Clinical Effectiveness During a Healthcare Crisis: Determining the Best Practices in Patient Care
The costs of medical care in the United States continue to escalate, putting severe financial strain on patients, employers, providers, and payers, and leading many to question whether healthcare can be provided in a more cost-effective manner.
A growing body of literature suggests that different providers and health systems have varying approaches to treating the same condition, and that considerable savings and improved outcomes could be achieved by reducing this variation. Much of the variation in practice seen today stems from differences in local culture and tradition, rather than differences in patient disease or presentation. The variation means that some patients are getting unnecessary care, while others are not getting the care they need.
So which diagnostic and treatment strategies for a particular disease and particular patients are best? What are the benefits and potential harms of each therapeutic approach? And how can we make sure that patients get the most value for their healthcare dollars?
These issues have formed the basis of an emerging – and critical – field of investigation, called comparative effectiveness research (CER). Recognizing the importance of this field, the federal government allocated more than $1.1 billion under the American Recovery and Reinvestment Act to this initiative and formed a Federal Coordinating Council specifically for CER.
The Children’s Hospital of Philadelphia Research Institute is taking a leading role in this initiative through the Center for Pediatric Clinical Effectiveness (CPCE), which promotes research on how to best manage pediatric illnesses, disseminates knowledge gained from these investigations, and collaborates to establish best practices to improve the healthcare of children everywhere.
Led by Ron Keren, MD, MPH, this Center of Emphasis at the CHOP Research Institute facilitates the performance of CER, partners to improve the care of children, and educates the next generation of comparative effectiveness investigators.
“Comparative effectiveness research is just one part of a larger issue around how we will respond to the nation’s healthcare crisis,” says Dr. Keren. “CPCE provides an essential link between determining what the best practices actually are and making sure that they are implemented in clinical care.”



