Watch for this buzzword to become important in health care quality and safety over the next few years: “Comparative effectiveness research.”
The $787 billion economic stimulus package that was signed into law in February 2009 will fund federal research on comparative effectiveness of treatment options, according to The New York Times’ Robert Pear. The research is aimed at saving money; health care in America totaled $2.2 trillion in 2007. But it could also provide a big boost toward higher quality health care.
Too few studies have been done to compare different treatments for a given illness, and as a result, doctors don’t really have solid information about what works for which patients. The gap in evidence translates into patients’ risk of getting ineffective or unnecessary treatments at billions of dollars each year. The new research projects will seek the most efficient and cost-effective treatments available to patients, and, in the process, reduce Americans’ spending on health care.
This new government effort in healthcare reform is a step toward improving quality of care. The studies of medical effectiveness already done have punctured many myths about medical treatments, proving over and over that what seems logical and reasonable does not always translate into proven benefits for patients.
One small example from the Patrick Malone law firm’s experience shows how tragic injuries can come from unnecessary medical treatment. Our 13-year-old client suffered a head injury when she fell off her bicycle. She developed bleeding on the surface of the brain which was successfully drained by drilling a small hole in her skull. She was on her way toward uneventful and complete recovery when her neurosurgeon prescribed, on her way home from the hospital, a six-month course of Dilantin to prevent possible seizures. Over the course of the next several weeks, she developed a severe allergic reaction to the Dilantin that caused permanent damage to the corneas of both eyes, leaving her legally blind. When we investigated the case, we discovered that researchers had published a comprehensive study in one of the leading medical journals, the New England Journal of Medicine, proving that Dilantin is ineffective in preventing seizures after head injury in patients who don’t spontaneously develop seizures in the first place. The surgeon was following traditional practice when he prescribed the drug to our client and was simply not aware of this research showing that the drug just didn’t work. (The study showed that when patients after a head injury were randomly assigned to either receive Dilantin or a dummy pill, the ones who got the Dilantin actually had a few more seizures in the following months than the ones on the dummy pill.)
With the government behind a push to expand effectiveness research and give more publicity to the results of such research, patients will benefit by receiving only treatments that are proven to work and not those that are dangerous because they are worthless and come with side effects such as the one our young client experienced.