Priorities Sought for Comparative Effectiveness Research

WASHINGTON — As with so many other things, when it comes to performing comparative effectiveness research, more is better, according to several speakers at an Institute of Medicine meeting.

But more of what? That was the thorny question addressed at the meeting, convened in March by the institute's 23-member Committee on Comparative Effectiveness Research Priorities. The meeting was held to get advice from stakeholders on how the federal government should spend the $1.1 billion in stimulus money allocated for comparative effectiveness research (CER).

Committee chair Harold C. Sox emphasized that the committee's work was just beginning. “This is an information-gathering process,” he told the audience. “It's a time for the committee to listen and take what we hear under advisement as we formulate our recommendations. We're early in our process.”

Once the committee finalizes its recommendations, it will write a report that will be scrutinized by a group of experts. The committee will be held accountable for responding to the criticisms of the reviewers, said Dr. Sox, editor of Annals of Internal Medicine and a past president of the American College of Physicians.

In a related effort, the Department of Health and Human Services recently named a 15-member Federal Coordinating Council for Comparative Effectiveness, which the department says will help the HHS, the Department of Veterans Affairs, the Department of Defense, and other federal agencies use the stimulus money “to coordinate comparative effectiveness and related health services research.” In addition to various agency representatives, the council includes Dr. Ezekiel Emanuel, special adviser for health policy at the White House Office of Management and Budget.

At the IOM meeting, the committee heard from dozens of speakers, each delivering a 3-minute talk advocating CER priorities. Ideas varied widely, from urologic diseases to the best way to use electronic health records. But one concept kept coming up over and over again: Focus on conditions that are widespread and cost a lot of money.

“The priority areas of CER should include high-volume, high-cost diagnostic and treatment modalities, and other kinds of health services for which there is significant variation in practice,” said Dr. Nancy Nielsen, president of the American Medical Association. “Areas in need of further research include cardiovascular disease; disorders of endocrine and metabolic systems, including diabetes; and nutrition, including obesity.”

Dr. Nielsen noted that CER findings are scarce in the area of nutrition and obesity. “It's an area of great national concern, and a wide range of interventions exist with little clarity about what is most effective.”

The IOM committee's report on CER priorities is expected to be finished by July.

WASHINGTON — As with so many other things, when it comes to performing comparative effectiveness research, more is better, according to several speakers at an Institute of Medicine meeting.

But more of what? That was the thorny question addressed at the meeting, convened in March by the institute's 23-member Committee on Comparative Effectiveness Research Priorities. The meeting was held to get advice from stakeholders on how the federal government should spend the $1.1 billion in stimulus money allocated for comparative effectiveness research (CER).

Committee chair Harold C. Sox emphasized that the committee's work was just beginning. “This is an information-gathering process,” he told the audience. “It's a time for the committee to listen and take what we hear under advisement as we formulate our recommendations. We're early in our process.”

Once the committee finalizes its recommendations, it will write a report that will be scrutinized by a group of experts. The committee will be held accountable for responding to the criticisms of the reviewers, said Dr. Sox, editor of Annals of Internal Medicine and a past president of the American College of Physicians.

In a related effort, the Department of Health and Human Services recently named a 15-member Federal Coordinating Council for Comparative Effectiveness, which the department says will help the HHS, the Department of Veterans Affairs, the Department of Defense, and other federal agencies use the stimulus money “to coordinate comparative effectiveness and related health services research.” In addition to various agency representatives, the council includes Dr. Ezekiel Emanuel, special adviser for health policy at the White House Office of Management and Budget.

At the IOM meeting, the committee heard from dozens of speakers, each delivering a 3-minute talk advocating CER priorities. Ideas varied widely, from urologic diseases to the best way to use electronic health records. But one concept kept coming up over and over again: Focus on conditions that are widespread and cost a lot of money.

“The priority areas of CER should include high-volume, high-cost diagnostic and treatment modalities, and other kinds of health services for which there is significant variation in practice,” said Dr. Nancy Nielsen, president of the American Medical Association. “Areas in need of further research include cardiovascular disease; disorders of endocrine and metabolic systems, including diabetes; and nutrition, including obesity.”

Dr. Nielsen noted that CER findings are scarce in the area of nutrition and obesity. “It's an area of great national concern, and a wide range of interventions exist with little clarity about what is most effective.”

The IOM committee's report on CER priorities is expected to be finished by July.

WASHINGTON — As with so many other things, when it comes to performing comparative effectiveness research, more is better, according to several speakers at an Institute of Medicine meeting.

But more of what? That was the thorny question addressed at the meeting, convened in March by the institute's 23-member Committee on Comparative Effectiveness Research Priorities. The meeting was held to get advice from stakeholders on how the federal government should spend the $1.1 billion in stimulus money allocated for comparative effectiveness research (CER).

Committee chair Harold C. Sox emphasized that the committee's work was just beginning. “This is an information-gathering process,” he told the audience. “It's a time for the committee to listen and take what we hear under advisement as we formulate our recommendations. We're early in our process.”

Once the committee finalizes its recommendations, it will write a report that will be scrutinized by a group of experts. The committee will be held accountable for responding to the criticisms of the reviewers, said Dr. Sox, editor of Annals of Internal Medicine and a past president of the American College of Physicians.

In a related effort, the Department of Health and Human Services recently named a 15-member Federal Coordinating Council for Comparative Effectiveness, which the department says will help the HHS, the Department of Veterans Affairs, the Department of Defense, and other federal agencies use the stimulus money “to coordinate comparative effectiveness and related health services research.” In addition to various agency representatives, the council includes Dr. Ezekiel Emanuel, special adviser for health policy at the White House Office of Management and Budget.

At the IOM meeting, the committee heard from dozens of speakers, each delivering a 3-minute talk advocating CER priorities. Ideas varied widely, from urologic diseases to the best way to use electronic health records. But one concept kept coming up over and over again: Focus on conditions that are widespread and cost a lot of money.

“The priority areas of CER should include high-volume, high-cost diagnostic and treatment modalities, and other kinds of health services for which there is significant variation in practice,” said Dr. Nancy Nielsen, president of the American Medical Association. “Areas in need of further research include cardiovascular disease; disorders of endocrine and metabolic systems, including diabetes; and nutrition, including obesity.”

Dr. Nielsen noted that CER findings are scarce in the area of nutrition and obesity. “It's an area of great national concern, and a wide range of interventions exist with little clarity about what is most effective.”

The IOM committee's report on CER priorities is expected to be finished by July.