A piece in Thursday's New York Times suggests that the battle lines are being drawn (again) on comparative effective research (CER). For the New England Journal of Medicine, it's not even a debate.The nation's preeminent medical journal has three articles published this week that come out strongly in favor of comparative effectiveness research.

Addressing concerns that CER creates barriers to medical progress, Alan M. Garber and Sean R. Tunis argue, in fact the opposite is true. While not a panacea, CER is "key to individualized care and innovation, not a threat." Noting that doctors often lack information on what works best for who, Garber and Tunis assert:

[F]ar from impeding personalized medicine, CER offers a way to hasten the discovery of the best approaches to personalization, providing more and better information with which to craft a management strategy for each individual patient.

Jerry Avorn wonders "what's the objection" to "conducting well-designed research to determine what works?" Dispelling some of the attacks made on CER funding during the economic stimulus debate, Avron argues that advocating ignorance is not just bad politics, it's bad policy:

Given the quality and cost crises we face, preserving ignorance would have been a poor strategy for improving the effectiveness, safety, and affordability of health care. Although CER dodged a barrage of well-coordinated bullets this time, the debate is bound to continue. To engage in it responsibly, we must stay focused on the methodologic, practical, and ethical issues we will face in the new era of CER, while avoiding the disinformation and distractions that seek to equate generating new knowledge with denial of care

Knowing is half the battle. The other half, Aanand D. Naik, and Laura A. Petersen argue, is implementation. CER needs to focus not just on what works, but how we translate research into everyday practice:

An implementation research and development program designed for this purpose could fulfill three important objectives: it could accelerate the translation of evidence into everyday care, enhance the opportunities for doctors and patients to define value (balancing expected benefits with costs) on the basis of their understanding of local contexts and constraints, and allow providers and patients to communicate with researchers and policymakers about clinically important issues earlier in the research process.