
education units (CE/CEU) through the appropriate accrediting 
organizations by providing 15 multimedia online continuing education 
modules per year for 3 years, on specific comparative effectiveness 
research reports and provide quantitative and qualitative metrics about 
usage of these programs by physicians, pharmacists, nurses, nurse 
practitioners, physician assistants, medical assistants, allied health 
professionals, and other clinicians. This activity is designed to raise 
awareness of and utility of comparative effectiveness research by 
providing free and easy access to clinician guides and consumer guides 
for clinicians and their patients/families to assist in making informed 
decisions about heath care.
    The following monthly utilization rates for the online CME/CE/CEU 
activities will be collected: the number of CME/CE/CEU certificates 
issued, monthly participation statistics, and the number of clinician 
and consumer guides ordered. Because all of the CME/CE/CEU activities 
are online, the utilization rates are automatically collected by the 
contractor's computer when the health care professional registers for 
the activity, participates in the online education, requests continuing 
education credit for the activity, and orders clinician and consumer 
guides. Therefore, this activity does not require OMB clearance.
    2. CME/CE/CEU registration data is provided by the health care 
professional when he or she logs on and registers for a course. The 
health care professional would key in their name, e-mail address, 
address (selecting either their home or business address), telephone 
number, type of discipline, and their practice setting. This data is 
collected to ensure that the health care professional receives CME/CE/
CEU credit for the courses that he or she takes and will be used to 
implement the AI-IRQ Online Continuing Education Participant Evaluation 
described below.
    3. AHRQ Online Continuing Education Participant Evaluation to 
evaluate the effectiveness and impact of the CME/CE/CEU modules at 60 
days, 6 months and 1 year after completion of the module (see 
Attachment B). The purpose of this evaluation is to assess the 
clinicians' confidence level in applying comparative effectiveness 
research, their understanding of the research, how valuable the 
research is to the clinician and their intent to change their practice 
based on this research. Evaluation questions have been developed based 
upon established conceptual frameworks and principles of adult 
    Data collected will be used to assess the utility and effectiveness 
of the educational module in increasing awareness and utility of 
information provided in comparative effectiveness research. Data will 
provide useful quantitative arid qualitative metrics which AHRQ can use 
to measure the outcomes of the project. Moreover, these metrics will 
enable AHRQ to identify new potential barriers that may thwart the 
outcome--lending important information regarding future educational 

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in this research. The AHRQ Online 
Continuing Education Participant Evaluation will be completed at 3 
different points in time after completion of the CME/CE/CEU education 
module. The CME/CE/CEU registration data is collected for an estimated 
1,500 health care professionals and takes approximately 5 minutes. The 
same estimated 1,500 health care professionals will complete the 
evaluation 3 times each year, which takes about 3 minutes to complete. 
The total annual burden is estimated to be 350 hours.
    Exhibit 2 shows the estimated annual cost burden to respondents, 
based on their time to participate in surveys for each CME/CE/CEU 
module. The annual cost burden is estimated to be $16,290.

                             Exhibit 1--Estimated Annualized Burden Hours per Module
                                                                     Number of       Hours per
                    Form name                        Number of     responses per     response      Total  burden
                                                    respondents     respondent        survey           hours
AHRQ Online Continuing Education CME/CE/CEU                1,500               1            5/60             125
 Registration Data..............................
AHRQ Online Continuing Education Participant               1,500               3            3/60             225
    Total.......................................           3,000              na              na             350

                             Exhibit 2--Estimated Annualized Cost Burden per Module
                    Form name                        Number of     Total  burden   hourly  wage     Total  cost
                                                    respondents        hours           rate*          burden
AHRQ Online Continuing Education CME/CE/CEU                1,500             125          $46.54          $5,818
 Registration Data..............................
AHRQ Online Continuing Education Participant               1,500             225           46.54          10,472
    Total.......................................           3,000             350              na        $16,290
* Based upon the mean of the average hourly wages for Physicians (29-1069; $83.59), Pharmacists (291051;
  $51.27), Physician Assistants and Nurse Practitioners (29-1071; $40.78), Registered Nurses (291111; $31.99)
  and Healthcare Practitioners (29-9099; $25.05), National Compensation Survey: Occupational wages in the United
  States May 2009, ``U.S. Department of Labor, Bureau of Labor Statistics.''

[[Page 10902]]

Estimated Annual Costs to the Federal Government

    Exhibit 3 shows the total and annualized cost for the 45 CME/CE/CEU 
modules (15 per year for 3 years). The total cost is estimated to be 

             Exhibit 3--Estimated Total and Annualized Cost
          Cost component                Total cost      Annualized cost
Development of CME/CE/CEU Module..         $2,256,300           $752,100
Module Accreditation..............            900,000            300,000
Module Dissemination..............            450,000            150,000
Evaluation instrument development             356,850            118,950
 and dissemination, data
 collection, processing and
    Total.........................         $3,963,150         $1,321,050

Request for Comments

    In accordance with the Paperwork Reduction Act, comments on AHRQ's 
information collection are requested with regard to any of the 
following: (a) Whether the proposed collection of information is 
necessary for the proper performance of AHRQ healthcare research and 
healthcare information dissemination functions, including whether the 
information will have practical utility; (b) the accuracy of AHRQ's 
estimate of burden (including hours and costs) of the proposed 
collection(s) of information; (c) ways to enhance the quality, utility, 
and clarity of the information to be collected; and (d) ways to 
minimize the burden of the collection of information upon the 
respondents, including the use of automated collection techniques or 
other forms of information technology.
    Comments submitted in response to this notice will be summarized 
and included in the Agency's subsequent request for OMB approval of the 
proposed information collection. All comments will become a matter of 
public record.

    Dated: February 15, 2011.
Carolyn M. Clancy,
[FR Doc. 2011-4130 Filed 2-25-11; 8:45 am]