Search

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, many individuals infected with the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have continued to experience lingering symptoms for months or even years following infection. Some symptoms can affect a person's ability to work or attend school for an extended period of time. Consequently, in 2022, the Social Security Administration requested that the National Academies convene a committee of relevant experts to investigate and provide an overview of the current status of diagnosis, treatment, and prognosis of long-term health effects related to Long COVID. This report presents the committee conclusions.

At any one time, at least 30,000 people in the U.S. are living with amyotrophic lateral sclerosis (ALS), a rapidly progressive, fatal neurological disease affecting individuals, caregivers, at-risk genetic carriers, and others. In 2022, Congress directed the National Institutes of Health to commission a National Academies committee of experts to recommend key actions public, private, and nonprofit sectors should take to make ALS a livable disease within the next 10 years. The resulting report, Living with ALS, focuses on an integrated ALS multidisciplinary care and research system to help facilitate earlier diagnosis and connections to specialty care.

Patients living with and beyond cancer often require care from a wide range of clinicians as they navigate cancer diagnosis, treatment, and survivorship care. To examine opportunities to improve equitable access to high-quality multispecialty and multidisciplinary expert care for people living with and beyond cancer, the National Academies National Cancer Policy Forum hosted a public workshop in collaboration with the Global Forum on Innovation in Health Professional Education.

To explore the current and future state of serious illness care research, the National Academies Roundtable on Quality Care for People with Serious Illness hosted a public workshop in November 2023. Speakers identified research gaps and challenges and explored strategies and opportunities to further develop the evidence base to improve care for all those living with serious illness, their families, and care partners.

The National Academies National Cancer Policy Forum hosted a Summer 2022 workshop to explore the current state of knowledge regarding risk factors for cancer and best practices for cancer prevention and risk reduction interventions. Speakers reviewed the current evidence base, examined best practices and innovative approaches for clinic- and population-based cancer prevention, and discussed strategies to promote effective communication about cancer prevention. This Proceedings of a Workshop summarizes the discussions held during the workshop. This workshop is the second in a series examining policy issues in cancer prevention and cancer screening. The first workshop, which took place in 2020, focused on advancing the development and implementation of effective, high-quality cancer screening.

A National Academies committee was tasked with identifying essential health care services for women related to intimate partner violence (IPV) during steady state conditions, determining whether the essential health care services related to IPV differ during public health emergencies (PHEs), and identifying strategies to sustain access to those essential health care services during PHEs. This report, Essential Health Care Services Addressing Intimate Partner Violence, presents findings from research and deliberations and lays out recommendations for leaders of health care systems, federal agencies, health care providers, emergency planners, and those involved in IPV research.

Racial and ethnic inequities in health and health care impact individual well-being, contribute to millions of premature deaths, and cost the United States hundreds of billions of dollars annually. Addressing these inequities is vital to improving the health of the nation's most disadvantaged communities—and will also help to achieve optimal health for all. In 2003, the Institute of Medicine examined these inequities in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Because disparities persist, the National Academies convened an expert committee with support from the Agency for Healthcare Research and Quality and the National Institutes of Health. The committee's report reviews the major drivers of health care disparities, provides insight into successful and unsuccessful interventions, identifies gaps in the evidence base, and makes recommendations to advance health equity.

At the request of the Health Resources and Services Administration, the National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop in April 2024 to explore mental health care services related to anxiety and mood disorders in women. Speakers provided evidence to identify, define, and prepare strategies for the provision of essential health care services for women experiencing anxiety and mood disorders. Presentations also described health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.

A subgroup of the National Academies Standing Committee on Primary Care was appointed to respond to the Request for Information (RFI) on the Pay PCPs Act of 2024, issued by Senators Bill Cassidy and Sheldon Whitehouse. The committee's report includes recommendations that address questions included in the RFI on payment-related primary care challenges.

The convergence of imaging, pathology, and laboratory testing data, augmented with information technology, is referred to as integrated diagnostics. To examine the current state of the science and strategies to facilitate precision cancer care through integrated diagnostics, the National Academies National Cancer Policy Forum hosted a public workshop in collaboration with the Computer Science and Telecommunications Board and the Board on Human-Systems Integration.

The use of immune modulator therapeutics, a type of immunotherapy enhancing the body immune system response to cancer, was perceived as the beginning of a new era in cancer care. While still important and frequently used, some of these therapeutics produce uneven response rates, disease resistance, and serious side effects. The National Academies National Cancer Policy Forum, in collaboration with the Forum on Drug Discovery, Development, and Translation, hosted a public workshop to discuss challenges related to immunotherapy treatment resistance, as well as potential policy opportunities to improve the development of immunotherapies for cancer treatment.

People with disabilities can be any age, face chronic health conditions or mental illness, be racial or ethnic minorities, experience low income or housing insecurity, have limited English proficiency, or a combination of many of these conditions. To better understand the effect of health inequities and the manner in which they affect Social Security Administration's (SSA) disability programs, the National Academies hosted a public workshop in April 2024 that examined the variety of different experiences of individuals with disabilities and the consequences of those experiences on an individual's health status, medical record, and SSA disability determinations.

A National Academies committee hosted a public workshop series in 2023. Speakers invited by the committee discussed the current state of racial and ethnic health care disparities in the U.S., highlighted major drivers of health care disparities, provided insight into successful and unsuccessful interventions, identified gaps in the evidence base and proposed strategies to close those gaps, and considered ways to scale and spread effective interventions to reduce racial and ethnic inequities in health care. This workshop series is part of an ongoing consensus study examining the current state of racial and ethnic health care disparities in the U.S., building on the 2003 Institute of Medicine consensus report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. The consensus study will publish its full conclusions and recommendations in summer 2024.

Existing systems are not prepared to provide the mental health care services needed by the growing population of older adults. The National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop in May 2023 to highlight the current state of mental health care for older adults, outline the challenges they face, and explore potential long-term strategies and solutions for addressing unmet mental health needs. Discussions emphasized information about wellness and prevention, social determinants of health in aging populations, the impact of workforce shortages and gaps, the need for supportive healthy communities, and strategies to promote positive mental health.This publication summarizes the presentations and discussion of the workshop.

There are significant challenges facing the workforce needed to provide high-quality care to increasing numbers of people living with serious illness. The National Academies Roundtable on Quality Care for People with Serious Illness hosted a hybrid public workshop in April 2023 to explore strategies and approaches to address major workforce challenges, such as health professional well-being; workforce shortages; workforce training and retention; as well as how to advance the diversity, equity, and inclusion of the workforce caring for people of all ages and all stages of serious illness. This workshop builds on the 2019 Roundtable workshop Building the Workforce We Need to Care for People with Serious Illness.

Approximately 3.6 million live births occur every year in the United States. Between 8 and 9 percent of infants are born with low birth weight (LBW), defined by the medical community as less than 2,500 grams or 5.5 pounds at birth. While most infants born with LBW are not impacted by severe developmental disabilities or major or multiple health conditions, research indicates that these infants often do experience elevated rates of mild to moderate chronic health conditions that have meaningful functional impacts throughout an individuals life course. The Social Security Administration (SSA) asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to provide an overview of the current status of the identification, treatment, and prognosis of LBW babies, including trends in survivability, in the U.S. population under age 1 year. SSA also asked the committee to provide information on the short- and long-term functional outcomes associated with and the most common conditions related to LBW, available treatments and services, and other considerations. The resulting report, Low Birth Weight Babies and Disability, presents the committees conclusions.

'Long COVID'refers to the wide range of long-lasting symptoms experienced by some patients after a SARS-CoV-2 infection. The most common symptoms include fatigue, headache, brain fog, shortness of breath, hair loss, and pain. At this time, there are many knowledge gaps related to Long COVID, including the prevalence of the condition, the impact of the symptoms on survivors'ability to function, and the long-term course of the condition. While many individuals with Long COVID recover within one year, others experience little or no decrease in symptom severity over time. Long COVID symptoms can affect a person's ability to work and otherwise function in daily life, so people with the condition may need to utilize programs such as Social Security Disability Insurance (SSDI) and the Supplemental Security Income Program (SSI). The Social Security Administration (SSA), which administers both of these programs, requested that the National Academies of Sciences, Engineering, and Medicine host a public workshop to discuss research into the long-term health effects of COVID-19, their impacts on individuals and populations, and how the SSDI and SSI programs can support individuals who suffer disability as a result of Long COVID. This publication summarizes the presentation and discussion of the workshop.

The U.S. Social Security Administration (SSA) administers the Social Security Disability Insurance program and the Supplemental Security Income program. As part of their process, immune system disorders are evaluated under Listing of Impairments 14.00 for adults and 114.00 for children. At the request of the SSA, the National Academies of Sciences, Engineering, and Medicine assembled a committee to review selected conditions related to the immune system. In particular, the SSA was interested in the current status of the diagnosis, treatment, and prognosis of immune system disorders including systemic lupus erythematosus (SLE), scleroderma, polymyositis, Sjögren's syndrome/disease, and inflammatory arthritis. This report provides an overview of the current status of the diagnosis, treatment, and prognosis of these immune system disorders in the U.S. population and the relative levels of functional limitation typically associated with them, common treatments, and other considerations.

Studies show that people commonly have psychotic symptoms for over a year before receiving treatment. Reducing this duration is critical, because early treatment is strongly associated with better outcomes. The National Academies Forum on Mental Health and Substance Use Disorders hosted a workshop in July 2022 to examine the current evidence on short- and long-term outcomes for people at high risk for psychosis. Speakers explored potential policy solutions and strategies that are most effective for coordinated, early-intervention specialty services. This Proceedings document summarizes workshop discussions.

The National Academies Roundtable on Genomics and Precision Health, in collaboration with the National Cancer Policy Forum, hosted a public workshop that examined how genomic data are used in health care, outside of the traditional settings for clinical genetics. The workshop identified opportunities for advancement of precision health care delivery. The event also explored how patients, clinicians, and payers assess and act upon the risks and benefits of genomic screening and diagnostic testing. Discussions focused on strategies to ensure that genomic applications are responsibly and equitably adopted to benefit populations as well as individuals over time. This Proceedings of a Workshop summarizes content from the event.

Emerging real-time data sources, together with innovative data science techniques and methods - including artificial intelligence and machine learning - can help inform upstream suicide prevention efforts. Select social media platforms have proactively deployed these methods to identify individual platform users at high risk for suicide, and in some cases may activate local law enforcement, if needed, to prevent imminent suicide. To explore the current scope of activities, benefits, and risks of leveraging innovative data science techniques to help inform upstream suicide prevention at the individual and population level, the Forum on Mental Health and Substance Use Disorders of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop series consisting of three webinars held on April 28, May 12, and June 30, 2022. This Proceedings highlights presentations and discussions from the workshop.

Despite advances in the delivery of high-quality cancer care and improvements in patient outcomes in recent years, disparities in cancer incidence, care, and patient outcomes persist. To examine opportunities to improve health equity across the cancer care continuum, the National Cancer Policy Forum and the Roundtable on the Promotion of Health Equity hosted a public workshop, Promoting Health Equity in Cancer Care, on October 25 and October 26, 2021. This virtual workshop featured presentations and panel discussions on topics that included: opportunities to improve equitable access to affordable, high-quality cancer care; strategies to identify and address the intersectionality of structural racism and implicit bias in cancer care delivery; the potential for quality measurement and payment mechanisms to incentivize health equity in cancer care delivery; and clinical practice data collection efforts to better assess and care for people living with and beyond cancer. This publication summarizes the presentation and discussion of the workshop.

Heritable disorders of connective tissue (HDCTs) are a diverse group of inherited genetic disorders and subtypes. Because connective tissue is found throughout the body, the impairments associated with HDCTs manifest in multiple body systems and may change or vary in severity throughout an affected individual's lifetime. In some cases, these impairments may be severe enough to qualify an eligible child or adult for monetary benefits through the U.S. Social Security Administration's (SSA's) Social Security Disability Insurance or Supplemental Security Income program. SSA asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee that would provide current information regarding the diagnosis, treatment, and prognosis of selected HDCTs, including Marfan syndrome and the Ehlers-Danlos syndromes, and the effect of the disorders and their treatment on functioning. The resulting report, Selected Heritable Disorders of Connective Tissue and Disability, presents the committee's findings and conclusions.

Pediatric subspecialists are critical to ensuring quality care and pursuing research to improve prevention, diagnosis, and treatment for children. However, there are substantial disincentives to pursuing a career as a pediatric subspecialist, which are often heightened for individuals from groups underrepresented in medicine, and more effective collaboration with primary care clinicians is needed. Changing health care needs, increasing care complexity, and access barriers to pediatric subspecialty care have raised concerns about the current and future availability of pediatric subspecialty care and research. In response, the National Academies, with support from a coalition of sponsors, formed the Committee on the Pediatric Subspecialty Workforce and Its Impact on Child Health and Well-Being to recommend strategies and actions to ensure an adequate pediatric subspecialty physician workforce to support broad access to high quality subspecialty care and a robust research portfolio to advance the health and health care of infants, children, and adolescents. This report outlines recommendations that, if fully implemented, can improve the quality of pediatric medical subspecialty care through a well-supported, superbly trained, and appropriately used primary care, subspecialty, and physician-scientist workforce.

The mental and behavioral health care needs of Americans, including veterans, have substantially grown over the past few decades. As the nations largest provider of mental health care, the U.S. Department of Veterans Affairs (VA) faces some of the greatest challenges in meeting the mental health care needs of its population. These challenges are exacerbated by a shrinking mental health care workforce and provider shortages in low-income and rural communities. To address these challenges, and at the request of VA, the National Academies of Sciences, Engineering, and Medicine Forum on Mental Health and Substance Use Disorders held a public workshop on Improving Access to High-Quality Mental Health Care for Veterans to explore the U.S. landscape for mental health care services, including telehealth services. The workshop considered ways to improve veterans timely access to high-quality care for mental health conditions. In particular, it explored internal and external best practices for three critical needs for mental health access (known as tripartite access in VA): urgent/crisis, engagement, and sustained access. This proceedings document summarizes discussions at the workshop.

Where people live can affect their health because of location-specific exposure to chemicals and toxicants, lifestyle, diet, immune function development, and social and historical determinants of health. A better understanding of the connections between environmental exposures and genetics that are associated with cancer can help inform efforts to identify risks and prevent potentially harmful outcomes. Recent scientific advancements have brought new insights into genomic and epigenomic biomarkers of cancer, which encompasses the toxicogenomic effects of environmental hazards, genetic susceptibility to environmental exposures, and the role of genetic and epigenetic changes in the development of cancer. Public communication around the potential risks of environmental hazards has also been evolving. The National Academies of Sciences, Engineering, and Medicine National Cancer Policy Forum convened a virtual public workshop in collaboration with the Roundtable on Genomics and Precision Health on April 13, 2023 to explore the state of the science in identifying potential genomic and epigenomic biomarkers of environmental exposures associated with cancers, with an emphasis on pediatric cancers. This proceedings document summarizes workshop discussions.

The National Academies Roundtable on Quality Care for People with Serious Illness, National Cancer Policy Forum, and Forum on Aging, Disability and Independence hosted a workshop that examined opportunities to better support family caregiving for people with cancer or other serious illnesses. This workshop built upon previous work, including the 2016 consensus report Families Caring for an Aging America. This Proceedings of a Workshop summarizes the discussions held during the workshop, which focused on: strategies to better capture, understand, and act on family caregiver input and experience; research gaps and opportunities to guide caregiving for patients with serious illnesses; potential policy and practice opportunities to advance family-centered care for serious illness; and opportunities to embed a health equity focus across family caregiving research, policy, and practice.

Whole health is physical, behavioral, spiritual, and socioeconomic well-being as defined by individuals, families, and communities. Whole health care is an interprofessional, team-based approach anchored in trusted relationships to promote well-being, prevent disease, and restore health. It aligns with a person's life mission, aspiration, and purpose. It shifts the focus from a reactive disease-oriented medical care system to one that prioritizes disease prevention, health, and well-being. It changes the health care conversation from'What's wrong with you?'to'What matters to you?'The Department of Veterans Affairs (VA), the Samueli Foundation, and the Whole Health Institute commissioned the National Academies of Sciences, Engineering, and Medicine to establish a committee to provide guidance on how to fill gaps and create processes to accelerate the transformation to whole health care for veterans, both inside and outside the VA system, and the rest of the U.S. population. The resulting report presents findings and recommendations that provide a roadmap for improving health and well-being for veterans and the nation.

The U.S. Social Security Administration (SSA) provides benefits to adults and children who meet the eligibility requirements for a disability as described in Title II and Title XVI of the Social Security Act. To determine whether more accurate or precise techniques exist for determining if a previously evaluated physical impairment is either more or less severe, SSA requested the National Academies assemble a committee to review new or improved diagnostic or evaluative techniques that have become generally available within the past 30 years for cardiovascular, neurological, respiratory, hematological, and digestive conditions. The resulting report presents a summary of the evidence and information around a selected subset of diagnostic and evaluative techniques.

Electronic Health Records (EHRs) are used across a wide variety of activities in cancer care and cancer research, including communication among health care team members and patients, clinical documentation and treatment planning, patient safety and quality improvement, scheduling and billing, as well as clinical research and disease surveillance activities. On February 28 and March 1, 2022, the National Cancer Policy Forum and the Computer Science and Telecommunications Board of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to examine opportunities to improve patient care and outcomes through collaborations to enhance innovation in the development, implementation, and use of EHRs in oncology care, research, and surveillance. This Proceedings of a Workshop summarizes the presentations and discussions that took place at the workshop.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), in partnership with other agencies and divisions of the United States Department of Health and Human Services, coordinates a portfolio of projects that build data capacity for conducting patient-centered outcomes research (PCOR). PCOR focuses on producing scientific evidence on the effectiveness of prevention and treatment options to inform the health care decisions of patients, families, and health care providers, taking into consideration the preferences, values, and questions patients face when making health care choices. ASPE asked the National Academies to appoint a consensus study committee to identify issues critical to the continued development of the data infrastructure for PCOR. Building Data Capacity for Patient-Centered Outcomes Research contains findings and conclusions in the areas that could benefit from being prioritized as part of ASPE's work, and offers input on strengthening the overall framework for building the data infrastructure over the coming years. The committee authoring this report also issued three interim reports, which summarized discussions from three workshops, and are included as appendices in the final report.

The COVID-19 pandemic has highlighted existing weaknesses in the United States health care system, while creating a new set of challenges related to caring for people with serious illness. The National Academy of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a three-part workshop to explore the initial responses to the pandemic by health care teams providing care to people with serious illness, the impact of the pandemic on the health care workforce, the use of telehealth, issues related to clearly communicating with the public about health emergencies, and policy opportunities to improve care for people with serious illness. Issues related to health equity were discussed throughout the three webinars.

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. Ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents. The devastating impact of the COVID-19 pandemic on nursing home residents and staff has renewed attention to the long-standing weaknesses that impede the provision of high-quality nursing home care. With support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff identifies seven broad goals and supporting recommendations which provide the overarching framework for a comprehensive approach to improving the quality of care in nursing homes.

The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop in March 2021 to examine the existing evidence base on how the Patient Protection and Affordable Care Act (ACA) has altered the landscape of cancer prevention and care delivery in the United States. The workshop featured presentations and discussions reviewing the effects of the ACA on people at risk for or living with cancer and providing insight into remaining policy challenges that could inform future efforts to improve and support the delivery of high-quality cancer care across the care continuum. This publication provides a high-level summary of the discussions presented during the workshop.

The Board on Health Care Services of the National Academies of Sciences, Engineering and Medicine hosted a virtual workshop, funded by the Social Security Association, to examine disability associated with hematopoietic stem cell transplantation. The workshop, held on November 15, 2021, included presentations on the functional outcomes for individuals who have received hematopoietic stem cell treatment, as well as medical advances, developments, and research in this area. This Proceedings of a Workshop highlights the presentations and discussions that occurred in the workshop.

The persistent trends in suicide necessitate action among mental health care providers and payers, researchers, and community leaders. Health care settings provide an important opportunity for suicide intervention and prevention, but they cannot yet fully manage suicide risk because of a lack of training, knowledge gaps, and reimbursement challenges. School, workplace, and community-based interventions can help reduce the incidence of suicidal behavior, as can better access to care and reduced access to lethal means of suicide. To better understand the strategies to improve access to effective interventions to prevent suicide, the Forum on Mental Health and Substance Use Disorders at the National Academies of Sciences, Engineering, and Medicine hosted a two-part virtual public workshop, Strategies and Interventions to Reduce Suicide, on June 22, 2021, and July 28, 2021. The first webinar examined the scope of the public health problem, discussed implementation of effective approaches for suicide prevention care, and addressed known barriers to health care access. The second webinar focused on building 9-8-8, the new nationwide emergency number designated to the National Suicide Prevention Lifeline. Participants discussed current crisis systems, gaps, challenges, and needs for marginalized populations. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshops.

Patients diagnosed with Alzheimer's disease and related dementias (ADRD) rely on family members, their community, and the health care system for progressively increasing support over the course of their disease. These people receive care through a frequently siloed health care system across hospitals, nursing homes, ambulatory care settings, and long-term care settings, as well as community- and home-based care. As the number of people living with a diagnosis of ADRD continues to grow, so does the need to provide better support for these people and their caregivers. The National Institute on Aging (NIA) Division of Behavioral and Social Research suggests that organizational behavior change will be needed for health care systems to integrate all of the services and supports required to provide high-quality care for people with ADRD. NIA sponsored a workshop hosted by the National Academies of Sciences, Engineering, and Medicine to explore mechanisms to improve the quality of care for people living with ADRD and the potential of innovative payment models to incentivize health care systems to make the necessary systemic changes. The workshop convened a diverse array of experts in fields including nursing, geriatrics, health care economics, health care services research, quality measurement, social work, medical ethics, law, health care finance, and health care policy. This publication summarizes the presentation and discussion of the workshop.

Indigenous communities experience higher risks for suicide compared to the general U.S. population, with suicide as the second-leading cause of death among Indigenous children and young adults in North America. To reduce this trend, it is essential for prevention and intervention efforts to build on scientific evidence; cultural and local knowledge; and the best community, family, and institutional practices to reduce risk and increase protection. The Forum on Mental Health and Substance Use Disorders and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine convened a three-part virtual public workshop on April 26, 2022, May 13, 2022, and June 10, 2022, to examine suicide risk and protective factors in Indigenous populations, discuss culturally appropriate and effective suicide prevention policies and programs, explore existing data systems and how data can be used for tracking suicide rates, and consider opportunities for action. This Proceedings highlights presentations and discussions from the workshop.

Over the past few years the common use of telehealth technology has been rapidly expanding. While remote models of care have been successfully used in rural communities for decades, the adoption of telehealth rapidly expanded during the COVID-19 pandemic, narrowing some gaps in care access and equity while exacerbating health care inequities in other ways. At the request of the Social Security Administration, the National Academies hosted a workshop on March 9 and 10, 2022 to examine the use of telehealth for patient evaluation. The workshop explored the evolution of telehealth and commonly used terminology, the impact of inequities in digital access, privacy and cybersecurity concerns, its use in a variety of allied health and medical specialties for patient evaluation, and interstate licensure related to providing telehealth care. This publication provides a high-level summary of the presentations and discussions from the workshop.

Methadone is a Food and Drug Administration- (FDA-) approved medication for treating opioid use disorder (OUD), a chronic brain disease that affects more than 2.7 million people in the United States aged 12 and older. Despite its effectiveness in saving lives, many barriers impede access to, initiation of, and retention in methadone treatment for OUD. To address these barriers, on March 3 and 4, 2022, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on'Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations and Laws,'at the request of the Office of National Drug Control Policy in the Executive Office of the President. This publication summarizes the presentation and discussion of the workshop.

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop.

Approximately five percent of Medicare beneficiaries (2.2 million Americans) are living with serious illness, as are many other non-Medicare eligible individuals. This number is expected to grow rapidly as the population ages and the prevalence of progressive illness increases. In many communities, particularly urban and rural underserved communities, primary care clinicians are the main workforce caring for people with serious illness, which underscores the need to integrate high quality serious illness care into primary care delivery. To better understand the challenges and opportunities for integrating serious illness care into primary care settings, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a virtual workshop on June 10 and 17, 2021. The workshop, titled Integrating Serious Illness Care into Primary Care Delivery, explored the shared principles of primary and serious illness care, the interdisciplinary teams that power both disciplines, the policy issues that can act as barriers to or incentives for integration, and best practices for integrating primary care and serious illness care. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshop.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), in partnership with other agencies and divisions of the United States Department of Health and Human Services, coordinates a portfolio of projects that build data capacity for conducting patient-centered outcomes research (PCOR). PCOR focuses on producing scientific evidence on the effectiveness of prevention and treatment options to inform the health care decisions of patients, families, and health care providers, taking into consideration the preferences, values, and questions patients face when making health care choices. ASPE asked the National Academies to appoint a consensus study committee to identify issues critical to the continued development of the data infrastructure for PCOR. The committee's work will contribute to ASPE's development of a strategic plan that will guide their work related to PCOR data capacity over the next decade. As part of its information gathering activities, the committee organized three workshops to collect input from stakeholders on the PCOR data infrastructure. This report, the third in a series of three interim reports, summarizes the discussion and committee conclusions from the third workshop, which focused on ways of enhancing collaborations, data linkages, and the interoperability of electronic databases to make the PCOR data infrastructure more useful in the years ahead. Participants in the workshop included researchers and policy experts working in these areas.

The COVID-19 pandemic has led to dramatic adjustments in cancer care delivery and cancer research. To examine these changes, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Innovation in Cancer Care and Cancer Research in the Context of the COVID-19 Pandemic, in July 2021. Workshop speakers considered the lessons learned from these adaptations in order to improve the delivery of high-quality cancer care and the conduct of cancer clinical trials in the post-pandemic era. This Proceedings of a Workshop highlights presentations and discussions from the workshop.

Every community is affected by traumatic brain injury (TBI). Causes as diverse as falls, sports injuries, vehicle collisions, domestic violence, and military incidents can result in injuries across a spectrum of severity and age groups. Just as the many causes of TBI and the people who experience it are diverse, so too are the physiological, cognitive, and behavioral changes that can occur following injury. The overall TBI ecosystem is not limited to healthcare and research, but includes the related systems that administer and finance healthcare, accredit care facilities, and provide regulatory approval and oversight of products and therapies. TBI also intersects with the wide range of community organizations and institutions in which people return to learning, work, and play, including the education system, work environments, professional and amateur sports associations, the criminal justice system, and others. Traumatic Brain Injury: A Roadmap for Accelerating Progress examines the current landscape of basic, translational, and clinical TBI research and identifies gaps and opportunities to accelerate research progress and improve care with a focus on the biological, psychological, sociological, and ecological impacts. This report calls not merely for improvement, but for a transformation of attitudes, understanding, investments, and care systems for TBI.

Patient-centered outcomes research (PCOR) studies consider the questions and outcomes that are meaningful to patients to compare the effectiveness of different prevention, diagnostic, and treatment options. PCOR also increases patient involvement in their care by providing them an opportunity to evaluate the quality, outcomes, and effectiveness of health care treatments and intervention, especially in areas where there is poor existing clinical evidence. The National Academies of Sciences, Engineering, and Medicine Board on Healthcare Services hosted a series of public workshops to explore ways of accelerating the use of PCOR findings in clinical practice to improve health and health care. Workshop discussions touched on the role of community health workers in helping care providers see and understand the whole picture of patient lives, the need for community engagement to ensure research is conducted and applied to practice equitably, and ways of measuring the impact of efforts to disseminate and implement new practices based on PCOR. This report summarizes the discussions that took place at these workshops.

Cancer treatment can lead to an array of significant short- and long-term physical, psychosocial, and socioeconomic consequences for patients and their families. To examine the opportunities to prevent and mitigate the adverse effects of cancer treatment, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop, Addressing the Adverse Consequences of Cancer Treatment, in November 2020. This workshop was convened by the Academies'National Cancer Policy Forum in collaboration with the Forum on Aging, Disability, and Independence. Workshop presentations and discussions described the range of adverse effects that patients with cancer may experience across the life course, and highlighted potential strategies to improve quality of life for cancer survivors and their families.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), in partnership with other agencies and divisions of the United States Department of Health and Human Services, coordinates a portfolio of projects that build data capacity for conducting patient-centered outcomes research (PCOR). PCOR focuses on producing scientific evidence on the effectiveness of prevention and treatment options to inform the health care decisions of patients, families, and health care providers, taking into consideration the preferences, values, and questions patients face when making health care choices. ASPE asked the National Academies to appoint a consensus study committee to identify issues critical to the continued development of the data infrastructure for PCOR. The committee's work will contribute to ASPE's development of a strategic plan that will guide their work related to PCOR data capacity over the next decade. As part of its information gathering activities, the committee organized three workshops to collect input from stakeholders on the PCOR data infrastructure. This report, the second in a series of three interim reports, summarizes the discussion and committee conclusions from the second workshop, focused on data standards, methods, and policies that could make the PCOR data infrastructure more useful in the years ahead. Participants in the workshop included researchers and policy experts working in these areas.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), in partnership with other agencies and divisions of the United States Department of Health and Human Services, coordinates a portfolio of projects that build data capacity for conducting patient-centered outcomes research (PCOR). PCOR focuses on producing scientific evidence on the effectiveness of prevention and treatment options to inform the health care decisions of patients, families, and health care providers, taking into consideration the preferences, values, and questions patients face when making health care choices. ASPE asked the National Academies to appoint a consensus study committee to identify issues critical to the continued development of the data infrastructure for PCOR. The committee's work will contribute to ASPE's development of a strategic plan that will guide their work related to PCOR data capacity over the next decade. As part of its information gathering activities, the committee organized three workshops to collect input from stakeholders on the PCOR data infrastructure. This report, the first in a series of three interim reports, summarizes the discussion and committee conclusions from the first workshop, focused on looking ahead at data user needs over the next decade. The workshop included representatives of patient groups with a wide reach and researchers with broad research interests as well as an understanding of the PCOR infrastructure.

There is a void in evidence-based information for making informed decisions on how to optimize care for older adults, particularly those 80 years and over. Because older adults are vastly underrepresented in clinical trials, there is a dearth of information about the appropriate use of drugs in this population. Yet older adults have higher rates of comorbidities and simultaneous use of multiple medications than the general population, and are the majority users of many medications. Additionally, age-related physiological and pathological changes, particularly for adults 80 years of age and older, can lead to significant differences in the pharmacokinetics (PK)2 and pharmacodynamics (PD)3 of a given drug compared to the general population. On August 5 and 6, 2020, the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Drug Research and Development for Adults Across the Older Age Span. The workshop was designed to examine the challenges and opportunities in drug research and development for older adult populations, explore barriers that impede safety and efficacy studies in these populations, and share lessons learned for better understanding clinical pharmacology for populations over age 65. This publication summarizes the presentation and discussion of the workshop.