Comparative Effectiveness Research-刘晓清.pdfVIP

Comparative Effectiveness Research 比较效果研究 刘晓清 Clinical Epidemiology Unit 中国医学科学院北京协和医学院北京协和医院 liuxqpumch@ Current Challenges Concerns about health spending Large variations in clinical care A lot of uncertainty about best practices involving treatments and technologies Pervasive problems with the quality of care that people receive Translating scientific advances into actual clinical practice Translating scientific advances into usable information for clinicians and patients Background Thousands of health care decisions are made daily. Unfortunately, the answer to these types of comparative, patient-centered questions in health care is often, ―We don’t really know.‖ Clinicians and patients confront important health care decisions without adequate information Background Patients and their caregivers search in vain on the Internet or elsewhere for evidence to help guide their decisions. They often fail to find this information either because it does not exist or because it has never been collected and synthesized to inform patients and/or their caregivers in patient- friendly language. When they do find information, it may be informed by marketing objectives, not the best evidence. Background Due to astonishing achievements in biomedical science, clinicians and patients often have a plethora of choices when making decisions about diagnosis, treatment, and prevention, but it is frequently unclear which therapeutic choice works best for whom, when, and in what circumstances. Background Patients increasingly and appropriately want to take responsibility for their care. Therefore we have a responsibility to provide comparative information to enable informed decision-making. This patient centered, pragmatic(注重实