VALUE-BASED MEDICINE: DOES COMPARATIVE EFFECTIVENESS REALLY INFER COST-EFFECTIVENESS?

摘要

It doesn't take too long in any day to hear how we should be or are seeking to compare effectiveness of healthcare interventions. The major healthcare legislation of 2010 cites the plans for a new nonprofit patient-centered research institute to identify research priorities and conduct research that specifically compares effectiveness of medical interventions. It is about how well an intervention actually works...does it improve cardiac function... or does it improve visual abilities... or does it improve pulmonary flow... and how does the intervention or medicine compare with other interventions that clinical trial results indicate are similarly effective? These are questions that clinical evidence and value assessments help quantify clinical effectiveness and impact on quality-of-life. In my mind, there are right and wrong ways of measuring. At the risk of sounding like a broken record, standardization of methods is critically important if the results are to be comparable.