Introduction to CLOUD
Our mission is to curate high quality, evidence-based resources on opioids and the opioid crisis for decision-makers across health care systems, state and local communities, and providers of care. CLOUD strives to be a centralized repository of information to assist decision-making at all levels of the system.
The library is a work in progress as we continue to add materials every day. If you have resources you would like to include in the library, please see our Call for Submissions page. We are particularly interested in resources that describe programs and initiatives that have been shown through research or program evaluation to be effective at achieving their intended goals. More information about our inclusion & exclusion criteria and evidence review system can be found below.
How Do I Use the Website?
Website materials have been organized to facilitate a simple user experience. The search function allows users to quickly search by keyword. Advanced search options include results filtered by audience (policymakers & community leaders; payers & providers; or patients & caregivers), type of resource (documents, videos and external links), topic, and/or evidence ranking.
When clicking on a resource, users are brought to a page that provides a detailed description of the resource and the option to download, view, or visit the resource’s webpage depending on the resource type. The resource page also lists related resources and topic tags linking users to other topical resources.
The library also includes featured collections for certain high interest topics. Featured collections include aggregated resources on a focused topic such as Recovery, Medication Assisted Treatment for Opioid Use Disorder, and Successful Programs for Pregnant and Parenting Women with Opioid Use Disorder. Users can browse featured collections through the link in the header of the homepage or can search for featured collections using the advanced search option’s filters.
What Resources are Included in the Cloud?
CLOUD has been given a broad mandate to include virtually any resource that supports our evidence-based mission and relates in some way to the opioid crisis or related issues such as alternative treatments for pain, addiction treatment, harm reduction and prevention. The library includes infographics, one- and two-page summary documents, policy reports, program evaluations, patient and provider educational materials, tool kits, government documents including relevant legislation and regulations, clinical practice guidelines, and links to videos and external websites. To fulfill our goal of curating high quality, evidence-based resources, the following criteria are applied:
What Are the Criteria for Inclusion into CLOUD?
- Primarily written or recorded in the English language. We do include non-English materials published by reputable government organizations for educational purposes.
- Publicly available without restriction on access.
- Focused on the subject of opioid use or an opioid related issue (e.g., non-opioid treatments for pain, addiction science and treatment)
- Relevant for decision-makers addressing aspects of problematic opioid use
- Objectively presented information without promotion or bias
Why Might a Resource be Excluded from CLOUD?
- Restricted access or fee requirement
- Prepared for commercial marketing purposes
- Clear financial, professional or political bias
- We strive to avoid financial, intellectual or political conflicts of interests when selecting materials for the library. However, we recognize that some individuals and organizations actively working on opioid related issues receive funding through political action committees, pharmaceutical manufacturers, or others in the industry with financial, intellectual, or political conflicts of interest. Therefore, we will consider including materials produced by individuals or organizations who have received such funding in limited circumstances. Materials must:
- Meet ALL of the inclusion criteria
- Not trigger any other exclusion criteria, particularly the criterion preventing materials with financial, professional, or political bias
What is CLOUD’s Policy on Funding Disclosures?
The administrators of CLOUD seek to identify the funding source for all materials included in the library by evaluating the specific resource for funding disclosures and the authoring organization’s websites and annual reports for their major funders. Funding sources are identified on each resource page. If material that was produced by an individual or organization who has accepted funding from an organization with an identified conflict of interest is included in CLOUD, the following additional disclosure statement detailing the conflict of interest policy will be added to the resource description:
This resource was produced by an individual/organization receiving funding from sources that have a conflict of interest such as a pharmaceutical company, political action committee, or other industry-related sources. Multiple studies indicate that research performed by individuals with relationships to industry and research funded by industry sources are more likely to favor the sponsor’s products. Industry funding of charities and non-profit organizations has also been linked to groups supporting industry-favorable positions. For more information, please visit the CLOUD 101 page.
For more information about how conflicts of interest can lead to bias in research and advocacy, please see:
Jacobson, M.F. “Lifting the Veil of Secrecy from Industry Funding of Nonprofit Health Organizations.” International Journal of Occupational and Environmental Health 11, no. 4 (2005): 349-55.
Lundh, A., J. Lexchin, B. Mintzes, J.B. Schroll, and L. Bero. “Industry Sponsorship and Research Outcome.” Cochrane Review (2017). https://doi.org/10.1002/14651858.MR000033.pub3.
Moynihan R, Bero L, Hill S, et al. Pathways to Independence: Towards Producing and Using Trustworthy Evidence. BMJ. 2019;367(6576). doi: 10.1136/bmj.l6576
Steele, S., G. Ruskin, L. Sarcevic, M. McKee, and D. Stuckler. “Are Industry-Funded Charities Promoting “Advocacy-Led Studies” or “Evidence-Based Science”?: A Case Study of the International Life Sciences Institute.” Globalization and Health 15, no. 36 (2019): 1-8. https://doi.org/10.1186/s12992-019-0478-6.
What is CLOUD’s Evidence Ranking System?
Where possible, resources include a ranking of the strength of the evidence for a particular strategy, clinical intervention, or community initiative’s effectiveness at addressing a challenge related to the opioid crisis. Evidence rankings are applied when there is evidence from research or program evaluations that can show whether a particular strategy, clinical intervention, or community initiative is successful at achieving its intended goals. The following 4-level evidence ranking system will be applied to these resources:
PROVEN: The intervention or program has demonstrated effectiveness through two or more rigorous, well-conducted studies or program evaluations where the preponderance of evidence indicates significant positive change in a clearly identified outcome or process measure AND the intervention or program has been implemented and evaluated in real-world settings with documented and sustained benefits to individuals or communities.
PROMISING: The intervention or program has demonstrated effectiveness either through one well-conducted study OR evaluation in a real-world setting with objective documentation of benefit to individuals or communities. These interventions might need further study to demonstrate application to multiple settings or more experience to document the elements needed for implementation fidelity.
POTENTIAL: The intervention or program exhibits either some evidence of positive outcomes with limitations in the evaluation/evidence design OR has been implemented in real world settings without objective documentation of benefit. The theoretical model behind such interventions or programs should be sound and lead one to expect a benefit from the intervention.
PROBLEMATIC: The intervention or program does not provide evidence of significant benefit, or demonstrates potentially harmful effects. This category also includes practices that have been implemented in real world settings and documented as ineffective or harmful.