Sunday, February 15, 2009

Show Me the Evidence

The NY Times reports on a significant health initiative that is part of the $787 billion dollar stimulus bill. It is specifically referred to as Comparative Effectiveness Research. A council will be formed that will study the effectiveness of current treatments including medications, procedures, medical devices and surgeries by examining the research. I imagine these will consist of systematic reviews of the research and will examine the validity of the studies conducted (including Confidence Intervals, p-values, etc.)

This is a major step towards integrating evidenced based practice (EBP) and cultural competence into our practice. There is often a significant lag time before research actually impacts daily practice. I recall a wise professor of mine stating that it would take a clinician reading 3 primary research articles every day of the year to stay current. I am hopeful that we will ultimately see treatments and outcomes tailored to gender and ethnicity (it is a fact that certain medications/treatments can act differently among groups).

Naysayers criticize this program and scare the public into thinking that this will negatively impact practice and government will now dictate how we are treated. I think that is shameful. We are dealing with a terribly inefficient and wasteful health care system and such moves will bring evidence to practice in an expeditious manner that will not only lead to better patient specific outcomes but will probably save significant dollars along the way. I am also hopeful that the council will consist of a multi-disciplinary team that will examine all types of treatments in health care today. Health reform is still a major initiative for the Obama administration and here is some proof towards reaching that goal.