What is the Concierge Clinical Evidence Service?

ENACT’s Concierge Clinical Evidence Service (CCES) is a clinician-initiated real-world evidence consultation service. A clinician submits a question to the service, CCES formulates a query leveraging SHRINE and the ENACT Network, applies statistical analysis, and provides a brief report out back to the clinician. The report allows for clinicians to discuss evidence with patients, facilitating shared decision making in situations without published data.

To learn more, check out our Grand Rounds recording on CCES.

When should I use CCES?  

CCES is designed to support clinical decision-making when published evidence, clinical guidelines, or randomized trials do not adequately address a specific patient care question. Examples include:

• Determining next steps in treatment when no clinical guidelines exist or available guidelines do not address a patient's specific circumstances.
• Comparing alternative treatment options using real-world evidence.
• Estimating the likelihood of adverse outcomes or complications when published evidence is limited or unavailable.
• Evaluating outcomes among patient populations that are underrepresented in clinical trials or have complex comorbidities.

Sample clinical questions include:

Example question 1: For patients who were on inhaled corticosteroids (ICS) and then developed Candida esophagitis (CE), what is the likelihood of recurrence of esophageal candidiasis if those patients are restarted on inhaled corticosteroids?

Example question 2: For a patient with peripheral artery disease (PAD) and diabetes, does the use of a GLP-1 agonist or SGLT2 inhibitor reduce the risk of limb loss compared to diabetics with PAD on other diabetic medications? Also, is there a minimum exposure window at which point the effect may appear?  

How do I submit a question?

Use the form below to submit your question and we will follow up with you. If you have multiple questions, you may submit them in one form.