Learning What Works: Infrastructure Required for Comparative Effectiveness Research

Excerpt

To improve the effectiveness and value of the care delivered, the nation needs to build its capacity for ongoing study and monitoring of the relative effectiveness of clinical interventions and care processes through expanded trials and studies, systematic reviews, innovative research strategies, and clinical registries, as well as improving its ability to apply what is learned from such study through the translation and provision of information and decision support. Several recent initiatives have proposed the development of an entity to support expanded study of the comparative effectiveness of interventions. To inform policy discussions on how to meet the demand for more comparative effectiveness research (CER) as a means of improving the effectiveness and value of health care, the Institute of Medicine (IOM) Roundtable on Value & Science-Driven Health Care convened a workshop on July 30–31, 2008, titled Learning What Works: Infrastructure Required for Comparative Effectiveness Research. Box S-1 describes the issues that motivated the meeting's discussions: the substantial and growing interest in activities and approaches related to CER; the lack of coordination of key activities, such as the selection and design of studies, synthesis of existing evidence, methods innovation, and translation and dissemination of CER information; shortfalls and widening gaps in the workforce needed in all areas of CER; the opportunities presented by the recent calls for expanded resources for work on the comparative effectiveness of clinical interventions; the growing appreciation of the infrastructure needed to support this work; and the need for a trusted, common venue to identify and characterize the need categories, begin to estimate the shortfalls, consider approaches to addressing the shortfalls, and identify priority next steps.