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CER priorities — a first draft
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The other day, I received an announcement that the Institute of Medicine had released its “Initial National Priorities for Comparative Effectiveness Research,” available freely on the web at www.iom.edu/cerpriorities. The IOM committee had been asked to develop a priority list of research topics to be undertaken with American Recovery and Reinvestment Act funding (an initial appropriation of $1.1 billion), which it compiled with the assistance of a broad array of stakeholder input. The topics felt to be of highest priority were ranked in four quartiles, with the first quartile comprising those topics of highest priority.
As it turns out, there weren’t actually a ton of oncology topics represented within this initial list, though there were a few in each quartile. These included comparing management strategies for localized prostate cancer (quartile one), comparing the effectiveness of imaging technologies for cancer patients, such as PET, MRI and CT (quartile one), comparing the effectiveness of genetic and biomarker testing and usual care in preventing and treating breast, colorectal, prostate, lung and ovarian cancer (quartile one), and scattered others in quartiles two through four.
The big question about many of the topics identified, is — so what? Most of these topics have been studied in some depth, with good articles published in decent journals; the CER researchers may not be breaking much new ground in tackling some of these previously discussed issues. The real test will be what is done with the recommendations that come from this CER research and whether it makes a difference for patients. Time will tell.