of activities that contribute to the field of CER and define key workforce components and related training requirements. CER will draw its workforce from a variety of backgrounds—clinical medicine, clinical epidemiology, biomedical informatics, biostatistics, and health policy—and settings, including academic units, university centers, contract research organizations, government, and industry. A key challenge will be developing programs to foster interdisciplinary and cross-sector approaches.

To provide an example of how different workforce elements might be best organized and engaged in a system focused on developing and applying clinical effectiveness information, Sean R. Tunis and colleagues present an overview of a program for health interventions assessment in Ontario, Canada. A direct link between decision makers and CER entities facilitates research timeliness and a clear focus on the information needs of decision makers. Ontario’s experience provides insights on how the United States might best expand CER capacity, offers a model for developing an integrated workforce that addresses important organizational and funding issues, and suggests some possible efficiencies to be gained through international cooperation.


William R. Hersh, M.D., Oregon Health and Science University;
Timothy S. Carey, M.D., M.P.H., University of North Carolina;
Thomas Ricketts, Ph.D., University of North Carolina; Mark Helfand,
M.D., M.P.H., Oregon Health and Science University; Nicole Floyd,
M.P.H., Oregon Health and Science University; Richard N. Shiffman,
M.D., M.C.I.S., Yale University; David H. Hickam, M.D., M.P.H.,
Oregon Health and Science University


There have been increasing calls for a better understanding of “what works” in health care (IOM, 2008), driven by a system that allows for learning and improvement based on such an understanding (IOM, 2007).


2 We thank the following individuals who provided comments, critiques, and additions to early versions of this report: Mark Doescher, M.D., M.P.H., University of Washington; Erin Holve, Ph.D., AcademyHealth; Marian McDonagh, Pharm.D., Oregon Health & Science University; Lloyd Michener, M.D., Duke University; Cynthia Morris, Ph.D., Oregon Health & Science University; LeighAnne Olsen, Ph.D., Institute of Medicine; Robert Reynolds, Sc.D., Pfizer Corp.; Robert Schuff, M.S., Oregon Health & Science University; Carol Simon, Ph.D., The Lewin Group; Brian Strom, M.D., M.P.H., University of Pennsylvania; Jonathan Weiner, Dr.P.H., Johns Hopkins University.

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