We were originally going to take a break from the blog this week, assuming that many readers would be on vacation. But I have decided instead to tell you about a new commentary I wrote with my colleague, John Mullahy. It appears in this week’s issue of the Journal of the American Medical Association and is titled “Comparative effectiveness—of what? Evaluating strategies to improve population health” (subscription required).
The commentary is a call to broaden and provide dedicated resources for broadening comparative effectiveness research (CER) to help us better understand the relationship between our social investments and population health improvement.
As most of you know, the goal of most CER is to learn about the effectiveness, benefits, and harms associated with healthcare treatments such as drugs, medical devices, and even health systems. Although the emphasis in CER is currently on healthcare, there is tremendous potential for this type of research to contribute to a much deeper understanding of the many factors that influence health, including health behaviors, social, economic, cultural, environmental, and genetic factors.
I have mentioned before our need for a better understanding of how to accurately translate investments into length and quality of life. But we also need a framework to guide our spending decisions that’s based on a solid understanding of the total cost, overall effectiveness, and cost effectiveness of our strategies. To get these things done will require expanding—and funding—a comparative effectiveness research portfolio that addresses not only clinical care but the many other determinants of health as well.
Check out the article and let us know if you agree or have strategies to suggest to accomplish this goal.
David A. Kindig, MD, PhD, is Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin School of Medicine and Public Health.
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