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Comparative effectiveness research paradigm: implications for systematic reviews and clinical practice guidelines.
Melissa C Brouwers1, Lehana Thabane, David Moher
1Department of Oncology, McMaster University, Hamilton, ON, Canada L8S 4K1. mbrouwer@mcmaster.ca
Summary
Comparative Effectiveness Research (CER) and Evidence-Based Medicine (EBM) share principles, but CER emphasizes patient-centered care in routine practice. CER may enhance systematic reviews and guidelines in oncology for better patient outcomes.
Area of Science:
- Health Services Research
- Oncology Research
- Medical Informatics
Background:
- Evidence-Based Medicine (EBM) and Comparative Effectiveness Research (CER) are key paradigms in healthcare.
- Understanding their relationship is crucial for advancing medical research and practice.
Purpose of the Study:
- To examine similarities and differences between CER and EBM.
- To describe CER's implications for oncology systematic reviews.
- To address CER's role in transitioning from systematic reviews to guideline development.
Main Methods:
- Analysis of CER principles and methods.
- Comparison with EBM, systematic reviews, and clinical guidelines.
Main Results:
- Significant overlap exists between CER and EBM principles and methods.
- CER places a stronger emphasis on patient-centered care within routine clinical practice.
- CER can refine systematic review questions for greater patient relevance.
Conclusions:
- CER can broaden the acceptance of diverse study designs, including pragmatic trials and observational studies.
- CER may accelerate the development of statistical methods for indirect treatment comparisons in oncology.
- The CER paradigm has the potential to improve clinical practice guidelines, quality of care, and system performance.
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