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Date:  June 30, 2009

Contacts:  Christine Stencel, Senior Media Relations Officer

Alison Burnette, Media Relations Assistant

Office of News and Public Information

202-334-2138; e-mail <>




IOM Report Recommends 100 Initial Priorities for Research To Determine Which Health Care Approaches Work Best


WASHINGTON -- A new report from the Institute of Medicine recommends 100 health topics that should get priority attention and funding from a new national research effort to identify which health care services work best.  It also spells out actions and resources needed to ensure that this comparative effectiveness research initiative will be a sustained effort with a continuous process for updating priorities as needed and that the results are put into clinical practice. 


A committee convened by the IOM developed the list of priority topics at the request of Congress as part of a $1.1 billion effort to improve the quality and efficiency of health care through comparative effectiveness research outlined in the American Recovery and Reinvestment Act of 2009.  The committee's report provides independent guidance -- informed by extensive public input -- to Congress and the secretary of the U.S. Department of Health and Human Services on how to spend $400 million on research to compare health services and approaches to care.


Health experts and policymakers anticipate that comparative effectiveness research will yield greater value from America's health care system and better outcomes for patients.  Despite spending more on care than any other industrialized nation -- $2.4 trillion in 2008 -- the United States lags behind other countries on many measures of health, such as infant mortality and chronic disease burden.  Comparative effectiveness research weighs the benefits and harms of various ways to prevent, diagnose, treat, or monitor clinical conditions to determine which work best for particular types of patients and in different settings and circumstances.  Study results can help consumers, clinicians, policymakers, and purchasers make more informed decisions, ultimately improving care for individuals and groups.


"Health care decisions too often area matter of guesswork because we lack good evidence to inform them," said committee co-chair Harold C. Sox, editor, Annals of Internal Medicine, American College of Physicians of Internal Medicine, Philadelphia.  "For example, we spend a great deal on diagnostic tests for coronary heart disease in this country, but we lack sufficient evidence to determine which test is best."


"This report lays the foundation for an ongoing enterprise to provide the evidence that health care providers need to make better decisions and achieve better results," added co-chair Sheldon Greenfield, Donald Bren Professor of Medicine and executive director, Health Policy Research Institute, University of California, Irvine.  "To make the most of this enterprise, HHS will need to ensure that the results are translated into practice and that the public is involved in priority setting to ensure that the research is relevant to everyday health care."


The 100 priority areas reflect the insights of health professionals, consumer advocates, policy analysts, and others who submitted nominations through an online form that was open to any individual or organization and through presentations at public meetings.  The committee received 1,268 unique topic suggestions, which it narrowed to 100 based on a set of criteria that included its charge to develop a balanced portfolio.  The list reflects a range of clinical categories, populations to be studied, categories of interventions, and research methodologies.  The committee developed its list of priorities independent from the comparative effectiveness research activities that other organizations have been charged to do through the American Recovery and Reinvestment Act.


The report also recommends actions necessary to establish an ongoing comparative effectiveness research effort that would not only carry out studies on the 100 recommended initial topics, but also develop priorities for future research and translate the knowledge gained into improvements in clinical care.  Effective coordination and governance among the agencies and disciplines involved will be crucial for ensuring the sustainability of the enterprise, the report notes.  Moreover, a skilled work force is needed to carry out the research.  The committee underscored the importance of having patients, families, and their caregivers actively engaged in identifying research topics of most concern to them.  Ultimately, comparative effectiveness research will fall short of its potential without vigorous efforts by HHS to promote adoption of the findings by health care providers and organizations, the committee added.


The study was sponsored by the U.S. Department of Health and Human Services.  Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.  A committee roster follows.


Pre-publication copies of Initial National Priorities for Comparative Effectiveness Research are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at  Reporters may obtain a copy from the Office of News and Public Information (contacts listed above). 

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[ This news release and report are available at ]



Board on Health Care Services


Committee on Comparative Effectiveness Research Prioritization


Sheldon Greenfield, M.D. (co-chair)

Donald Bren Professor of Medicine, and

Executive Director

Center for Health Policy Research

School of Medicine

University of California



Harold C. Sox, M.D., M.A.C.P. (co-chair)


Annals of Internal Medicine

American College of Physicians



Christine K. Cassel, M.D., M.A.C.P

President and Chief Executive Officer

American Board of Internal Medicine



Kay Dickersin, Ph.D., M.A.

Professor of Epidemiology; and

Director, Center for Clinical Trials; and

Director, U.S. Cochrane Center

Bloomberg School of Public Health

Johns Hopkins University



Alan M. Garber, M.D., Ph.D.

Henry J. Kaiser Professor and Professor of Medicine; and

Director, Center for Health Policy, and

Director, Center for Primary Care and Outcomes Research

Stanford University

Stanford, Calif.


Constantine Gatsonis, Ph.D.

Professor of Medical Science (Biostatistics), and


Center for Statistical Sciences

Brown University

Providence, R.I.


Gary L. Gottlieb, M.D., M.B.A.


Brigham and Women’s Hospital, and

Professor of Psychiatry

Harvard Medical School



James A. Guest, J.D.

President and Chief Executive Officer

Consumers Union

Yonkers, N.Y.


Mark Helfand, M.D., M.P.H., M.S.

Professor of Medicine and Director

Oregon Evidence-Based Practice Center, and

Staff Physician

Oregon Health and Science University



Maria Carolina Hinestrosa, M.P.H. +

Executive Vice President for Programs and Planning 

National Breast Cancer Coalition

Washington, D.C.


George J. Isham, M.D., M.S.

Medical Director and Chief Health Officer

HealthPartners Inc.

Bloomington, Minn.


Arthur A. Levin, M.P.H.


Center for Medical Consumers

New York City


JoAnn E. Manson, M.D., Dr.P.H., M.P.H., F.A.C.P.

Professor of Medicine and the Elizabeth Fay Brigham Professor of Women's Health

Harvard Medical School


Division of Preventive Medicine

Brigham and Women's Hospital



Katie Maslow, M.S.W.


Policy Development

Alzheimer's Association

Washington, D.C.


Mark B. McClellan, M.D., Ph.D.


Engelberg Center for Health Care Reform

Brookings Institution

Washington, D.C.


Sally C. Morton, Ph.D., M.S.

Vice President for Statistics and Epidemiology

RTI International

Research Triangle, N.C.


Neil R. Powe, M.D., M.P.H., M.B.A.

Chief, Medical Services

San Francisco General Hospital

Professor and Vice Chairman

Department of Medicine

University of California

San Francisco


Joe V. Selby, M.D., M.P.H.


Division of Research

Kaiser Permanente

Oakland, Calif.


Lisa Simpson, M.B., B.Ch.  M.P.H., FAAP


Child Policy Research Center

Cincinnati Children's Hospital Medical Center



Sean Tunis, M.D., M.Sc.

Founder and Director

Center for Medical Technology Policy



I. Steven Udvarhelyi, M.D., M.Sc.

Senior Vice President and Chief Medical Officer

Independence Blue Cross



A. Eugene Washington, M.D., M.Sc.

Executive Vice Chancellor and Provost

University of California

San Francisco


James N. Weinstein, D.O., M.S.

Dartmouth College Third Century Professor, and

Director, The Dartmouth Institute for Health Policy and Clinical Practice, and

Professor and Chair, Department of Orthopedic Surgery, Dartmouth Medical School; and

Vice Chair, Board of Governors, Dartmouth-Hitchcock Medical Center

Lebanon, N.H.



Robert Ratner, M.D.

Study Director



 + Deceased