Ask the Expert: Ellen-Marie on Comparative Effectiveness Research

What is comparative effectiveness research?

Comparative effectiveness research describes the kind of research that examines different kinds of procedures done for the same illness. Most research today looks at different kinds of procedures, and when they examine them, they look at it compared to doing nothing without being able to account for the full range of possibilities of things that could make you better. For example, comparative effectiveness research could look at similar kinds of treatments, like two different competing drugs, or a brand new drug compared to a generic drug that we've been using for a long time, or it could compare two very different kinds of procedures, like major surgery compared to a new drug or an old drug that's been on the market.

Why does it matter?

So, why is this important? We have so many new procedures and innovation happening on the health care marketplace every year now with new procedures, and new drugs, and new medical devices; it's hard to sort through all that new information. Doctors want to make the best decisions based on science and evidence, and not on hearsay. And I think it's obvious we all want to make sure we have a procedure done to us that actually works. But interestingly, many researchers say that up to a third of the things we have done to us has no evidence based that it actually makes us better or improves our health. Not only is that not good health care, but it's also really expensive. Economists have estimated that up to 700 billion dollars every year is spent on unnecessary services.

How will comparative effectiveness research improve health care?

Well, the most important thing comparative effectiveness research will do is it will allow a health care team, working really closely with patients, to make the best decisions on what makes each patient better. Without comparative effectiveness research, we might have to rely on information from people who would actually benefit from promoting a certain service, such as a drug company or a medical device company who might actually want the medical community to start using their service when making decisions about treatment. We need to know what works and what doesn't work. Just because something's new automatically make it better.

How can we promote comparative effectiveness research?

The federal government just allocated over a billion dollars in the American Recovery and Reinvestment Act to begin comparative effectiveness research at a higher level in the United States. While this is a great start, we really need the federal government, working with the private sector, to continue to do these kinds of research. In health care, more is not always better. No one wants to have a surgery that's unnecessary or take a medication that doesn't make us better. What comparative effectiveness research will enable us to do is make the best decision for each patient based on science, not anecdote, and based on evidence, not hearsay.