Let the comparison shopping begin

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The august Institute of Medicine is out with academic medicine’s answer to the Billboard Hot 100. A panel of experts has come up with a list of the top 100 health topics that deserve a rigorous comparison of options to determine which are best.



The recommendations, part of a larger report that lays out a blueprint for research, are organized by quartile, and the top 25 would be the ones with a bullet, to stretch the pop music analogy.

Some of the high priorities:

  • What are the best strategies to reduce infections spread in health-care settings?
  • What’s the best way to use expensive biotech drugs – like Remicade, Enbrel and Humira – to treat inflammatory diseases, such as rheumatoid arthritis?
  • How should dental care be delivered to children to most effectively prevent cavities?

Comparing effectiveness is suddenly an idea whose time has come. “Health care decisions too often are a matter of guesswork, because we lack good evidence to inform them,” said Harold C. Sox, editor of The Annals of Internal Medicine, and panel co-chairman, according to The New York Times.

In legislation to boost the economy, Congress set aside more than $1 billion to fund comparisons that would pick health winners and losers. It was the IOM’s job to come up with recommendations on where to start.

For a little peek into how the priorities were chosen, Consumer Reports‘ Health Blog has a Q&A with Consumer Union President Jim Guest, who was a member of the Federal Coordinating Council for Comparative Effectiveness Research that came up with the recommendations.

The New England Journal of Medicine weighed in with a “Perspective” piece on implications of the report. For more about comparative effectiveness, see this piece from AHCJ board member Andrew Holtz, M.P.H.

Scott Hensley