title: Creating a new structure for research on health care effectiveness.
abstract: Effectiveness research (a term we use in preference to the more confining and difficult health services or outcomes research) evaluates the clinical setting and the health care system on which it depends. It uses a variety of health care assessment techniques and the practical clinical trial to inform clinical practice, quality interventions, and health policy decisions. Effectiveness research had not had sufficient public or private funding to produce the information needed to facilitate evidence-based health care improvement. However, recent trends, such as the likelihood for continued substantial increases in health care costs and concern regarding the quality and safety of the US health care system, are among the important arguments for increasing its funding and capacity. We propose a new entity, a public-private consortium to expand and offer new capability and resources in this area. The consortium would consist of all relevant public and private entities. It would be organized into an executive committee, which would identify research priorities and panels to design requests for proposals. Competitive peer-reviewed proposals, transparency and balance of forces in choice of topics, conduct of research, and interpretation of results would be important features. Metrics for success would be use of the data derived from consortium projects in medical decision making and benefit design. The consortium would provide balance and potential mediation of conflicting or competing interests in which all stakeholders will be present to establish the rules. Broad representation of all interests would serve to avoid the economic, policy, and political issues that have bedeviled past efforts. Models for the consortium include the Health Effectiveness Institute, the Centers for Education and Research on Therapeutics, and the Transportation Research Board.
authors.affiliation: Institute of Medicine, National Academies, Washington, DC 20001, USA. jkupersmith@nas.edu
authors.forename: Joel
authors.initials: J
authors.lastname: Kupersmith
authors.forename: Nancy
authors.initials: N
authors.lastname: Sung
authors.forename: Myron
authors.initials: M
authors.lastname: Genel
authors.forename: Harold
authors.initials: H
authors.lastname: Slavkin
authors.forename: Robert
authors.initials: R
authors.lastname: Califf
authors.forename: Robert
authors.initials: R
authors.lastname: Bonow
authors.forename: Louis
authors.initials: L
authors.lastname: Sherwood
authors.forename: Nancy
authors.initials: N
authors.lastname: Reame
authors.forename: Veronica
authors.initials: V
authors.lastname: Catanese
authors.forename: Catherine
authors.initials: C
authors.lastname: Baase
authors.forename: John
authors.initials: J
authors.lastname: Feussner
authors.forename: Adrian
authors.initials: A
authors.lastname: Dobs
authors.forename: Hugh
authors.initials: H
authors.lastname: Tilson
authors.forename: E Albert
authors.initials: EA
authors.lastname: Reece
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000592:standards*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D017149:Private Sector; D015980:Public Health Practice; D011785:Quality Assurance, Health Care / Q000379:methods*