In the struggle for life, some perish and others succeed; the less give way to the greater, and are changed into the qualities of the predominant type.
—Augustine, De Civitate Dei
In times of contracting resources in health care, demands are being voiced ever louder that all components of current medical care pass the litmus test of comparative effectiveness. In the wake of the American Recovery and Reinvestment Act of 2009, a council was created and tasked with fostering comparative effectiveness and related health services research . This Federal Coordinating Council for Comparative Effectiveness Research defines comparative effectiveness research as the conduct and synthesis of systematic research comparing different interventions and strategies to prevent, diagnose, treat, and monitor health conditions . The council proposed the following criteria for scientifically meritorious comparative effectiveness research:
1. potential impact (on the basis of prevalence of condition, burden of disease, variability in outcomes, and costs of care);
2. potential to evaluate comparative effectiveness in diverse populations and patient subpopulations;
3. uncertainty within the clinical and public health communities regarding management decisions;
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References
1. US Department of Health and Human Services. Text of the Recovery Act related to comparative effectiveness funding: American Recovery and Reinvestment Act of 2009. Available at: http://www.hhs.gov/recovery/programs/cer/recoveryacttext.html . Accessed December 20, 2011.
2. US Department of Health and Human Services. Draft definition, prioritization criteria, and strategic framework for public comment. Available at: http://www.hhs.gov/recovery/programs/cer/draftdefinition.html . Accessed December 20, 2011.
3. Branch K.R., Bresnahan B.W., Veenstra D.L., et. al.: Economic outcome of cardiac CT-based evaluation and standard of care for suspected acute coronary syndrome in the emergency department: a decision analytic model. Acad Radiol 2012; 19: pp. 265-273.
4. Deloitte Center for Health Solutions. Comparative effectiveness: perspectives for consideration. Available at: http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/us_chs_ComparisoneffectivenessStudy_may2009(1).pdf . Accessed December 22, 2011.