Tag Archives: comparative effectiveness

First class of AHCJ Comparative Effectiveness Research Fellows named

Fellowship on Comparative Effectiveness ResearchTwelve journalists have been chosen for the inaugural class of the AHCJ Fellowship on Comparative Effectiveness Research. The fellowship program was created with support from the Patient-Centered Outcomes Research Institute to help reporters and editors produce more accurate in-depth stories on medical research and how medical decisions are made.

The fellows will gather in Washington, D.C., the week of Oct. 11 for a series of presentations, round tables, hands-on database sessions and interactions with researchers.

Read more to find who the fellows are and some examples of the sessions they will participate in.

NEHI maps out future of comparative effectiveness

NEHI,  a nonprofit research group that was known as the New England Healthcare Institute, has released a white paper mapping out a potential near future for comparative effectiveness research in the United States. We first noticed the report on the Kaiser Family Foundation’s Health Reform Source site.

The white paper’s authors, Tom Hubbard, Shin Daimyo and Karan Desai, make a strong case that proper dissemination will be the real key to the success of CER. Their argument hinges on the observation that, even today, good medical research rarely makes it into clinical practice without a hefty nudge. cer_white_paperWhen it comes to delivering this nudge to all that stimulus-funded comparative effectiveness research, the paper’s authors have singled out the newly created Patient-Centered Outcomes Research Institute. PCORI’s stated role is to help all stakeholders make informed health care decisions. It’s also, the authors write, uniquely positioned to become a key force in CER dissemination alongside the AHRQ’s Office of Communications and Knowledge Transfer. Unlike AHRQ, PCORI is an independent organization that’s free to form relationships and build consensus across the spectrum.

All in all, the report’s a quick and handy read. There are only 9 pages of text, and you’ll come out with a better understanding of the practical problems facing those who seek to apply comparative effectiveness research. If you’re  looking for examples of successful implementation programs, head to pages 8 through 10.

Video, presentations from comparative effectiveness conference available online

Earlier this month, ECRI’s 17th annual conference tackled the thorniest detail of comparative effectiveness research, namely that it’s rarely a simple matter of A > B. Groups and individuals respond differently.

With a theme of “Comparative Effectiveness and Personalized Medicine,” the nonprofit and its partners at NIH and Health Affairs, among others, sought to better understand how big research ideas will interface with the person-by-person decisions through which such work will ultimately be implemented.

The conference has a detailed postmortem online, including two days of video (Fair warning: Together, they’re a good 700+ minutes of conference) and slides from a number of the presentations. I strongly recommend using the conference schedule listed on the slides page as a rough guide to finding the most relevant bits of video.

In case you’re looking for a place to start, here are two of the most relevant presentations:

The online Q and A is also interesting, though there are only a handful of answers up at present. The most relevant one so far comes from Vivian Coates (Vice President, Information Services and Health Technology Assessment, ECRI Institute), in response to a query about a central listing of comparative effectiveness projects.

The CER inventory contract was awarded to the Lewin Group Center for Comparative Effectiveness Research (CER) in June, 2010. Over the 27 month period of the contract, Lewin will design, build and launch a web-based inventory that catalogs CER outputs and activity, including research studies, relevant research methods, training of researchers, data infrastructure and approaches for dissemination and translation of comparative effectiveness research to health care providers and patients.

Days numbered for UK’s arbiter of comparative effectiveness

While comparative effectiveness research in the United States is booming thanks to the stimulus, a United Kingdom bastion of the discipline may be on the way out. Over at the NPR health blog, Joanne Silberner reports that the National Institute for Health and Clinical Excellence (NICE), which publishes guidelines on treatments and medical devices based on their cost and effectiveness, could be gone by 2013.

At a drug industry trade group meeting in London earlier this week, Health Minister Lord Howe, Under Secretary of State for Quality, said NICE has become “redundant,” and that it should focus on setting quality standards rather than evaluating individual drugs.

Meanwhile, the Cameron administration has disregarded NICE advice on several cancer drugs, and Howe reports that the government is working on a new “value-based pricing system.”

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For more European health news, see AHCJ’s Covering Europe initiative.

Article looks at evidence behind back surgery

In the Star Tribune, Janet Moore seeks to counter aggressive spinal surgery with equally aggressive journalism. It’s a comprehensive take on a subject which journalists have been hammering away at piecemeal for some time now. Her anecdotes are strong, and her numbers doubly so. For example:

spine

Photo by planetc1 via Flickr

Four out of five Americans will suffer from disabling back pain during their lifetimes, according to the National Institutes of Health. Spending on back care soared between 1997 and 2005, reaching $86 billion — just shy of what Americans spent battling cancer.

As those numbers have multiplied, so have questions about the more aggressive forms of back treatment. A 2008 study in the Journal of the American Medical Association, for example, noted that the increase in back-care spending occurred “without evidence of corresponding improvement” in patients’ health.

As Moore points out, this is a debate that will continue as health reform is implemented because the new legislation will “require doctors and hospitals to demonstrate that their services are cost-effective. In that vein, the New England HealthCare Institute estimates the United States could save roughly $1 billion a year by eliminating unnecessary back surgeries.”

Minnesota is home to Medtronic, a leading maker of devices used in spinal surgery. Medtronic has consultation arrangements with a number of doctors and some experts question whether that relationship has an effect on how many spinal surgeries are done. The head of the Association for Ethics in Spine Surgery, says these financial incentives create demand for certain brands of product.

It’s a lengthy piece, and the numbers are just one component. The whole package is definitely worth a read.

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