The landscape of comparative effectiveness research in rheumatology.
Comparative effectiveness research (CER) is a growing area of investigation aimed at determining the most beneficial treatments for patients in view of their clinical characteristics. CER provides personalized treatment information that cannot be obtained from traditional clinical trials. However, many analytical challenges to performing CER remain, particularly in nonexperimental settings. The main obstacles to CER include bias from variation in use of treatments, and heterogeneity in types and quality of data across registries. Increasing standardization of care and consensus among stakeholders regarding CER methodology will strengthen the validity of CER from observational data. Innovations in outcomes measurement, and the ability to repurpose electronic health record data for research will increase the capability to assess treatment effects by CER in clinical practice. Investment in infrastructure, informatics, and data management to sustain high-quality registries, along with engagement of stakeholders to maintain a co-ordinated research agenda, are essential for successful CER in rheumatology.
Department of Pediatrics and The James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Centre, Division of Rheumatology, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA.
Esi Morgan
EM
DeWitt
Department of Pediatrics and The James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Centre, Division of Rheumatology, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA.
Hermine I
HI
Brunner
D057186:Comparative Effectiveness Research / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D012107:Research Design; D012216:Rheumatic Diseases / Q000628:therapy*; D012219:Rheumatology / Q000379:methods*; D016896:Treatment Outcome