OMG! CEA! CER! Voo Doo
Economics, the Holy Grail, or the
Right
Ri ht Thi
Thing to
t Do?
D ?
Jean Slutsky
Slutsky, Director
Center for Outcomes and Evidence
A
Agency
for
f Healthcare
H lth
R
Research
h and
dQ
Quality
lit
June 29, 2010
How Can We Make Better
Healthcare Decisions?
 Improve research base
– Relevance
– Quality
 Improve
I
use off data
d t in
i decision
d i i making
ki
Excellence & Mediocrity
“A society which scorns
excellence in plumbing
simply
i l b
because it iis
plumbing, but rewards
mediocre philosophy
simply because it is
philosophy will soon
become a society in
which neither its p
pipes
p
nor its theories will hold
water.”
John W. Gardner (1961)
What is Comparative
Eff ti
Effectiveness
Research?
R
h?
Definition: HHS
Comparative effectiveness research is the
conduct and synthesis of research comparing the
benefits and harms of different interventions and
strategies to prevent, diagnose, treat and monitor
health conditions in “real
real world”
world settings.
settings. The
purpose of this research is to improve health
outcomes by developing and disseminating
evidence--based information
evidence
f
to patients,
clinicians, and other decisiondecision-makers, responding
to their expressed needs
needs,, about which
interventions are most effective for which patients
under specific
p
circumstances.
Recovery Act Spend Plan, Office of the Secretary, 11/09
Can we Communicate Better
Than This?
Sorting it Out
Effectiveness is most
important factor in the
choice of drugs or
treatments… then safety
and cost
Obama, iPad, and the value of information
in
i 21c
21 d
democracy (and
( d business)
b i
)
 “What Jefferson recognized [is] … that in the
long run, their improbable experiment —
called
ll d A
America
i — wouldn’t
ld ’t work
k if itits citizens
iti
were uninformed, if its citizens were apathetic,
if its citizens checked out
out, and left democracy
to those who didn’t have the best interests of
all the people at heart
heart. It could only work if
each of us stayed informed and engaged, if
we held our g
government accountable,, if we
fulfilled the obligations of citizenship.”
Some Thoughts on the Role
of Costs
 From which perspective
 Transparency
 Advancing methods
 Communication, communication,
communication,, and did I sayy
EFFECTIVE communication