Comparative Effectiveness Research: Evidence, Medicine, and - download pdf or read online

By Carol M. Ashton

ISBN-10: 019996856X

ISBN-13: 9780199968565

For all its bills, flaws, and inequities, American future health care is essentially rooted in a trust that therapy could be in keeping with strong medical examine. To this finish, among 2003 and 2010, 3 diversified federal legislation have been enacted, the latest being the cheap Care Act of 2010, that mandated new federal investments in one of those scientific study known as comparative effectiveness examine (CER) — learn into what works top in treatment. Comparative Effectiveness study: facts, drugs, and coverage offers the 1st whole account of ways — and why — the government made up our minds to make CER an incredible characteristic of overall healthiness reform. regardless of past legislative uptake of coverage proposals on CER, help for federal mandates took dramatic twists and turns, with eventual compromises cast amid failing bipartisan alliances, certain pursuits, and mobilized public opinion. according to exhaustive study and first-hand interviews, the authors learn the place CER suits within the creation of clinical facts in regards to the advantages and harms of remedies for human ailments and prerequisites. Their paintings bargains sobering affirmation that modern American remedy falls, no longer strangely, good wanting the evidence-based excellent. Comparative Effectiveness study demonstrates that dealing constructively with the big uncertainties inherent to therapy calls for rules to make the iteration of high quality proof an inseparable a part of regimen well-being care.

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The continuing unethical conduct of underpowered clinical trials. JAMA 2002;288:358–62, and Wenner DM, Brody BA, Jarman AF, Kolman JM, Wray NP, Ashton CM. Do surgical trials meet the scientific standards for clinical trials? J Am Coll Surg 2012;215:722–30. 29. Information on FDA’s Sentinel Initiative. (Accessed January 31, 2011, at http://www. ) See also Behrman RE, Benner JS, Brown JS, McClellan M, Woodcock J, Platt R. Developing the Sentinel System—a national resource for evidence development.

22. Though the pertussis vaccine trial began before the streptomycin for tuberculosis trial, because the streptomycin trial results were reported earliest it is usually labeled as the fi rst clinical trial in which random allocation was used. See Medical Research Council. The prevention of whooping-cough by vaccination. Br Med J 1951;i:1463–71, and Streptomycin treatment of pulmonary tuberculosis: a Medical Research Council investigation. Br Med J 1948;1:769–82. Bradford Hill wanted to be a physician but his medical education was forestalled by World War I and his enlistment in 1916 into the Royal Naval Air Service.

25 Heart and Estrogen/Progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI), were subsequently conducted. HERS, which studied 2,673 women who had established coronary heart disease, showed that hormone replacement therapy does not reduce the overall rate of coronary heart disease events, increases the risk for venous thromboembolism and biliary surgery, shows unfavorable trends for cancer and fractures, and does not improve cognitive function (Hulley S, Grady D, Bush T, et al.

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Comparative Effectiveness Research: Evidence, Medicine, and Policy by Carol M. Ashton

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