Current Issues and Trends in Comparative Effectiveness Research

Comparative Effectiveness Research (CER) has received national attention in recent years and since the passage of the American Recovery and Reinvestment Act of 2009 as a way to improve health outcomes and reduce healthcare spending. This paper explores current trends and issues in CER, and illustrates the use and future potential of CER through a recent case study. According to the Institute of Medicine, CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care (Sox, 2010). Simply put, the purpose of CER is to help patients and their healthcare providers, especially physicians, make better-informed healthcare decisions. CER embraces the concept of patient-centeredness by ensuring the right treatment for the right patient at the right time (Biskupiak et al., 2012). It has potential to not only improve individual patient outcomes, but also population health through the use of evidence to recommend care guidelines and standards. By making healthcare more efficient and effective, it is also thought that CER can reduce healthcare spending. It is anticipated that healthcare payers, providers, biopharmaceutical companies, medical device companies and patients all have great benefits to reap from CER. The Patient-Centered Outcomes Research Institute (PCORI), which was established as an independent non-profit corporation in 2010 by the Patient Protection and Affordable Care Act, is a driving force behind recent interest and support of CER, and has funded high-profile studies. This paper reviews the benefits of CER as a methodology to compare treatment options by synthesizing existing evidence or generating new evidence to inform decision-making. It illustrates these benefits though a currently ongoing, PCORI funded, uterine fibroids case study. It also provides a brief overview of some of the many ways to perform CER, emphasizing consideration of the research question at hand to select the most effective method for assessing comparative effectiveness. Finally, it briefly reviews benefits and criticisms of CER and identifies areas for further discussion. An important conclusion is that the future of CER is about making research more patient-friendly, useful and scientifically credible. To do so, continued collaboration is needed between all healthcare stakeholders - most importantly - patients. In this way, CER can play an important role to achieve national goals of reduced healthcare spending and improved health outcomes.Master of Public Healt