Hieu-Pham/cpgQA huggingface dataset:
Background information

The presidential memorandum of October 2015 mandated that executive departments and agencies shall, to the extent permitted by law, provide training on the appropriate and effective prescribing of opioid medications to all employees who are health care professionals and who prescribe controlled substances as part of their federal responsibilities and duties. The DoD Opioid Prescriber Safety  Training Program, launched accordingly, includes modules on pain management and opioid prescribing safety, the recent Centers for Disease Control and Prevention (CDC) guideline, and the identification of substance misuse and referral to specialized services. Defense Centers of  Excellence for Psychological Health and Traumatic Brain Injury is sponsoring the training and related management support. Training is available online at http://opstp.cds.pesgce.com/hub.php.  

Question: What does the DoD Opioid Prescriber Safety  Training Program include?
Answer: modules on pain management and opioid prescribing safety, the recent Centers for Disease Control and Prevention (CDC) guideline, and the identification of substance misuse and referral to specialized services
Background information

The presidential memorandum of October 2015 mandated that executive departments and agencies shall, to the extent permitted by law, provide training on the appropriate and effective prescribing of opioid medications to all employees who are health care professionals and who prescribe controlled substances as part of their federal responsibilities and duties. The DoD Opioid Prescriber Safety  Training Program, launched accordingly, includes modules on pain management and opioid prescribing safety, the recent Centers for Disease Control and Prevention (CDC) guideline, and the identification of substance misuse and referral to specialized services. Defense Centers of  Excellence for Psychological Health and Traumatic Brain Injury is sponsoring the training and related management support. Training is available online at http://opstp.cds.pesgce.com/hub.php.  

Question: Which training program was launched according to the mandate by the presidential memorandum of October 2015?
Answer: DoD Opioid Prescriber Safety  Training Program
Background information

The presidential memorandum of October 2015 mandated that executive departments and agencies shall, to the extent permitted by law, provide training on the appropriate and effective prescribing of opioid medications to all employees who are health care professionals and who prescribe controlled substances as part of their federal responsibilities and duties. The DoD Opioid Prescriber Safety  Training Program, launched accordingly, includes modules on pain management and opioid prescribing safety, the recent Centers for Disease Control and Prevention (CDC) guideline, and the identification of substance misuse and referral to specialized services. Defense Centers of  Excellence for Psychological Health and Traumatic Brain Injury is sponsoring the training and related management support. Training is available online at http://opstp.cds.pesgce.com/hub.php.  

Question: Who is sponsoring the training and related management support?
Answer: Defense Centers of  Excellence for Psychological Health and Traumatic Brain Injury
Background information

The presidential memorandum of October 2015 mandated that executive departments and agencies shall, to the extent permitted by law, provide training on the appropriate and effective prescribing of opioid medications to all employees who are health care professionals and who prescribe controlled substances as part of their federal responsibilities and duties. The DoD Opioid Prescriber Safety  Training Program, launched accordingly, includes modules on pain management and opioid prescribing safety, the recent Centers for Disease Control and Prevention (CDC) guideline, and the identification of substance misuse and referral to specialized services. Defense Centers of  Excellence for Psychological Health and Traumatic Brain Injury is sponsoring the training and related management support. Training is available online at http://opstp.cds.pesgce.com/hub.php.  

Question: Where can the DoD Opioid Prescriber Safety  Training Program be found?
Answer: http://opstp.cds.pesgce.com/hub.php
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: Who are the targeted individuals for the CDC Guideline for Prescribing Opioids for Chronic Pain?
Answer: primary care physicians
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: When did the CDC released its Guideline for Prescribing Opioids for Chronic Pain? 
Answer: March 15, 2016
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: What is the aim of the CDC Guideline for Prescribing Opioids for Chronic Pain?
Answer: assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT.
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: Which topics are covered in the CDC Guideline for Prescribing Opioids for Chronic Pain?
Answer: initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: Which system is used by the CDC guideline to assign a  grade for the strength for each recommendation? 
Answer: GRADE system
Background information

The CDC released its Guideline for Prescribing Opioids for Chronic Pain, directed toward primary care physicians, on March 15, 2016. The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline,  similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of  OT, and risk assessment and use of risk mitigation strategies. It also used the GRADE system to assign a  grade for the strength for each recommendation which includes assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development. 

Question: What does the GRADE system include?
Answer: assessment of the quality of the evidence and consideration of the balance of desirable and undesirable outcomes, patient values and preferences,  and other considerations (e.g., resource use, equity) during recommendation development
Background information

On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) was enacted with the aim of addressing the epidemic of overdoses from prescription opioids and other prescription drugs and heroin. While this act was primarily focused on opioid abuse treatment and prevention, it also gave specific instruction to the VA in regard to broad aspects of OT including consideration of the CDC guideline in revising the prior VA/DoD OT CPG and adopting it for the VA. There are, however, some important distinctions between the CDC guideline and the VA/DoD OT CPG. 

Question: What is CARA?
Answer: the Comprehensive Addiction and Recovery Act
Background information

On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) was enacted with the aim of addressing the epidemic of overdoses from prescription opioids and other prescription drugs and heroin. While this act was primarily focused on opioid abuse treatment and prevention, it also gave specific instruction to the VA in regard to broad aspects of OT including consideration of the CDC guideline in revising the prior VA/DoD OT CPG and adopting it for the VA. There are, however, some important distinctions between the CDC guideline and the VA/DoD OT CPG. 

Question: When was CARA enacted?
Answer: July 22, 2016
Background information

On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) was enacted with the aim of addressing the epidemic of overdoses from prescription opioids and other prescription drugs and heroin. While this act was primarily focused on opioid abuse treatment and prevention, it also gave specific instruction to the VA in regard to broad aspects of OT including consideration of the CDC guideline in revising the prior VA/DoD OT CPG and adopting it for the VA. There are, however, some important distinctions between the CDC guideline and the VA/DoD OT CPG. 

Question: What is the aim of CARA?
Answer: addressing the epidemic of overdoses from prescription opioids and other prescription drugs and heroin
Background information

On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) was enacted with the aim of addressing the epidemic of overdoses from prescription opioids and other prescription drugs and heroin. While this act was primarily focused on opioid abuse treatment and prevention, it also gave specific instruction to the VA in regard to broad aspects of OT including consideration of the CDC guideline in revising the prior VA/DoD OT CPG and adopting it for the VA. There are, however, some important distinctions between the CDC guideline and the VA/DoD OT CPG. 

Question: What is the primary focus of the CARA?
Answer: opioid abuse treatment and prevention
Background information

The VA/DoD OT CPG was developed with a specific patient population in mind—Service Members,  Veterans, and their families—that has unique characteristics and needs related to the military culture and communities to which they return. Throughout the VA/DoD OT CPG, attention is paid to the characteristics and needs of these patients, particularly regarding specific risk factors such as risk for suicide, SUD, and other medical and mental health co-occurring conditions that may complicate the management of pain for these patients. Further, these recommendations were made keeping in mind the implications they would  have within the VA/DoD healthcare settings, particularly regarding considerations such as resource use, accessibility, and equity related to each recommendation and the urgent need for rigorous attention to the balance of risks and benefits for patients within the VA/DoD specifically. 

Question: Who are the target population for the VA/DoD OT CPG?
Answer: Service Members,  Veterans, and their families—that has unique characteristics and needs related to the military culture and communities to which they return
Background information

The VA/DoD OT CPG was developed with a specific patient population in mind—Service Members,  Veterans, and their families—that has unique characteristics and needs related to the military culture and communities to which they return. Throughout the VA/DoD OT CPG, attention is paid to the characteristics and needs of these patients, particularly regarding specific risk factors such as risk for suicide, SUD, and other medical and mental health co-occurring conditions that may complicate the management of pain for these patients. Further, these recommendations were made keeping in mind the implications they would  have within the VA/DoD healthcare settings, particularly regarding considerations such as resource use, accessibility, and equity related to each recommendation and the urgent need for rigorous attention to the balance of risks and benefits for patients within the VA/DoD specifically. 

Question: Throughout the VA/DoD OT CPG, particular attention is paid regarding which factors?
Answer: specific risk factors such as risk for suicide, SUD, and other medical and mental health co-occurring conditions that may complicate the management of pain for these patients
Background information

The VA/DoD OT CPG was developed with a specific patient population in mind—Service Members,  Veterans, and their families—that has unique characteristics and needs related to the military culture and communities to which they return. Throughout the VA/DoD OT CPG, attention is paid to the characteristics and needs of these patients, particularly regarding specific risk factors such as risk for suicide, SUD, and other medical and mental health co-occurring conditions that may complicate the management of pain for these patients. Further, these recommendations were made keeping in mind the implications they would  have within the VA/DoD healthcare settings, particularly regarding considerations such as resource use, accessibility, and equity related to each recommendation and the urgent need for rigorous attention to the balance of risks and benefits for patients within the VA/DoD specifically. 

Question: What was the considerations behind the recommendations made in the CPG?
Answer: the implications they would  have within the VA/DoD healthcare settings, particularly regarding considerations such as resource use, accessibility, and equity related to each recommendation and the urgent need for rigorous attention to the balance of risks and benefits for patients within the VA/DoD specifically
Background information

There were also some differences in the methodology used between the development of the VA/DoD OT  CPG and the CDC guideline. Along with a clinical evidence review, during which the evidence was evaluated using GRADE, the CDC guideline developers also considered the findings of a contextual evidence review. Further, the CDC Core Expert Group, which consisted of subject matter experts,  representatives of primary care professional societies and state agencies, and an expert in guideline methodology, reviewed recommendations drafted by the CDC and evaluated how the evidence was used in the development of the recommendations, rather than developing the recommendations themselves  (as was the VA/DoD OT Work Group’s role in the development of the VA/DoD OT CPG). While experts provided feedback on the CDC recommendations and their development, the CDC determined the final recommendations. CDC also used a review process considering and incorporating feedback from federal partners (e.g., SAMHSA, VA, DoD), stakeholders (e.g., professional organizations, delivery systems,  community organizations), and other constituents (e.g., clinicians, prospective patients). The CDC guideline development process included notice in the Federal Register for a public review and comment period as well as peer review. Thus, the recommendations made in the CDC guideline, although similar to those made in this CPG, were likely based on a slightly different evidence base and revised based on the feedback of individuals who were considering a larger group of potential patients relative to the VA/DoD. Thus, while the VA/DoD OT Work Group was aware of the release of the CDC guideline and considered potential implications, the CDC guideline did not form the basis of the deliberations on the strength or direction of these recommendations. The Work Group followed the VA/DoD Guideline for Guidelines, a document that details the process by which VA/DoD guidelines will be developed, including the use of the  GRADE methodology. As required by Congress in CARA, the Work Group reviewed and considered the  CDC guideline and its inclusion in the VA/DoD OT CPG.

Question: What did the CDC guideline development process include? 
Answer: notice in the Federal Register for a public review and comment period as well as peer review
Background information

There were also some differences in the methodology used between the development of the VA/DoD OT  CPG and the CDC guideline. Along with a clinical evidence review, during which the evidence was evaluated using GRADE, the CDC guideline developers also considered the findings of a contextual evidence review. Further, the CDC Core Expert Group, which consisted of subject matter experts,  representatives of primary care professional societies and state agencies, and an expert in guideline methodology, reviewed recommendations drafted by the CDC and evaluated how the evidence was used in the development of the recommendations, rather than developing the recommendations themselves  (as was the VA/DoD OT Work Group’s role in the development of the VA/DoD OT CPG). While experts provided feedback on the CDC recommendations and their development, the CDC determined the final recommendations. CDC also used a review process considering and incorporating feedback from federal partners (e.g., SAMHSA, VA, DoD), stakeholders (e.g., professional organizations, delivery systems,  community organizations), and other constituents (e.g., clinicians, prospective patients). The CDC guideline development process included notice in the Federal Register for a public review and comment period as well as peer review. Thus, the recommendations made in the CDC guideline, although similar to those made in this CPG, were likely based on a slightly different evidence base and revised based on the feedback of individuals who were considering a larger group of potential patients relative to the VA/DoD. Thus, while the VA/DoD OT Work Group was aware of the release of the CDC guideline and considered potential implications, the CDC guideline did not form the basis of the deliberations on the strength or direction of these recommendations. The Work Group followed the VA/DoD Guideline for Guidelines, a document that details the process by which VA/DoD guidelines will be developed, including the use of the  GRADE methodology. As required by Congress in CARA, the Work Group reviewed and considered the  CDC guideline and its inclusion in the VA/DoD OT CPG.

Question: What are differences in the recommendations between the CDC guideline and the CPG?
Answer: based on a slightly different evidence base and revised based on the feedback of individuals who were considering a larger group of potential patients relative to the VA/DoD