title: Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration.
abstract: BACKGROUND
  As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues common to such data reuse.
  
  
  METHODS
  After reviewing the current state of knowledge regarding biomedical informatics challenges and best practices related to CER, we then present 2 research projects at our institution. We analyze these and highlight several common themes and challenges related to the conduct of CER studies. Finally, we represent these emergent themes.
  
  
  RESULTS
  The informatics challenges commonly encountered by those conducting CER studies include issues related to data information and knowledge management (eg, data reuse, data preparation) as well as those related to people and organizational issues (eg, sociotechnical factors and organizational factors). Examples of these are described in further detail and a formal framework for describing these findings is presented.
  
  
  CONCLUSIONS
  Significant challenges face researchers attempting to use often diverse and heterogeneous datasets for CER. These challenges must be understood in order to be dealt with successfully and can often be overcome with the appropriate use of informatics best practices. Many research and policy questions remain to be answered in order to realize the full potential of the increasingly electronic clinical data available for such research.
authors.affiliation: Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA. peter.embi@osumc.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Embi
authors.forename: Courtney
authors.initials: C
authors.lastname: Hebert
authors.forename: Gayle
authors.initials: G
authors.lastname: Gordillo
authors.forename: Kelly
authors.initials: K
authors.lastname: Kelleher
authors.forename: Philip R O
authors.initials: PR
authors.lastname: Payne
mesh_terms: D057186:Comparative Effectiveness Research / Q000458:organization & administration* / Q000592:standards; D003625:Data Collection; D006801:Humans; D058436:Knowledge Management; D008491:Medical Informatics Applications; D012107:Research Design; D009626:Terminology as Topic