1. Expanding the Capacity for Comparative Effectiveness Research
Carolyn Clancy, MD
Director
U.S. Agency for Healthcare Research and Quality
AcademyHealth Annual Research Meeting
Orlando – June 3, 2007

2. Research Needs Gaining Increased Attention

3. Rationale for Evidence-Based Medicine
Maximize the likelihood that beneficial treatments are used and that harmful treatments are not used
Reduce costs and/or improve cost effectiveness
Provide an explicit, fair and rational method of resource allocation

4. Why do we Need Effectiveness Research?
Not all interventions that sound “logical” are beneficial when carefully studied
Not all beneficial interventions are equally beneficial, or equally safe
Budgets are limited
Issues are complex and cannot be clarified without careful analysis

5. The Intersection of Effectiveness and Safety
Effectiveness – Benefits

6. The Intersection of Effectiveness and Safety
Safety – unintended consequences, harms

7. The Intersection of Effectiveness and Safety
Balance of Benefits and Harms

8. Agency for Healthcare Research and Quality
Performance
Accountability,
Resources & Technology
Communication
&
Knowledge Transfer
Extramural Research,
Education &
Priority Populations
Center for
Financing, Access
& Cost Trends
AHRQ
Center for Primary
Care, Prevention,
Partnerships
Center for Delivery
& Organization
& Markets
Center for Quality
Improvement
& Patient Safety
Outcomes
& Evidence
Effective Health Care

9. Effective Health Care Program
Evidence Synthesis (EPC program)
Systematically reviewing, synthesizing, comparing existing evidence on treatment effectiveness.
Identifying relevant knowledge gaps.
Evidence Generation (DEcIDE, CERTs)
Development of new scientific knowledge to address knowledge gaps.
Accelerate practical studies.
Evidence Communication/Translation (Eisenberg Center)
Translate evidence into improvements
Communication of scientific information in plain language to policymakers, patients, and providers.

10. New Effective Health Care Web site

11. AHRQ Comparative Effectiveness Reviews (CERs)
Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression - 1/24/2007
Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics - 1/17/2007
Comparative Effectiveness of Management Strategies for Renal Artery Stenosis - 10/24/2006
Comparative Effectiveness and Safety of Analgesics for Osteoarthritis - 9/25/2006
Comparative Effectiveness of Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment - 5/23/2006
Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities - 2/9/2006
Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease - 12/13/2005

12. AHRQ Focuses on the Health Care System
Assess the effectiveness, comparative effectiveness and cost- effectiveness of health care services
Identify ways to improve patient safety and quality of health care systems
Advance the appropriate use of health information technology
Understand system issues: role of organizational design, management, workflow, management, and incentives on efficiency and effectiveness
Develop data on the health care system for monitoring and decision-making

13. Questions & Comments?