Briefly stated, comparative effectiveness research pertains to the
direct, succinct and precise comparison of existing healthcare
interventions to determine what works best for each individual
patient, and which treatment course poses the greatest benefits,
costs and harms. The core question of comparative effectiveness
research goes beyond establishing what treatment works best, for
whom, and under what circumstances: it is a hypothesis-driven
endeavor designed to uncover and implement the consensus of the
best evidence base for patient-centered, effectiveness-focused and
evidence-based health care. Members at the Institute of Medicine
and the Patient-Centered Outcomes Research concur that comparative
effectiveness research involves the generation and synthesis of the
best available evidence for a treatment intervention by means of a
process driven by the PICOTS question/hypothesis, and are directed
at comparing and contrasting the benefits, costs and harms of
alternative methods to prevent, diagnose, treat, and monitor a
clinical conditions with the specified intent of improving the
delivery of health care. The purpose of comparative effectiveness
research is to assist healthcare providers, patients, allied
clinicians, caregivers and other stakeholders to engage together
and make informed decisions that will improve healthcare at both
the individual and population levels, and in so doing utilize the
identified best evidence base in specific clinical settings, a
process that the Agency for Healthcare Research and Quality defines
as "Translational Effectiveness". In brief, comparative
effectiveness research is the tool and the process necessary for
translational effectiveness. In this light, it is critical and
timely to facilitate comparative effectiveness research as one of
the essential and primary components of patient-centered,
effectiveness-focused and evidence-based clinical decision-making
in healthcare, as the premier process that results in improved
patient outcomes, enhanced research planning, better products, and
novel evidence-based policy development. This book is a compilation
of the writings of several experts in the field and their
collaborators. Each chapter examines specific facets of the process
of comparative effectiveness research-based clinical
decision-making in the principal domains of healthcare, which are
subsumed in this work as dentistry, Western and alternative
medicine, nursing, and pharmacology. Taken together, the chapters
in this book present a brief, yet comprehensive overview and
discussion of the current state of comparative effectiveness in
healthcare. They establish the central role of systematic reviews
in the process of clinical decision-making in evidence-based health
care, and examine in depth the statistical significance and the
clinical relevance of actualising and evaluating clinical
decision-making. Additionally, policies in optimizing
evidence-based, patient-centered and effectiveness-focused clinical
outcomes, stakeholders engagement for raising health literacy in
the U.S. and worldwide in this decade of the twenty-first century
and beyond are discussed.
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