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IOM Report Lists Comparative Effectiveness Priorities

NEW YORK (GenomeWeb News) –The Institute of Medicine has issued a report for the Department of Health and Human Services that pulls together information about comparative effectiveness from the public and from an appointed committee that will inform decision-making at HHS and Congress as they develop plans to implement comparative effectiveness policies for health care.

The "Initial National Priorities for Comparative Effectiveness Research" report lists several actions and resources that IOM said should guide the CER initiative, which was funded with $1.1 billion under the American Recovery and Reinvestment Act of 2009, and it lists 100 initial health issues as priority areas.

The priority areas cover a wide range of issues, including some focused on genomics and personalized medicine, two areas which may be used in a variety of CER projects, particularly in assessing the effectiveness and side-effects of drugs.

Also this week, the Department of Health and Human Services' Federal Coordinating Council for Comparative Effectiveness Research outlined goals for CER, saying that it should "complement the trend in medicine to develop personalized medicine," and should use the ability to investigate drug and dosage effects at the sub-group level in ways that are difficult in randomized trials.

IOM was charged with developing a list of high priority research questions, which it did by consulting stakeholders and receiving input from a public session, a web-based questionnaire, and through a direct mail program.

The priority list was drawn from 1,268 unique topic suggestions, and it was trimmed down to the 100, which IOM said reflect "a range of clinical categories, populations to be studied, categories of inventions, and research methodologies."

"This report lays the foundation for an ongoing enterprise to provide the evidence that health care providers need to make better decisions and achieve better results," Sheldon Greenfield, a professor and executive director of the Health Policy Research Institute at the University of California, and a member of the CER committee, said in a statement. "To make the most of this enterprise, HHS will need to ensure that the results are translated into practice and that the public is involved in priority setting to ensure that the research is relevant to everyday health care."

The list of priorities includes studies that compare the effectiveness of patient decision support tools on informing diagnostic and treatment decisions; adding information about new biomarkers (including genetic information) with standard care in motivating behavior change and improving clinical outcomes; diagnostic imaging performed by non-radiologists and radiologists; and alternative clinical management strategies for hepatitis C, including alternative duration of therapy for patients based on viral genomic profile and patient risk factors.

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