Comparative Effectiveness Research: Trends and Issues at MLA 2012
By Katherine Downton, Liaison & Outreach Services Librarian, Health Sciences and Human Services Library, University of Maryland, Baltimore
With the advent of the Affordable Care Act an emphasis on quality improvement and lowering costs in health care, comparative effectiveness research (CER) is becoming increasingly important and visible in the health care community. The AHRQ defines CER as research designed to “…inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options.” The final plenary session of MLA 2012, moderated by Barbara Epstein from the University of Pittsburgh, explored CER from policy and clinical practice perspectives and suggested ways that librarians can support research and dissemination of information.
Dr. Kate Goodrich, senior technical advisor in the Office of Clinical Standards and Quality at the Centers for Medicare and Medicaid Service, addressed the policy issues that surround comparative effectiveness research. She began her presentation by emphasizing the importance of patient-centered outcomes research (PCOR) in improving quality and lowering cost in health care. Dr. Goodrich did an excellent job defining CER and distinguishing between comparative effectiveness research, evidence-based practice (EBP), health technology assessment (HTA), and randomized controlled trials.
Unlike randomized controlled trials, CER focuses on real-world, clinical environments. Dr. Michael Parchman, Director of the MacColl Center for Healthcare Innovation, described his experience working with a research network of primary care physicians in Texas who were conducting clinically-based research on prevalence of type 2 diabetes. Similar research is being conducted by Primary Care Practice-Based Research Networks (PBRNs) throughout the United States with networks of physicians conducting research and collecting data through their work with patients. More information about PRNS can be found at http://www.pbrn.ahrq.gov.
Joyce Backus, Deputy Associate Director for Library Operations NLM, concluded the program with a discussion of what information professionals can bring to CER and what resources are available for research. She suggested that librarians become involved by researching our own search methods to standardized strategies, disseminating information about tools, and exploring the best ways to work with clinical and patient information systems. She discussed tools familiar to all of us, such as clinicaltrials.gov, and newer resources that will be useful for CER, including PubMed Health and HSRProj. She recommended NLM Resources for Informing Comparative Effectiveness as a good place to get started.
This final plenary of the MLA 2012 conference in Seattle was an excellent overview for those of us who are learning about CER, promoting it to our users, and trying to improve access to research tools.