produces evidence that is timely, relevant, and applicable to real-world care. Patrick Conway, formerly of the Office of the Secretary of the Department of Health and Human Services (HHS), reviews the unique nature of comparative effectiveness research (CER) and its core aim of helping to inform decisions of patients, clinicians, and policy makers. Recent federal investments have expanded national capacity for CER, and ensuring the long-term success of this emerging enterprise will require a near-term focus on devising a sustainable funding strategy, developing a research agenda for a balanced portfolio of high-impact topics, selecting methods appropriate to information needs, and evaluating and reporting progress to the public. Elements essential to ensuring the availability and use of comparative information at the point of decision making are discussed as well. John Noseworthy and Sherine Gabriel of Mayo Clinic offer insights into what might be possible if health systems were better engaged in the research enterprise. To illustrate the potential, they review several examples of the use of clinical data captured as part of healthcare delivery to improve care quality and health outcomes. They describe key characteristics of knowledge-driven healthcare delivery systems of the future, including patient-centered care; real-time data and feedback; a culture of collaboration, innovation, and translation; health information technology (HIT); and delivery of high-value health care.

Without the willing participation of the public and patients as contributors to learning, however, capacity for research will remain limited. Diane Simmons and Kenneth Getz of the Center for Information and Study on Clinical Research Participation review current public and patient attitudes toward participation in clinical research and offer some suggestions for fostering a culture that better supports and encourages public appreciation of and participation in such research. Educational and outreach efforts by the clinical research community and other stakeholders are needed to enhance public awareness, enable participation, and sustain interest over time.

COMPARATIVE EFFECTIVENESS RESEARCH: PATIENT, CLINICIAN, AND POLICY NEEDS

Patrick Conway, M.D., M.Sc.
Office of the Secretary, Department of Health
and Human Services (formerly)
Cincinnati Children’s Hospital

National Investments in a Comparative Effectiveness Research Enterprise

The American Recovery and Reinvestment Act (ARRA) of 2009 dedicated $1.1 billion to CER and established the Federal Coordinating Council



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