Research Needs Gaining
Increased Attention
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
Rationale for
EvidenceEvidence-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
The Intersection of
Effectiveness and Safety
Effectiveness –
Benefits
Why do we Need
Effectiveness Research?
„ Not all interventions that
sound “logical”
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
Safety – unintended
consequences, harms
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The Intersection of
Effectiveness and Safety
Agency for Healthcare
Research and Quality
Effective Health Care
Center for
Financing, Access
& Cost Trends
Center for
Outcomes
& Evidence
Balance of Benefits and Harms
Effective Health Care Program
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
New Effective Health Care
Web site
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..
AHRQ Comparative
Effectiveness Reviews (CERs
(CERs))
„ Comparative Effectiveness of SecondSecond-Generation
„
„
„
„
„
„
Antidepressants in the Pharmacologic Treatment of Adult
Depression - 1/24/2007
Efficacy and Comparative Effectiveness of OffOff-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
http://effectivehealthcare.ahrq.gov/
AHRQ Focuses on the
Health Care System
„ Assess the effectiveness, comparative
effectiveness and costcost- 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:
issues: role of
organizational design, management, workflow,
management, and incentives on efficiency and
effectiveness
„ Develop data on the health care system for
monitoring and decisiondecision-making
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Questions &
Comments?
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