Case Studies

An NIH study of treatments for high blood pressure, called the ALLHAT trial, shows some of the strengths and limitations of comparative effectiveness research to improve patient care. More...

Recent Blog Posts

PIPC chairman delivers speech to specialty docs on importance of patient centered CER
July 6, 2010 |

Partnership to Improve Patient Care (PIPC) chairman, Tony Coelho, recently delivered a speech on patient centered comparative effectiveness research (CER) in front of fifty specialty doctors from around the country, among others, at the Alliance for Specialty Medicine’s (ASM) “Capitol Hill Advocacy Conference.” The conference took place just a day before the specialty doctors met w

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Tony Coelho's recent speech on patient centered CER
June 24, 2010 |

Below: PIPC Chairman Tony Coelho's recent speech on patient centered CER. The speech was delivered on Tuesday, June 22, 2010 at the Alliance for Specialty Medicine's “Capitol Hill Advocacy Conference,” in Washington, D.C.

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Lack of support for "evidence-based health care"— don't blame the patient
June 10, 2010 |

A new Health Affairs article concludes, based on focus groups and interviews, that "consumers will revolt if evidence-based efforts are perceived as rationing or as a way to deny them needed treatment."

You don't need to look any further than public reaction to the U.S. Preventive Service Task Force's updated recommendations on mammography screening to see the proof of this.
 
How should policy-makers react? Should they conclude that consumers, and even more so, patients, cannot be relied on to make evidence-based decisions, and therefore these decisions need to be made for them? Or should they conclude that evidence-based models of medical care and health delivery need to be carefully constructed so they have the trust and support of patients and consumers?

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Informing and Deciding

How should research be used? Every patient is different, so what works best for one patient may not work for someone else. That's why government CER efforts should focus on making research widely available to decision-makers, but shouldn't make policy recommendations or decisions itself, which would lead to one-size-fits-all policies that ignore how people are different. If a new CER entity has a mandate to make decisions about what types of treatments should or should not be covered, then patients and providers could lose their ability to apply research results to their unique situation. To learn more about the risks of centralized coverage policy decisions, click here.

This is also why it is important for research results to be communicated quickly and accurately, and in ways that help doctors and patients apply results to the individual's circumstances. This means discussing the different factors that can help decide which treatment is optimal for the individual, like the patient's particular medical condition and genetic variations.

What kinds of research can help improve patient care? To improve patient care, CER research should examine the range of issues that affect the quality of patient care. This includes the range of medical tests and treatments, and well as questions related to health care delivery and organization, such as benefit designs and care management programs. All of these elements of health care affect patients' quality of care and health outcomes. In addition. research should include the different factors important to patients, including quality of life, independence, and productivity.