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Health Services Research & Development

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Evidence Synthesis Program

About the ESP Program

ESP logo The VA Evidence Synthesis Program (ESP), established in 2007, makes high-quality evidence synthesis available to clinicians, managers, and policymakers as they work to improve the health and healthcare of Veterans. ESP reports help:

  • Develop clinical policies informed by evidence;
  • Implement effective services to improve patient outcomes and to support VA clinical practice guidelines and performance measures; and
  • Set the direction for future research to address gaps in clinical knowledge.

ESP is helping VA fulfill its vision of functioning as a continuously "learning healthcare system" to improve Veteran health and healthcare. ESP achieves this by providing timely, targeted, thorough, unbiased, and innovative syntheses of the medical literature for the VHA to translate into evidence-based clinical practice and policy, and quality improvement and practice-based future research initiatives at the national level. The ESP offers a range of products from rapid review evidence briefs to full systematic reviews, tailored to the needs of decision-makers. In addition to being made available throughout VA and in the public domain, ESP reports are also published in top medical journals, so that clinicians worldwide may access them, and some evidence syntheses have informed the clinical guidelines of large professional organizations.

The program consists of four ESP Centers across the US, each with an active University affiliation, and a Coordinating Center, located in Portland, Oregon which oversees national program operations, program development and evaluation, and dissemination efforts. Center directors are recognized leaders in the field of systematic review methodology with close ties to the AHRQ Evidence-based Practice Centers and are practicing clinicians in the VA. This unique expertise enables ESP to produce comprehensive reports that answer a wide range of research questions in a variety of clinical and health system settings with a special emphasis on the Veteran population and geared towards helping VA leadership with policy and clinical decision making.

Nominate a Topic for Research in the Program

Would an independent and rigorous review of the scientific literature help your office plan or implement a program, develop a guideline or directive, make a health policy decision, or inform future research needs? The Evidence Synthesis Program (ESP) is soliciting nominations from VHA leadership for review topics for FY 2023. Nominations will be accepted electronically using the Topic Submission Form.

Peer Review

ESP reports are externally peer-reviewed by clinical and policy experts. If you're interested in serving as a peer reviewer for the program, please register here.

ESP in the News

  • Mederos MA, Jacob RL, Ward R, et al. Trends in Robot-Assisted Procedures for General Surgery in the Veterans Health Administration. Journal of Surgical Research. 2022;279:788 795. DOI: https://doi.org/10.1016/j.jss.2022.06.055

  • Shenoy R, Mederos MA, Jacob RL, et al. Robot-Assisted General Surgery Procedures at the Veterans Health Administration: A Comparison of Surgical Techniques. Journal of Surgical Research. 2022;279:330 337. DOI: https://doi.org/10.1016/j.jss.2022.06.032

  • Kondo K, Williams B, Ayers C, et al. Factors Associated with Health Inequalities in Infectious Disease Pandemics Predating COVID-19 in the United States: A Systematic Review. Health Equity. Published online March 24, 2022. DOI: https://doi.org/10.1089/heq.2021.0049

  • Kaka A, MacDonald R, Linskens E, et al. Major Update 2: Remdesivir for Adults With COVID-19: A Living Systematic Review and Meta-analysis for the American College of Physicians Practice Points. Annals of Internal Medicine. Published online on March 1, 2022. DOI: 10.7326/M21-4784.

  • Shepherd-Banigan M, Drake C, Dietch JR, et al. Primary Care Engagement Among Individuals with Experiences of Homelessness and Serious Mental Illness: an Evidence Map. Journal of General Internal Medicine. Published online March 8, 2022. DOI: https://doi.org/10.1007/s11606-021-07244-z.

  • Veazie S, Lafavor B, Vela K, et al. Mental health outcomes of adults hospitalized for COVID-19: A Systematic Review. Journal of Affective Disorders Reports. 2022(8):100312. DOI: https://doi.org/10.1016/j.jadr.2022.100312.

  • Mackey K, Kansagara D, and Vela K. Update Alert 9: Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults. Annals of Internal Medicine. Published online February 8, 2022. DOI: 10.7326/L21-0791.

  • Ballengee LA, Rushton S, Lewinski AA, et al. Effectiveness of Quality Improvement Coaching on Process Outcomes in Health Care Settings: A Systematic Review. Journal of General Internal Medicine. Published online January 3, 2022. DOI: https://doi.org/10.1007/s11606-021-07217-2.

  • Mederos MA, de Virgilio MJ, Shenoy R, et al. Comparison of Clinical Outcomes of Robot-assisted, Video-assisted, and Open Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis. JAMA Network Open. 2021;4(11):e2129228. DOI: 10.1001/jamanetworkopen.2021.29228.

  • Duan-Porter W, Ullman K, Majeski B, Miake-Lye I, Diem S, and Wilt TJ. Care Coordination Models and Tools - Systematic Review and Key Informant Interviews. Journal of General Internal Medicine. Published online October 26, 2021. DOI: https://doi.org/10.1007/s11606-021-07158-w.

  • Kaka AS, MacDonald R, Linskens EJ, Wilt TJ. Update Alert 2: Remdesivir for Adults With COVID-19. Annals of Internal Medicine. Published online October 5, 2021. DOI: https://doi.org/10.7326/L21-0600.


Click for list of published reports Click for topic nomination form Click for list of reports in progress

Resource for evidence reviews on COVID-19

ESP has developed a catalog of COVID-19 evidence reviews conducted by evidence synthesis groups in the US and around the world to maximize the collective contributions to all those responding to the pandemic and avoid duplicating efforts. We aim for this to be a resource for both systematic reviewers and for those looking to inform practice or health systems policies.

Cannabis Provider Education Packet

This product was developed to help familiarize VHA clinicians with basic information about cannabis so that they might feel more comfortable engaging in discussions with their patients and answering questions.

Deprescribing Narrative

In a new initiative, ESP has created a narrative companion to the report entitled "Deprescribing for Older Veterans" which reviews the scientific literature around the effectiveness and harms of deprescribing interventions for older adults.

The report itself is publicly available here.

Recent Reports

  • Evidence Inventory - Emergency Department-based Geriatric Risk Assessment (intranet only)
  • Evidence Inventory - Emergency Department-based Telehealth Interventions for Older Adults (intranet only)

More...




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Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.