Who compares the comparisons? - July 01, 2009
US President Barack Obama controversially decided to spend a billion dollars on ‘comparative effectiveness’ research, as part of the huge stimulus package announced earlier this year. Now the Institute of Medicine has brought out the list he asked for suggesting where the money should go.
Comparing difference between different treatments is hugely controversial in the US, where some see it as an outrageous attempt to bring cost as a factor into the health system.
Others disagree. In a statement Harold Sox, co-chair of the committee behind the new IOM list, said, “Health care decisions too often are a matter of guesswork because we lack good evidence to inform them. For example, we spend a great deal on diagnostic tests for coronary heart disease in this country, but we lack sufficient evidence to determine which test is best.”
His committee whittled down 1,268 suggestions for comparative effectiveness research topics into a 100 item list. It will come as no surprise to find out that coronary heart disease is on it. The best suggestion though has to be this one:
Compare the effectiveness of dissemination and translation techniques to facilitate the use of CER [Comparative Effectiveness Research] by patients, clinicians, payers, and others.
So the committee carefully considering controversial comparisons concluded comparing clinician communication criteria could create crucial clarity? Crikey!
Stand by for more fighting. “Because the committee's work was requested by Congress and the resulting portfolio is so broad in scope, the recommendations may be more influential than they might otherwise have been, but the report is unlikely to quell the controversy surrounding CER,” opines the New England Journal of Medicine.
More coverage
Candidates Aplenty for Spending on Comparative Effectiveness – WSJ health blog
Panel Suggests U.S. Medical Priorities – NY Times
Image: Punchstock
