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Weekly UpdatesA special panel convened by the Institute of Medicine has identified 100 areas ripe for study as part of a federal comparative effectiveness research program.
The panel called on the federal government to use new research funding to compare treatments for artial fibrillation, strategies to prevent falls among the elderly, and methods to prevent and treat methicillin resistant Staphylococcus aureus (MRSA), among others.
A complete list of the research topics is available at www.iom.edu/cerpriorities.
When Congress passed the American Recovery and Reinvestment Act earlier this year, it included $1.1 billion for comparative effectiveness research. It also instructed the IOM to recommend national priorities for spending a portion of that money--the $400 million that will be spent at the discretion of the Health and Human Services secretary. The work of the IOM panel was sponsored by the HHS.
In selecting the initial priorities for research, the panel considered the total burden of illness, current gaps in the medical literature, and the potential for the research to actually change practice. The IOM panel suggested research questions that focus on comparing active treatments in patient populations that are typical of the types of patients seen in daily practice.
The panel also used cost as one of the criteria in determining which research topics would make its list. The panel did not discuss cost effectiveness as a tool for decision making, Dr. Harold C. Sox, cochair of the IOM panel and outgoing editor of the Annals of Internal Medicine, said during a news briefing.
In addition to identifying specific research areas that should be funded, the IOM panel recommended that the HHS establish some type of federal infrastructure to select priority areas for comparative studies and carry out that research in the future.
"Priority setting needs to be a continuous process," Dr. Sox said. "Gaps in the evidence will be filled as [comparative effectiveness] research is carried out and new technologies will come along that require careful evaluation in order to facilitate decision making about them."
The IOM panel recommended that the HHS set up an advisory body that would organize, monitor, and evaluate the implementation of a comparative effectiveness research program. The panel also urged the HHS to establish large-scale clinical and administrative data networks to encourage better use of data gathered in day-to-day patient care. And the panel called on the HHS to develop a plan for research workforce development that includes long-term funding for early career development.
The IOM recommendations appear to complement work done by another congressionally mandated panel of experts. A recent report by the Federal Coordinating Council for Comparative Effectiveness Research outlines a framework for spending comparative effectiveness research funding. That panel concluded that the primary focus for the HHS should be investing in data infrastructure that would link current data sources like patient registries. The group also recommended that funding be focused on the dissemination of research findings and research that focuses on "priority populations," such as racial and ethnic minorities, individuals with disabilities, and individuals with multiple chronic health conditions.
The recommendations from both groups will be used by HHS Secretary Kathleen Sebelius to formulate a specific plan on how to spend the full $1.1 billion in comparative effectiveness research funds that was allocated by Congress.
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