Opposing Comparative Effectiveness Research is like opposing stop lights because you don’t want anyone telling you what to do. It’s like opposing having scales in doctors’ offices out of concern that the information might be used to suggest to people who are overweight that they may benefit by making some lifestyle changes. Wouldn’t you want to know — and want your doctor to know — if one treatment helped 75% of people like you who had a disease you have, and another treatment helped only 35%? Which of those treatments would you want to try first? Today, your doctor may not have any idea which treatment works best — because very little Comparative Effectiveness Research has been done — so there’s a good chance you’ll waste time and money and get sicker trying a treatment that’s less likely to help you.
July 16, 2010
July 15, 2010
July 14, 2010
“I have said before, and I’ll stand behind it, that the waste level in American medicine approaches 50 percent.” Don Berwick, newly appointed to run the federal agency that oversees Medicare and Medicaid, insurance programs for the elderly, the poor, and the disabled, which collectively pay nearly half of the country’s health care tab, in an interview by Robert Galvin in Health Affairs, 12 Jan 2005. Much of the waste involves giving people treatments that don’t work for the problem they have.
“Treatments are based largely on rules and traditions, not scientific evidence.” John Carey, “Medical Guesswork,” Business Week, 29 May 2006.
July 13, 2010
When offered a treatment, ask what a good result looks like, ask what percentage of patients get that result, and ask what percentage of patients end up with troublesome side effects or complications.
Particularly for treatments for chronic conditions, be wary if told that the treatment helps everyone and doesn’t cause any problems. Consider checking it out at a reputable website like the Mayo Clinic, WebMD, or the National Institutes of Health to find out its advantages and disadvantages.
July 12, 2010
Myth or Fact: Doctors know what they need to about drugs and other treatments; there’s no need for more research into what treatments work best.
Fact: only about 20-25% of treatments have enough facts backing them up to say whether they actually help or not. See Sean R. Tunis, “Reflections of Science, Judgment, and Value in Evidence-Based Decision-Making: A Conversation with David Eddy,” Health Affairs, 19 June 2007.
This week’s blog looks at Comparative Effectiveness Research, a part of health reform variously hailed as salvation and as damnation by different politicians. CER is intended to answer the first question above: what treatments work best.