BU Library: Research Directions in Complementary, Integrative & Alternative Medicine: Patient Outcomes/CER

Comparative Effectiveness Research (CER) is ...

CER "...is concerned with the comparative assessment of interventions in routine practice settings."

Luce, B.R. et al. (2010). EBM, HTA, and CER: Clearing the confusion. Milbank Quarterly, 88/2: 256-76.

Clarifies distinctions between evidence-based medicine, health technology assessment, and comparative effectiveness research; calls for more specific terminology and concepts. (2010)

NIH>NLM>NICHSR. CER-HTA-PCOR: Converging on What Works for Patients (9-7-2011)

Transcript of a National Information Center on Health Services Research and Health Care Technology (NICHSR) webinar (pt. 2) defining comparative effectiveness and patient-centered outcomes research, within the broader context of health technology assessment and personalized medicine.

Developing Patient-Centered Outcomes....

Development of Items for the Patient-Reported Healing Context in CAM

Poster presentation by University of Pittsburgh researchers: “The goal of this project is to develop a battery of self-report item banks to measure contextual factors of healing that are generalizable across a broad array of population and treatment modalities, including Complementary and Alternative Medicine (CAM).”

Articles: Patient-Centered Outcomes

Unanticipated benefits of CAM therapies for back pain: an exploration of patient experiences
Hsu C, Bluespruce J, Sherman K, Cherkin D. J Altern Complement Med. 2010 Feb;16(2):157-63. doi: 10.1089/acm.2009.0188.

"Standard measures used to assess the outcomes of CAM treatments fail to capture the full range of outcomes that are important to patients. ... [F]uture trials should include a broader range of outcome measures."
Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care
Bell IR, Caspi O, Schwartz GE, Grant KL, Gaudet TW, Rychener D, Maizes V, Weil A. Arch Intern Med. 2002 Jan 28;162(2):133-40.

Outlines the relevance of complex systems theory as an approach to health outcomes research: "The systemic outcomes encompass the simultaneous, interactive changes within the whole person."
The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review
Duncan E and Murray J. BMC Health Services Research 2012, 12:96 doi:10.1186/1472-6963-12-96

"Whilst the importance of routinely measuring outcomes within the allied health professions is well recognized, it has largely failed to be delivered in practice."

Websites for Patient-Centered Outcomes

IN-CAM Outcomes Database
Developed by Marja Verhoef, PhD, University of Calgary, and other members of the Canadian IN-CAM Research Network, which promotes the use of valid, reliable, relevant and appropriate outcome measures in CAM research and practice.
Patient-Centered Outcomes Research Institute (PCORI)
Created in 2010 to conduct and compile research on the best available evidence to inform the decision-making process of patients and their health care providers; emphasis on science-based prevention and treatment options.
Patient-Reported Outcomes Measurement Information System (PROMIS)
PROMIS will be focusing on CAM-related outcome measures in the near future, but no date yet.

Articles: Pragmatic RCTs

Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy
Tunis SR, Stryer DB, Clancy CM. JAMA. 2003 Sep 24;290(12):1624-32.
Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity
Godwin M, Ruhland L, Casson V, MacDonald S, Delva D, Birtwhistle R, Lam M, Seguin R. BMC Med Res Methodol. 2003; 3: 28.
What are pragmatic trials?
Roland M & Torgerson DJ. BMJ, v.316(7127); Jan 24, 1998.