The stimulus bill allocated $1.1 billion towards comparative effectiveness research, or CER, to improve national strategies in health care.
Last week, a forum was held in DC by the Friends of Cancer Research to discuss CER as a component of the health care reform discussions. The meeting was held in tandem with the release of the report ?Improving Medical Decisions Through Comparative Effectiveness Research: Cancer as a Case Study.? This report was developed by a number of experts and organizations, including the Lance Armstrong Foundation, as an outline for CER development policies to improve individual and population health. The paper highlights strategies to incorporate into a national plan for CER and emphasizes an approach to ?ensure continuous learning and the rapid translation of the best available evidence into clinical practice.?
So what is CER and how can it help improve public health?
As defined in the report, CER compares the effectiveness of two or more different health care interventions when applied to a diverse population of patients in a real world setting. Basically, CER tires to compare how one medical strategy works compared to another. On its surface, this may seem to be a relatively simple task like comparing drug A to drug B. But in reality, people respond differently to various treatments and it can be challenging to determine if one approach is better than another, particularly since many treatments and surgeries also cause side effects ? a case all too true in the field of cancer care.
For example, a patient diagnosed with prostate cancer has a variety of options ranging from surgery to radiation to chemotherapy. And since prostate cancers are many times slow growing, there is also the ?watchful waiting? approach to monitor the disease and intervene if only when the cancer appears to turn aggressive. CER would try to compare and evaluate each approach to determine which is most effective to help inform patients and direct clinicians as to which option is best.
But CER will also be a research strategy in the new era of personalized medicine in which we target treatments based on an individual?s molecular profile. Such treatment are already being applied in breast cancers with the drug Herceptin and in chronic myeloid leukemia with the drug Gleevec. CER can be applied in personalized medicine strategies to help identify sub-groups of patients who will likely respond to a new drug.
Over 25 groups have signed on in support of this report and it is hoped that it will be a guiding document to advance research strategies in the upcoming years.
You can download the report here.