Comparative effectiveness research in inflammatory bowel disease: Prospects and challenges

摘要

Comparative effectiveness research (CER), as defined by the Institute of Medicine (IOM), is 'the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers and policy makers to make informed decisions that will improve healthcare at both the individual and population levels' [l]. Two key elements of this process are the direct comparison of effective interventions and specifically studying them in patients who are typical of routine clinical practice [2]. The goal of CER is to shift the focus of clinical research from placebo-controlled trials that frequendy lack patients typical of clinical practice [3], to trials that concentrate on how to improve care for the individual patient.