Basic science, clinical, epidemiological, and many other types of medical research provide the knowledge and understanding that help advance the quality of modern medicine. Clinical trials are now becoming increasingly important in determining which of our diagnostic or treatment options are not only effective, but also cost-effective.
Value is now an important element of consideration when medical policy decisions are made. Different treatments for a particular medical problem are examined to determine which is more valuable. Two or more treatments can be studied in a head-to-head fashion, in one research study. This is known as comparative effectiveness research (CER). Clinical treatment decisions, or even formal algorithms, are often made using the best available evidence. This application of the research is known as evidence based medicine (EBM).
You will find, here, resources to help further your understanding of, or assist in your pursuit of, medical research.
The Centre for Evidence Based Medicine, of the University of Oxford, is an excellent resource site for researchers:
Levels of Evidence:
http://www.cebm.net/index.aspx?o=1025 (March 2009)
Critical Appraisal Sheets and Statistics Calculators:
Comparative Effectiveness Research (CER):
AHRQ on CER:
There is a growing emphasis on capturing not only pain and functional outcomes data, but also utility and cost data when conducting clinical research. DenverBackPain.org promotes the incorporation of VALUE AND COST-BENEFIT ANALYSIS into research protocols. Utility scores can be gathered from the EuroQoL, EQ5D, or AQoL, or can be obtained from the commonly used SF-36 (SF-6D), Neck Disability Index, or Oswestry Disability Index. Direct medical costs, as well as an estimated cost (savings) related to outside care or medication utilization may be captured. Work status/loss should be followed when possible.
See the value, utility, and cost-benefit references within the Research Related References section of this site.
The Institute of Medicine placed the formation of an OUTCOMES REGISTRY FOR LOW BACK PAIN TREATMENTS in the top quartile of its CER priority list. The AHRQ is working with medical societies and other stakeholders on the formation of this, and many other registries. It is useful to keep informed of the content details of such pertinent registries, so that the chosen outcome measures can be incorporated into future research projects as well as practices’ electronic health record systems. More information on this and related topics can be found at:
Registry of Patient Registries (RoPR) – Project Summary December 2010:
“Registries for Evaluating Patient Outcomes: A User’s Guide”