title: Real-world impact of comparative effectiveness research findings on clinical practice.
abstract: OBJECTIVE
  Unprecedented funding for comparative effectiveness research (CER) to help provide better evidence for decision making as a way to lower costs and improve quality is under way. Yet how research findings are adopted and applied will impact the nation's return on this investment. We examine the relationship between the publication of findings from 4 seminal CER trials, the release of subsequent clinical practice guidelines (CPGs), and utilization trends for associated surgical interventions, diagnostic interventions, or medications.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Using a large national administrative claims database, we examined time series utilization trends before and after publication of findings from 4 CER trials published within the last decade.
  
  
  RESULTS
  We found no clear pattern of utilization in the first 4 quarters after publication. However, we found that results for 2 of the studies were in concert with the release of CPGs and publication of study results. The trend in intensive statin therapy rose rapidly starting at the end of 2007, while the trend in standard therapy remained relatively constant (PROVE-IT). And, 9 months after trial publication, breast magnetic resolution imaging (MRI) utilization rates rose 43.2%, from 0.033 to 0.048 per 100 enrollees (Mammography With MRI).
  
  
  CONCLUSIONS
  Our analysis of 4 case studies supports the call others have made to translate and disseminate CER findings to improve application of research findings to clinical practice and the need for continued development and dissemination of CPGs that serve to synthesize research findings and guide practitioners in clinical decision making. Further research is needed to determine whether these findings apply to different medical topics.
authors.affiliation: Truven Health Analytics, 777 E Eisenhower Parkway, Ann Arbor, MI 48108. E-mail: teresa. gibson@truvenhealth.com.
authors.forename: Teresa B
authors.initials: TB
authors.lastname: Gibson
authors.forename: Emily D
authors.initials: ED
authors.lastname: Ehrlich
authors.forename: Jennifer
authors.initials: J
authors.lastname: Graff
authors.forename: Robert
authors.initials: R
authors.lastname: Dubois
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Farr
authors.forename: Michael
authors.initials: M
authors.lastname: Chernew
authors.forename: A Mark
authors.initials: AM
authors.lastname: Fendrick
mesh_terms: D057186:Comparative Effectiveness Research; D003324:Coronary Artery Disease / Q000601:surgery; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D033181:Information Dissemination; D007345:Insurance Claim Review; D007405:Intervertebral Disc Displacement / Q000628:therapy; D008327:Mammography / Q000379:methods; D062645:Percutaneous Coronary Intervention; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors