Here are some responses to last week’s NY Times op-ed suggesting that a comparative effectiveness institute be considered.
Most of the resistance comes from the fact that medicine is infinitely more complex and variable than the current tools of empirical data can resolve:
The number of variables in medical care (patient and treatment variability, co-morbid conditions) and degree of subjective interpretation (severity of illness) is far greater than in baseball.
That’s true. No study can incorporate the myriad of patient conditions that doctors routinely face.
Costs of such an idea also present an obstacle:
More money for evidence-based research is not the answer and is quite an irresponsible request in these precarious economic times.
Probably goes a bit too far, as I don’t think the suggestion was irresponsible at all.
I think basic comparative effectiveness needs to happen, if only to place more gravitas on medical evidence.
Without knowing whether treatment truly works, or if diagnostic tests are really necessary, the current trend of practice variation will continue to balloon health care spending.
