Comparative Effectiveness Definitions
In general, Comparative Effectiveness Research is defined as:
The direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms. The core question of comparative effectiveness research (is) which treatment works best, for whom, and under what circumstances.
The following list of more detailed definitions are provided by leading medical, medical research or governmental agencies and institutions.
Congressional Budget Office (CBO)
A rigorous evaluation of the impact of different options that are available for treating a given medical condition for a particular set of patients. Such a study may compare similar treatments, such as competing drugs, or it may analyze very different approaches, such as surgery and drug therapy. The analysis may focus only on the relative medical benefits and risks of each option, or it may also weigh both the costs and the benefits of those options. In some cases, a given treatment may prove to be more effective clinically or more cost-effective for a broad range of patients, but frequently a key issue is determining which specific types of patients would benefit most from it. Related terms include cost-benefit analysis, technology assessment, and evidence-based medicine, although the latter concepts do not ordinarily take costs into account.
Medicare Payment Advisory Commission (MedPAC)
Comparative-effectiveness analysis evaluates the relative value of drugs, devices, diagnostic and surgical procedures, diagnostic tests, and medical services. By value, we mean the clinical effectiveness of a service compared with its alternatives. Comparative-effectiveness information has the potential to promote care of higher value and quality in the public and private sectors.
Agency for Healthcare Research and Quality (AHRQ)
A type of health care research that compares the results of one approach for managing a disease to the results of other approaches. Comparative effectiveness usually compares two or more types of treatment, such as different drugs, for the same disease. Comparative effectiveness also can compare types of surgery or other kinds of medical procedures and tests. The results often are summarized in a systematic review.
Institute of Medicine, Committee on Reviewing Evidence to Identify Highly Effective Clinical Services (IOM, "Knowing What Works")
[Comparison of . . . the impacts of different options for caring for a medical condition for a defined set of patients. The comparison may be between similar treatments, such as competing prescription medications, or for very different treatment approaches, such as surgery or radiation therapy. Or, the comparison may be between using a specific intervention and its nonuse (sometimes called watchful waiting). This report uses the terms "effectiveness," "clinical effectiveness," and "comparative effectiveness" interchangeably.
IOM Roundtable on Evidence-Based Medicine (IOM, Roundtable)
The comparison of one diagnostic or treatment option to one or more others. In this respect, primary comparative effectiveness research involves the direct generation of clinical information on the relative merits or outcomes of one intervention in comparison to one or more others, and secondary comparative effectiveness research involves the synthesis of primary studies to allow conclusions to be drawn. Secondary comparisons of the relative merits of different diagnostic or treatment interventions can be done through collective analysis of the results of multiple head-to-head studies, or indirectly, in which the treatment options have not been directly compared to each other in a clinical evaluation, and inferences must be drawn based on the relative effect of each intervention to a specific comparison, often a placebo.
American College of Physicians
Comparative effectiveness analysis evaluates the relative (clinical) effectiveness, safety, and cost of two or more medical services, drugs, devices, therapies, or procedures used to treat the same condition. Although the use of the term comparative effectiveness broadly refers to the evaluation of both the relative clinical and cost differences among different medical interventions, it is notable that most comparative effectiveness research engaged in and used by stakeholders in this country focuses solely on evaluating relative clinical differences to the exclusion of cost factors.
