From Methods to Policy: The intended and unintended consequences of comparative effectiveness research

Abstract

As funding and interest in comparative effectiveness research (CER) in the USA and around the world continues to grow, this first From Methods to Policy column will kick off an ongoing dialog about several intended and unintended consequences stemming from that growth. This column will briefly introduce these consequences, and expanded views will occur in future issues of the journal. By starting this dialog, we hope to inform everyone who will have a role in shaping what CER becomes and how it ultimately impacts healthcare. The aim of CER is to create evidence for providers, patients, payers and other healthcare decision-makers. To reach its full potential, this evidence should identify what works best for which patients and under what circumstances. Where feasible, the evidence should derive from real-world environments, utilize comparators that represent best care alternatives and address outcomes relevant to key stakeholders. Looking forward, both intended and unintended consequences will arise related to the creation and expansion of CER agencies, a sheer increase in the volume of available CER and the variety in approaches to implementation, among other issues. Although the examples in this current article reflect activities in the USA, future columns will explore similar themes from other countries.