Comparative Effectiveness
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Comparative Effectiveness Research (CER) is the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms. The core question of comparative effectiveness research is which treatment works best, for whom, and under what circumstances.
In 2009, $1.1 Billion of President Obama's stimulus package was earmarked for CER. [1]. There is disagreement regarding whether CER will be used to limit patient health care options[2], or help lower health care costs. [3]
An important component of CER is the concept of Pragmatic Trials[4]. These clinical research trials measure effectiveness—the benefit the treatment produces in routine clinical practice. This is different than many regularly clinical trials, which measure efficacy, whether the treatment works or not.
Several groups have emerged to provide leadership in the area of Comparative Effectiveness Research. The Agency for Healthcare Research and Quality (AHRQ) is a federal agency focused on health care quality, while the Center for Medical Technology Policy is a non-profit organization that brings disparate health care stake holders together to build consensus on practical models for comparative effectiveness research.
In 2009, The Institute of Medicine released Initial National Priorities for Comparative Effectiveness Research(CER)[5]. This report is designed to assist patients and healthcare providers across diverse settings in making more informed decisions. In this report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise.
In April 2009, the New England Healthcare Institute released a white paper identifying ways to design and implement the new federal comparative effectiveness research program without stifling valuable innovation in health care.[6]
[edit] Notes
- ^ http://www.nytimes.com/2009/02/16/health/policy/16health.html
- ^ http://online.wsj.com/article/SB123423024203966081.html
- ^ http://content.nejm.org/cgi/content/short/360/19/1925?rss=1&query=current
- ^ http://www.bmj.com/cgi/content/extract/316/7127/285
- ^ http://www.nap.edu/catalog.php?record_id=12648
- ^ http://www.cq.com/display.do?docid=3098444&productId=5&binderName=healthbeat-20090417
[edit] Further Information
- Alexander GC, Stafford RS. Does comparative effectiveness have a comparative edge? JAMA. 2009;301:2488-2490.
