Expanding the Capacity for
Comparative Effectiveness Research
Carolyn Clancy, MD
Director
U.S. Agency for Healthcare Research and Quality
AcademyHealth Annual Research Meeting
Orlando – June 3, 2007
Research Needs Gaining
Increased Attention
Rationale for
Evidence-Based Medicine
 Maximize the likelihood
that beneficial treatments
are used and that harmful
treatments are not used
 Reduce costs and/or
improve cost effectiveness
 Provide an explicit, fair
and rational method of
resource allocation
Why do we Need
Effectiveness Research?
 Not all interventions that
sound “logical” are
beneficial when carefully
studied
 Not all beneficial
interventions are equally
beneficial, or equally safe
 Budgets are limited
 Issues are complex and
cannot be clarified without
careful analysis
The Intersection of
Effectiveness and Safety
Effectiveness –
Benefits
The Intersection of
Effectiveness and Safety
Safety – unintended
consequences, harms
The Intersection of
Effectiveness and Safety
Balance of Benefits and Harms
Agency for Healthcare
Research and Quality
Effective Health Care
Center for
Financing, Access
& Cost Trends
Center for
Outcomes
& Evidence
Center for Quality
Improvement
& Patient Safety
AHRQ
Extramural Research,
Education &
Priority Populations
Center for Primary
Care, Prevention,
Partnerships
Communication
&
Knowledge Transfer
Center for Delivery
& Organization
& Markets
Performance
Accountability,
Resources & Technology
Effective Health Care Program
A. Evidence Synthesis (EPC program)
–
–
Systematically reviewing, synthesizing, comparing existing
evidence on treatment effectiveness.
Identifying relevant knowledge gaps.
B. Evidence Generation (DEcIDE, CERTs)
–
–
Development of new scientific knowledge to address
knowledge gaps.
Accelerate practical studies.
C. Evidence Communication/Translation
(Eisenberg Center)
–
–
Translate evidence into improvements
Communication of scientific information in plain language
to policymakers, patients, and providers.
New Effective Health Care
Web site
http://effectivehealthcare.ahrq.gov/
AHRQ Comparative
Effectiveness Reviews (CERs)
 Comparative Effectiveness of Second-Generation






Antidepressants in the Pharmacologic Treatment of Adult
Depression - 1/24/2007
Efficacy and Comparative Effectiveness of Off-Label Use of
Atypical Antipsychotics - 1/17/2007
Comparative Effectiveness of Management Strategies for
Renal Artery Stenosis - 10/24/2006
Comparative Effectiveness and Safety of Analgesics for
Osteoarthritis - 9/25/2006
Comparative Effectiveness of Epoetin and Darbepoetin for
Managing Anemia in Patients Undergoing Cancer Treatment
- 5/23/2006
Effectiveness of Noninvasive Diagnostic Tests for Breast
Abnormalities - 2/9/2006
Comparative Effectiveness of Management Strategies for
Gastroesophageal Reflux Disease - 12/13/2005
AHRQ Focuses on the
Health Care System
 Assess the effectiveness, comparative




effectiveness and cost- effectiveness of health
care services
Identify ways to improve patient safety and
quality of health care systems
Advance the appropriate use of health
information technology
Understand system issues: role of
organizational design, management, workflow,
management, and incentives on efficiency and
effectiveness
Develop data on the health care system for
monitoring and decision-making
Questions &
Comments?