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The New Health Dialogue

A Blog from New America's Health Policy Program

QUALITY: IOM Panel Lists 100 Priorities for Comparative Effectiveness Research

Published:  July 1, 2009

Earlier this week, we discussed the Federal Coordinating Council for Comparative Effectiveness Research's recommendations for comparative effectiveness research. Recently, an Institute of Medicine panel released a similar report, which offers a comprehensive list of 100 health issues ranked according to priority.

Comparative effectiveness research gives doctors and patients access to verified, scientific information on best treatments that they otherwise could only get through their best guesswork.

"Health care decisions too often are a matter of guesswork, because we lack good evidence to inform them," Dr. Harold C. Sox, a co-chairman on the panel and the editor of The Annals of Internal Medicine, told the New York Times. "For example, we spend a great deal on diagnostic tests for coronary heart disease in this country, but we lack sufficient evidence to determine which test is best," he added in a press release.

Here is a rundown of the some health issues that were flagged as top priorities for the Administration, specifically, the HHS:

  • Compare the effectiveness of treatment strategies for atrial fibrillation (the most common kind of abnormal heart rhythm) including surgery, catheter ablation, and pharmacologic treatment (aka drug therapy).
  • Compare the effectiveness of the different treatments (hearing aids, cochlear implants, or rehabilitation methods such as sign language) for hearing loss in children and adults, especially individuals with diverse cultural, language, medical, and developmental backgrounds.
  • Compare the effectiveness of various screening, prophylaxis, and treatment interventions in eradicating methicillin resistant Staphylococcus aureus (MRSA—a dangerous, common hospital acquired infection) in communities, institutions, and hospitals.
  • Compare the effectiveness of management strategies for localized prostate cancer (e.g., active surveillance, radical prostatectomy [conventional, robotic, and laparoscopic], and radiotherapy [conformal, brachytherapy, proton-beam, and intensity-modulated radiotherapy]) on survival, recurrence, side effects, quality of life, and costs.
  • Compare the effectiveness of various strategies (e.g., clinical interventions, selected social interventions [such as improving the built environment in communities and making healthy foods more available], combined clinical and social interventions) to prevent obesity, hypertension, diabetes, and heart disease in at-risk populations such as the urban poor and American Indians.
  • Compare the effectiveness of imaging technologies in diagnosing, staging, and monitoring patients with cancer including positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT).

Over at Gooznews.com, Merril Goozner pointed out a "sleeper" towards the top of the list, (number five to be precise)...

"Compare the effectiveness of dissemination and translation techniques to facilitate the use of CER by patients, clinicians, payers, and others."

Given that Congress will probably insert language in health care reform legislation stipulating no one should ever be bound to actually use the findings of comparative effectiveness research (why that's like EVIL BIG GOVERNMENT coming between YOU and YOUR DOCTOR), it's probably a good idea for someone to study how to "disseminate and translate" this information so that parts of the health care system might actually put it to use.





A summary of all 100 items is attached below.

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