Among other significant changes in healthcare delivery, the Accountable Care Act of 2010 increases funding and visibility of comparative effectiveness research. What is comparative effectiveness research and what is its intended use?
[img_assist|nid=753|title=|desc=|link=none|align=right|width=180|height=270]The future state envisioned by those who support comparative effectiveness research improvements is better quantitative outcome comparisons among treatment options for medical conditions. This data is intended to help both clinicians and their patients make informed and shared decisions regarding treatment alternatives. Despite the volume of current medical publications, clear quantitative side-by-side comparisons of treatment options even for common conditions are hard to come by. The Agency for Healthcare Research and Quality (AHRQ) describes comparative effectiveness research in patient- centered terms.
On the Dartmouth Atlas site, there are several commentaries on this topic. A blog suggests the differences in end-of-life care expenses (during the last 2 years of life) vary from $54,000 to $94,000 yet there are few indications that there is any difference in outcome. The blog author also points out that the original author of the Dartmouth Atlas, Jack Wennberg, concludes 60 percent of Medicare is spent on supply sensitive care (physician visits, consultations, imaging exams, and hospital and ICU admissions) while 25 percent is spent on preference sensitive care (PSA tests, mammography, and elective surgery). Yet there is no science to guide patients or doctors as to how to choose frequency of visits. And if patients engage in patient centered decision making, they often choose not to pursue preference sensitive care.
With a billion dollars allocated to comparative effectiveness research, we need to pay attention. Our patients will have access to this information; providers also need to notice what is going on.
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