Affiliation:
1. Melissa C. Brouwers, Cancer Care Ontario and McMaster University; Lehana Thabane, McMaster University, Hamilton; David Moher, Ottawa Hospital Research Institute and University of Ottawa, Ottawa; and Sharon E. Straus, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
Abstract
PurposeThe objectives of this article are (1) to examine the similarities and differences between comparative effectiveness research (CER) and evidence-based medicine (EBM); (2) to describe the implications of CER for systematic review methodologies in oncology; and (3) to address the transition from systematic reviews to guideline development and the implications of CER in this process.MethodAn analysis of the principles and methods of CER was undertaken in light of EBM, systematic reviews, and guidelines.Results and ConclusionThere is considerable overlap between the principles and methods of the two paradigms. The focus on best care options in the context of routine practice is a more central tenet of the CER paradigm. Thus, its value is not that it is the first paradigm to recognize the importance of a patient-focused approach in the research community, but rather, given the attention it has garnered, the CER paradigm may be precisely the reminder and push required to: one, influence how systematic questions are framed so that a more patient-relevant perspective is achieved; two, broaden the types of study designs that are valued and to include those, such as pragmatic trials and observational studies, that are better able to answer effectiveness questions; three, accelerate the development and application of statistical methods that enable indirect comparisons of cancer care options; and four, create clinical practice guidelines that are better positioned to improve quality of care and system performance. Over time, we will see if the CER paradigm lives up to its potential.
Publisher
American Society of Clinical Oncology (ASCO)
Reference33 articles.
1. Comparative Effectiveness Research: A Report From the Institute of Medicine
2. National leadership summit on CER priorities, methods, and policy: Building a strategic framework for comparative effectiveness research in oncology—Final report 2011 Center for Medical Technology Policy: Baltimore, MD Center for Medical Technology Policy
3. Prioritizing Comparative-Effectiveness Research — IOM Recommendations
4. Evidence-Based Medicine
5. Evidence based medicine: what it is and what it isn't
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