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The State of CER: Some Progress, Cautious Optimism

This article was originally published in RPM Report

Executive Summary

It isn’t a household name—yet—but the Patient-Centered Outcomes Research Institute has certainly increased its name recognition among health care stakeholders during the last year, especially as it works to meet the federally mandated requirements of the Affordable Care Act. This was just one of the findings by the National Pharmaceutical Council from the second year of surveying key stakeholders about comparative effectiveness research (CER) perceptions and its impact on health care decisions.

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Issues Abound Tracking Efficacy And Effectiveness In Clinical Trials

A recent JAMA paper assesses the progress of ClinicalTrials.gov, concluding that concerns continue around the use of best methods for generating evidence and the capacity of the clinical trials enterprise to supply the high quality evidence needed to ensure confidence in guidelines. That these issues hold for interventional trials suggests that other strands of clinical research, notably those focused on comparative effectiveness, face similar if not even greater challenges to be able to provide meaningful real-world evidence.

Scant Intersection Between Patient-Centered Outcomes Research And Personalized Medicine’s Needs

On its face, comparative effectiveness research and its new cousin, patient-centered outcomes research, would seem to support, if not enable, personalized medicine. But as currently established in the US, there is little conceptual overlap. That’s largely because much CER and patient-centered outcomes research steer clear of anything that smacks of the development of cost data, which personalized medicine may need to truly make its value proposition.

State of Comparative Effectiveness Research: Benchmark Survey

Comparative Effectiveness Research is a phrase with talisman qualities inside the Beltway -- ascribed with almost magical properties to improve product/treatment choices and drive down health care expenditures. Outside the political sphere, the meaning of the term and concepts about how to effect CER are less clear.

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