Triangle symposium calls for better head-to-head comparisons of health care services
As health spending continues to rise to unprecedented levels it now consumes one-quarter of the $3.7 trillion federal budget everyone seems to have an opinion of what works and what doesn't in health care. But many people might not realize that there are teams of scientists actively studying which treatments, diagnostic tests, public health strategies, and other health care services do the most good. Their work is known as comparative effectiveness research, a relatively new name for an old concept that is finally getting its due.
In April, the North Carolina Translational and Clinical Sciences NC TraCS), Institute, in collaboration with RTI International and Duke Clinical Research Institute, sponsored the Triangle CER Research Symposium to showcase some of the most recent developments in the field. The event was held in conjunction with the 10th Annual Harry Guess Memorial Lecture honoring the late Dr. Harry Guess, a pediatrician and a leading figure in pharmacoepidemiology who died in 2006 following a battle with lung cancer. More than 30 clinicians, faculty, and students attended the event, which was held at RTI International's location in Research Triangle Park.
"We are very fortunate in the Triangle to have a deep bench in CER," said Tim Carey, MD, MPH, Co-Principal Investigator of NC TraCS, as he opened the symposium. Over the last five years, NC TraCS has built a strategic initiative centered on CER, which provides researchers with expert guidance and advice through senior faculty and staff at The University of North Carolina at Chapel Hill and RTI with specific expertise in CER as well as pilot grant funding through targeted RFAs.
CER is so critical because much of the health care that Americans receive is not grounded in empirical evidence of effectiveness. According to an analysis by the Institute of Medicine, more than half the treatments provided to patients lack clear evidence that they are effective at all. The symposium focused on two areas where evidence is particularly lacking, pediatric research and drug safety. Throughout the day-long event, speakers presented the lessons that can be gleaned from CER as tool for answering questions that cannot easily be answered by conventional randomized clinical trials.
For example, Bryce Reeve, PhD, Professor of Health Policy and Management at UNC-Chapel Hill, presented a new system he has designed for pediatric oncology patients to report symptoms they experience while participating in clinical trials. "CER 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. When we look at that definition, I don't think we are spending enough time on the harms of treatment," said Reeve. "Adverse event monitoring is a valuable way to make sure these are safe and tolerable for patients. It gives children a voice."
Reeve was joined by a dozen other speakers, including Arthur Stone, PhD, Professor of Psychology at University of Southern California Los Angeles. Stone gave a keynote address on patient-reported outcomes (PROs), which he said were now ubiquitous in a world where people feel free to share their opinions about all matter of things (politics, goods, friendships). He explained that PROs, if used properly, could provide a powerful metric for comparative effectiveness research and for society in general.
"If we want to assess how individuals, or regions, or countries are doing, perhaps looking at economic growth or GDP is not sufficient," said Stone. "Perhaps instead we should be looking at subjective measures of well-being."
To see who else spoke at the conference or peruse the topics covered, you can find the conference program at tracs.unc.edu/docs/strategic-initiatives/program_CER_Symposium_2017.pdf
To learn more about the CER strategic initiative at NC TraCS, visit tracs.unc.edu/index.php/services/comparative-effectiveness-research