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BALTIMORE, July 7 – If you are a consumer and you want to buy a blender or a new car, there are dozens of research studies available comparing cost, effectiveness, reliability, and durability.
But if you are a doctor dealing with your patient’s high blood pressure, hearing loss, depression or prostate cancer, you have few places – and in some case, nowhere – to turn.
A new report by the consumer watchdog U.S. Public Interest Research Group (U.S. PIRG) finds that for the majority of medical conditions, no studies exist that determine the most effective course of treatment among all the available options.
“The information just isn’t out there. Should a patient use a drug, undergo surgery, or change her diet? With technological advancement as rapid as it is, the distance between what we know and what we need to know grows daily. We can get the answers, but we need to devote the resources to research them,” explained Jeff Bernstein, Policy Analyst for U.S. PIRG and author of the new report.
Drawing on numerous medical journal resources, The Facts About Comparative Effectiveness Research looks at “comparative effectiveness research” (CER), which is the scientific study of treatments, drugs, and medical devices to determine which are most effective for which types of patient.
“Doctors have been performing this kind of research for centuries,” continued Bernstein. “In the 16th century, a French surgeon figured out the best way to treat battlefield wounds, and debunked a folk remedy for poison. Today, places like the Mayo Clinic and Intermountain Healthcare in Utah are saving lives and millions of dollars by finding the best ways to treat their patients.”
At Intermountain, for example, Caesarian sections were reduced from a national average of 1 in 3 to 1 in 5, and women admitted to Intermountain have spent 45,000 fewer hours in labor than would have been expected under previous protocols, saving over $10 million per year.
But while individual efforts are laudable, the country’s ailing health care system needs a coordinated, national research effort, U.S. PIRG’s study finds. Doctors and prestigious health institutions, like the Institute of Medicine of the National Academies, agree.
The Institute, part of the National Academy of Sciences, recently listed 100 medical conditions or health concerns where comparative effectiveness is needed and called on the government to fund and develop “a robust CER infrastructure… to sustain CER well into the future.”
Some comparative effectiveness studies do exist, but, as "The Facts About Comparative Effectiveness Research" details, many of them are slanted or biased since they are funded by companies with a financial stake in the results.
Due to the lack of impartial information, unsuspecting doctors sometimes provide unnecessary and even harmful care. These ineffective treatments can leave patients at risk, and drive up health care costs.
“Our report shows that when for-profit companies do this type of research, the results are biased towards the product they are trying to sell,” Bernstein noted.
Despite its demonstrated beneficial effect on both health care and the price we pay for it, comparative effectiveness research in the health care reform legislation making its way through Congress has been attacked by reform opponents.
“The people opposing President Obama’s health care reform say that comparative effectiveness research leads to the rationing of health care, but that’s just not true,” said Johanna Neumann, State Director for Maryland PIRG. “Helping doctors provide the most effective treatments isn’t rationing – it’s common sense.”
"The Facts About Comparative Effectiveness Research" points out the prejudice in industry-funded studies and calls for government-funded unbiased medical research in order to cut the skyrocketing costs of health care while improving treatment.
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