Academic Health Centers and Comparative Effectiveness Research

Comparative effectiveness research (CER) is like a projective test. Individuals (and organizations) have presumptions about the connotations and "baggage" that accompany the term. To some, it implies studies that compare Drug A against Drug B (so-called "Coke versus Pepsi" studies). For others, the term raises the specter of government interfering with medical practice, dictating specific treatment procedures. To others, it conjures up the "R" word (rationing) and images of death panels. The battles surrounding health care reform attached so much baggage that a new term for CER was created in the Patient Protection and Affordable Care Act — patient-centered outcomes research. In fact, CER has a specific definition spelled out in an Institute of Medicine report, built around the simple concept of providing more and better information to patients, providers, and policy makers. This editorial attempts further clarification by identifying seven "bins" into which activities that take place under CER can be sorted: (1) workforce development; (2) research infrastructure; (3) evidence creation; (4) analysis and synthesis; (5) clinical and systems implementation; (6) priority setting; and (7) policymaking.