Within the 2000 pages of the 2010 Patient Protection and Affordable Care Act (ACA) is a short section authorizing the creation of the Patient-Centered Outcomes Research Institute (PCORI) — a research organization dedicated to the support and promotion of ...

Escalating health care costs threaten the viability of the economy, forcing physicians to reexamine the choices they make in caring for patients. How can a commitment to cost-effective care be reconciled with a fundamental principle of primacy of patient welfare?

To achieve its goals, comparative-effectiveness research (CER) must address health care's greatest consumers: patients with multiple chronic conditions. The complexity of this population's conditions and treatments makes the necessary studies difficult to conduct.

Some U.S. health care organizations deliver high-quality care at a cost 20% below average. Why don't their models diffuse rapidly, as cost-effective approaches do in other industries? The answers lie in perceptions and behaviors of health care's major participants.

Two procedures for treating osteoporotic vertebral fracture have been widely adopted, but their efficacy is now in doubt. Their story suggests ways in which comparative-effectiveness research (CER) may influence medical practice and health care expenditures.

New data suggest that a human papillomavirus (HPV) vaccine prevents anal intraepithelial neoplasia in men, particularly in men who have sex with men. As the FDA reviews this new evidence, the debate over routine HPV vaccination of boys and men is likely to be reignited.

Dr. Daniel Martin and colleagues describe their experience with a comparative-effectiveness study that highlights important roadblocks and dramatic changes needed in federal infrastructure for such research to be conducted efficiently.

The complex agenda for comparative-effectiveness research outlined by the Institute of Medicine and the Federal Coordinating Council will require sustained, mission-focused leadership. Jordan VanLare and colleagues propose a five-step process.

Dartmouth Atlas researchers aim to identify and rank high- and low-efficiency hospitals. Dr. Peter Bach argues that the rankings are unsound, both conceptually and methodologically.

The “value index,” a reimbursement approach that would adjust providers' payments on the basis of regional performance on quality and cost measures, is controversial. Jonathan Skinner and colleagues argue that the debate over how best to measure costs is ...

Experts believe that comparative-effectiveness research (CER) can substantially reduce future health care spending and improve the quality of care.¹,² Their analyses indicate that CER can control costs if its results are used to inform coverage, payment, ...

Dr. Howard Brody argues that to help control costs, each specialty society create a “Top Five” list of common tests or treatments that provide no meaningful benefit to major categories of patients.

Health care reform will eventually pit the goal of expanding health insurance coverage against strong pressure to reduce the growth in health care costs. If left to measures in the proposed reform legislation, cost containment will be driven primarily by ...

The Senate Finance Committee's health care reform bill would mandate industry involvement in the oversight of comparative-effectiveness research. Drs. Harry Selker and Alastair Wood make a case for the independence of the scientific process.

New recommendations on screening for breast cancer have raised concerns about access to potentially lifesaving care. Dr. Robert Truog believes that for health care reform to progress with clarity, transparency, and honesty, we must discuss how, not ...

Drs. Gary Franklin and Brian Budenholzer discuss the use of evidence-based principles in improving the quality of care, reducing overuse and underuse of health care services, and determining what benefits should be covered by Washington State's public ...

In an address to the American Medical Association on June 15, 2009, President Barack Obama acknowledged that he needed physicians' support on health care reform and offered to work with physicians to achieve the reform he believes is essential. In recent ...