What’s In A Name? The Semantics of Comparative Effectiveness

Somewhere, Senate Finance Committee Chairman Max Baucus (D-Mt.) is smiling.

Baucus may be making inroads on his effort to relabel comparative effectiveness research as something a bit more patient – and industry – friendly.

As congressional debate on creating a public/private entity to conduct such research was heating up, Baucus decided that the term "comparative effectiveness research" was becoming too much of a lightning rod for controversy and changed the term in health care reform legislation to "patient-centered outcomes research."

CER, it seems, had become too linked to issues such as whether research data would limit physician's latitude for prescribing and whether costs might play a determining role.

HHS apparently jumped on the terminology bandwagon with its Sept. 1 announcement of grants to build up research capabilities in health facilities, with a focus on diverse populations. The announcement says the $17 million in awards will go toward "patient-centered outcomes research" or PCOR. Interestingly, the entire release eschews the loaded CER terminology, save for a link for more information on "about patient-centered and comparative effectiveness research" in the second to last sentence.

CER/PCOR stakeholders are now eagerly watching for HHS to name the first board members of the Patient-Centered Outcomes Research Institute, created as part of the health reform initiative. One key issue facing the group is how to effectively disseminate research findings. Who knows? Perhaps research branded as PCOR will be more effective than that branded as CER.

PCOR may hold one advantage over CER – it won't be easy to sub in "cost" for "centered" in the same way opponents of CER fueled resistance for the approach by calling it "cost-effectiveness research".

Not everyone has gotten with the new lingo, of course. A variety of health policy groups are sticking with CER, including the New England Healthcare Institute. And the HHS Agency for Healthcare Research and Quality "Effective Health Care Program" today announced an upcoming conference featuring topics such as "The Role of CER in Health Care Improvement" and "Examples of Incorporating CER Into Clinical Practice."

Only time will tell if Baucus will have the last laugh and get everyone to adopt his vision of patient-centered outcomes research.

- Gregory Twachtman

Image courtesy of flickrer dullhunk used with permission via a creative commons license.