Research Definitions

Definitions of Comparative Effectiveness Research (CER)

“Which treatment works best, for whom, and under what circumstances?”  -Slutsky and Clancy (Am J Med Qual 2009;24:67-70)

“The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual and population levels.” - Institute of Medicine (IOM) Definition (Institute of Medicine. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: National Academies Press; 2009.)

  1. Compares at least two alternative interventions, each with the potential to be “best practice”
  2. Conducted in settings similar to those in which the intervention will be used in practice
  3. Measures outcomes, both benefits and harms, that are important to patients
  4. Informs a specific clinical decision from the patient perspective or a health policy decision from the population perspective
  5. Describes results at both the population and subgroup levels
  6. Employs methods and data sources appropriate for the decision of interest

The Federal Coordinating Council for Comparative Effectiveness Research defines CER as, “the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in ‘real world’ settings.” Federal Coordinating Council for Comparative Effectiveness Research. Report to the President and Congress; June 30, 2009. US Department of Health and Human Services. 

 

Definition of Patient-Centered Outcomes Research

Patient-Centered Outcomes Research (PCOR) answers patient-centered questions, such as:

  1. “Given my personal characteristics, conditions, and preferences, what should I expect will happen to me?”
  2. “What are my options, and what are the potential benefits and harms of those options?”
  3. “What can I do to improve the outcomes that are most important to me?”
  4. “How can clinicians and the care delivery systems they work in help me make the best decisions about my health and health care?”

To answer these questions, PCOR:

  • Assesses the benefits and harms of preventive, diagnostic, therapeutic, palliative, or health delivery system interventions to inform decision making, highlighting comparisons and outcomes that matter to people;
  • Is inclusive of an individual's preferences, autonomy, and needs, focusing on outcomes that people notice and care about such as survival, function, symptoms, and health-related quality of life;
  • Incorporates a wide variety of settings and diversity of participants to address individual differences and barriers to implementation and dissemination; and
  • Investigates (or may investigate) optimizing outcomes while addressing burden to individuals, availability of services, technology, and personnel, and other stakeholder perspectives.