Comparative effectiveness looks like a real game-changer

There's a reason why we picked Dr. Carolyn Clancy among our "Fierce Women to Watch in Health IT" two weeks ago. The director of the Agency for Healthcare Research and Quality is a key figure in the federal comparative-effectiveness research program that's getting a $1.1 billion funding increase from the American Recovery and Reinvestment Act since AHRQ has received $300 million of that appropriation. That's 10 times what AHRQ budgeted for comparative-effectiveness research in fiscal year 2008.

Why does comparative effectiveness matter? Unlike traditional medical research, comparative effectiveness is intended to study "real people" in the "real world," according to a feature in Hospitals & Health Networks this month.

"One of the things that is such a missed opportunity is that healthcare is probably the only industry that doesn't formally learn from its daily work," Johns Hopkins health policy expert Dr. Peter J. Pronovost tells the magazine. "We find out what works and what doesn't in healthcare in clinical studies." But the tight parameters of some studies make it near impossible to translate findings from the controlled setting of a lab into actual clinical practice, according to Pronovost. 

AHRQ already has dedicated $48 million of its new funding to support the study of up to five electronic registries in hopes of determining the types of tests, medical devices or surgical procedures that produce the best outcomes. The agency has issued a request for applications to study the registries of high-volume hip- and knee-replacement centers.

While hospitals stand to benefit greatly not only from the results, but from conducting the research itself, many are not prepared to take on such work. Partnering with a university, or, better yet, installing clinical decision support systems to track and ultimately implement results could help.

To learn more about comparative effectiveness and how it will affect the practice of medicine:
- take a look at this Hospitals & Health Networks feature story

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