QUALITY: Report Details Recommendations for CER Money in Stimulus

Remember that $1.1 billion in the economic stimulus package (aka the American Recovery and Reinvestment Act) dedicated to comparative effectiveness research? Though many of us have had a lot on our minds lately with health care on the Hill, others have stayed focused on how to best use those stimulus funds. This week, the Federal Coordinating Council for Comparative Effectiveness Research, an independent advisory committee, released recommendations.

Comparative effectiveness research provides insight into the best treatments based on real world data. The Council's goal is to create a solid foundation of research that both patients and clinicians could use to inform their treatment decisions.

Health care is a large, diverse field, so the Council also had to come up with a framework for prioritizing research areas. To be considered, a research topic has to meet certain criteria:

• Does it fit with the definition of CER?
• Is it going to provide useful information to patients, clinicians, and stakeholders?
• Does it respond to the needs expressed by patients, clinicians, and stakeholders?
• Is it feasible to research? (Can we actually produce something valuable in a reasonable amount of time?)

High priority CER research topics had:

• a large potential impact (looking into health conditions that are particularly widespread, burdensome, or costly)
• high variability or uncertainty in clinical practice
• the potential to positively effect diverse and/or large populations (priority populations include racial and ethnic minorities, persons with disabilities, persons with multiple chronic conditions (including co-existing mental illness), the elderly, and children)
• the potential to lay a strong foundation and get the ball rolling on future research
• the potential to affect areas that other organizations are unlikely to address

According to the report, "the primary investment for this funding should be data infrastructure. Data infrastructure could include linking current data sources to enable answering CER questions, development of distributed electronic data networks and patient registries, and partnerships with the private sector."

The Council's recommendations are directed specifically at the Office of the Secretary of HHS. The Council expects the Agency for Healthcare Research and Quality (AHRQ), which received $300 million of the $1.1 billion, and the National Institutes of Health (NIH), which received $400 million, to fill in the gaps in translating and distributing the findings of CER to the right places. Thus "dissemination and translation of CER findings, priority populations, and priority types of interventions" are a secondary priority for CER investment.

The Council prioritized transparency and public input in their recommendations; they held numerous public listening sessions, collected feedback through their website, and heard testimony from doctors, patients, and stakeholders.

The full report is available here.