The Institute of Medicine released 100 health topics today that should receive priority attention and funding under the new national research initiative to identify healthcare services and procedures that work best. IOM also specified what needs to be done to update comparative effectiveness research initiatives in the future.
IOM's recommendations follow the release on Monday of the Federal Coordinating Council for Comparative Effectiveness Research's Report to Congress and the President advising how $1.1 billion could be spent under the economic stimulus legislation to assist federal agencies in coordinating and comparing the effectiveness of health services research.
The committee's report provides independent guidance--built on public input from the past several months--to Congress and to Department of Health and Human Services Secretary Kathleen Sebelius on how HHS should spend its $400 million on research to compare health services and approaches to care under the stimulus bill.
The IOM panel recommended 29 research priority categories, which include both primary and secondary research areas. The top priority category was health delivery, followed by disparities, disabilities, cardiovascular, geriatrics, psychiatry, neurology, pediatrics, endocrinology, and musculoskeletal.
Among the list of priority topics listed are:
- Compare the effectiveness of treatment strategies for atrial fibrillation, including surgery, catheter ablation, and pharmacologic treatment.
- Compare the effectiveness of the different treatments (e.g., assistive listening devices; cochlear implants; electric acoustic devices; and habilitation and rehabilitation methods, such as auditory/oral, sign language, and total communication) for hearing loss in children and adults, especially individuals with diverse cultural, language, medical, and developmental backgrounds.
- Compare the effectiveness of upper endoscopy utilization and frequency for patients with gastroesophageal reflux disease on morbidity, quality of life, and diagnosis of esophageal adenocarcinoma.
- Compare the effectiveness of primary prevention methods, such as exercise and balance training, versus clinical treatments in preventing falls in older adults at varying degrees of risk.
- Compare the effectiveness of dissemination and translation techniques to facilitate the use of CER by patients, clinicians, payers, and others.
- Compare the effectiveness of comprehensive care coordination programs, such as the medical home, and usual care in managing children and adults with severe chronic disease, especially in populations with known health disparities.
"This report lays the foundation for an ongoing enterprise to provide the evidence that healthcare providers need to make better decisions and achieve better results," said IOM Committee Co chair Sheldon Greenfield, Donald Bren Professor of Medicine and executive director, Health Policy Research Institute, University of California, Irvine, in a statement.
"To make the most of this enterprise, HHS will need to ensure that the results are translated into practice and that the public is involved in priority setting to ensure that the research is relevant to everyday health care," Greenfield said.