Comparative effectiveness research in recent medical literature

January 01, 0001

Comparative effectiveness research in recent medical literature

Comparative effectiveness (CE) research examines the efficacy of therapeutic treatments as compared to other known treatments, not merely placebo. These British and American authors described the qualities of all the randomized trials, observational studies, and meta-analyses involving medications from the 6 highest impact general medicine and internal medicine journals between June 2008 and September 2009.

The authors report: "We identified 328 studies evaluating medications, 104 of which were CE studies. Among the CE studies, 45 (43%) compared different medications, 11 (11) compared medications with nonpharmacologic interventions, 32 (31%) compared pharmacologic strategies, and 16 (15%) compared different medication dosing schedules. Twenty (19%) CE studies focused on safety and 2 (2%) included cost-effectiveness analyses. Comparative effectiveness studies were less likely than non-CE studies to have been exclusively commercially funded: 13% vs 45%, respectively. In total, 90 (87%) of the CE studies received noncommercial funding, including 66 that received government funding (63%). Of 212 randomized trials, 97 (46%) used an active comparator. The rest used an inactive control. Active-comparator trials were less likely than trials with inactive controls to report positive results: 44% vs 66%, respectively."

The authors concluded: "In these high-impact general medicine journals, approximately one-third of studies evaluating medications were CE studies. Of these studies, only a minority compared pharmacologic and nonpharmacologic therapies, few focused on safety or cost, and most were funded by noncommercial funding sources."

This research highlights both the need to changes to future treatment research and suggests limitation to much of the current data.

For the full abstract, click here.

JAMA 303(10):951-958, 10 March 2010
© 2010 the American Medical Association
303(10):951-958. Michael Hochman, Danny McCormick.

Category: A General/Unspecified. Keywords: comparative effectiveness, medications, pharmacological therapy, non-pharmacological therapy, commercial funding, descriptive study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 30 March 2010

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