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Comparative Effectiveness Research

Comparative effectiveness research (CER) is the systematic evaluation of two or more health care interventions to determine which are most effective for patients in "real world" settings. The $1.1 billion in new CER funding provided under the American Recovery and Reinvestment Act and the continued discussion of its role in health care reform have made CER an intensely debated topic.

CER has traditionally used broad population averages as a means to compare and evaluate different treatments and health interventions. But as molecular science, health information technology and novel epidemiologic methods mature and converge, it is vital that CER and policy incentives take full advantage of the emerging knowledge of the heterogeneity of patient response to treatment.

For CER and personalized medicine to work together:

  • Research should encompass all aspects of care relevant to personalized medicine, including diagnostic tests, pharmaceuticals, devices, prevention programs, disease management, benefit design, and health care delivery. The whole spectrum of care should be examined within subpopulations of patients.
  • Communication of results of evidence reviews should discuss available data on variations in the needs of different patient subgroups, including minority populations, based on genetic and other medical and environmental factors. In order to foster personalized medicine, CER must account for variation between patients rather than looking for one-size-fits-all solutions.
  • Evidence should be applied in ways that promote personalized medicine by supporting a physician's ability to select treatments based on the range of treatment options available and the needs of the individual patients.

Additional Resources