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Expanding the Capacity for Expanding the Capacity for Comparative Effectiveness ResearchComparative Effectiveness Research
Carolyn Clancy, MDCarolyn Clancy, MDDirectorDirector
U.S. Agency for Healthcare Research and QualityU.S. Agency for Healthcare Research and Quality
AcademyHealth Annual Research MeetingAcademyHealth Annual Research Meeting
Orlando – June 3, 2007Orlando – June 3, 2007
Research Needs Gaining Research Needs Gaining Increased AttentionIncreased Attention
Rationale for Rationale for Evidence-Based MedicineEvidence-Based Medicine
Maximize the likelihood Maximize the likelihood that beneficial treatments that beneficial treatments are used and that harmful are used and that harmful treatments are not used treatments are not used
Reduce costs and/or Reduce costs and/or improve cost effectivenessimprove cost effectiveness
Provide an explicit, fair Provide an explicit, fair and rational method of and rational method of resource allocationresource allocation
Why do we Need Why do we Need Effectiveness Research?Effectiveness Research?
Not all interventions that Not all interventions that sound “logical” are beneficial sound “logical” are beneficial when carefully studiedwhen carefully studied
Not all beneficial Not all beneficial interventions are equally interventions are equally beneficial, or equally safebeneficial, or equally safe
Budgets are limitedBudgets are limited Issues are complex and Issues are complex and
cannot be clarified without cannot be clarified without careful analysiscareful analysis
The Intersection of The Intersection of Effectiveness and SafetyEffectiveness and Safety
Effectiveness – Effectiveness – BenefitsBenefits
The Intersection of The Intersection of Effectiveness and SafetyEffectiveness and Safety
Safety – Safety – unintended unintended consequences, harmsconsequences, harms
The Intersection of The Intersection of Effectiveness and SafetyEffectiveness and Safety
Balance of Benefits and HarmsBalance of Benefits and Harms
Agency for Healthcare Agency for Healthcare Research and QualityResearch and Quality
Performance Performance Accountability,Accountability,
Resources & Technology Resources & Technology
CommunicationCommunication & &
Knowledge TransferKnowledge Transfer
Extramural Research,Extramural Research, Education & Education &
Priority PopulationsPriority Populations
Center for Center for Financing, AccessFinancing, Access
& Cost Trends& Cost Trends
AHRQAHRQCenter for PrimaryCenter for Primary Care, Prevention,Care, Prevention,
PartnershipsPartnerships
Center for DeliveryCenter for Delivery & Organization& Organization
& Markets& Markets
Center for QualityCenter for Quality ImprovementImprovement
& Patient Safety& Patient Safety
Center for Center for OutcomesOutcomes
& Evidence& Evidence
Effective Health CareEffective Health Care
Effective Health Care ProgramEffective Health Care Program
A.A. Evidence Synthesis (EPC program)Evidence Synthesis (EPC program)– Systematically reviewing, synthesizing, comparing existing
evidence on treatment effectiveness.– Identifying relevant knowledge gaps.
B.B. Evidence Generation (DEcIDE, CERTs)Evidence Generation (DEcIDE, CERTs)– Development of new scientific knowledge to address
knowledge gaps. – Accelerate practical studies.
C.C. Evidence Communication/Translation Evidence Communication/Translation (Eisenberg Center)(Eisenberg Center)– Translate evidence into improvements – Communication of scientific information in plain language to
policymakers, patients, and providers..
New Effective Health Care New Effective Health Care Web siteWeb site
http://effectivehealthcare.ahrq.gov/
AHRQ Comparative AHRQ Comparative Effectiveness Reviews (CERs)Effectiveness Reviews (CERs)
Comparative Effectiveness of Second-Generation Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Antidepressants in the Pharmacologic Treatment of Adult Depression - 1/24/2007Depression - 1/24/2007
Efficacy and Comparative Effectiveness of Off-Label Use of Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics - 1/17/2007Atypical Antipsychotics - 1/17/2007
Comparative Effectiveness of Management Strategies for Comparative Effectiveness of Management Strategies for Renal Artery Stenosis - 10/24/2006 Renal Artery Stenosis - 10/24/2006
Comparative Effectiveness and Safety of Analgesics for Comparative Effectiveness and Safety of Analgesics for Osteoarthritis - 9/25/2006Osteoarthritis - 9/25/2006
Comparative Effectiveness of Epoetin and Darbepoetin for Comparative Effectiveness of Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Managing Anemia in Patients Undergoing Cancer Treatment - 5/23/2006 Treatment - 5/23/2006
Effectiveness of Noninvasive Diagnostic Tests for Breast Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities - 2/9/2006 Abnormalities - 2/9/2006
Comparative Effectiveness of Management Strategies for Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease - 12/13/2005Gastroesophageal Reflux Disease - 12/13/2005
AHRQ Focuses on the AHRQ Focuses on the Health Care SystemHealth Care System
Assess the Assess the effectiveness, comparative effectiveness, comparative effectivenesseffectiveness and cost- effectiveness and cost- effectiveness of health of health care servicescare services
Identify ways to improve Identify ways to improve patient safetypatient safety and and qualityquality of health care systems of health care systems
Advance the appropriate use of Advance the appropriate use of health health information technologyinformation technology
Understand Understand system issuessystem issues: role of : role of organizational design, management, workflow, organizational design, management, workflow, management, and incentives on efficiency and management, and incentives on efficiency and effectivenesseffectiveness
Develop Develop datadata on the health care system for on the health care system for monitoring and decision-makingmonitoring and decision-making
Questions & Questions & Comments?Comments?