Comparative Effectiveness Research
Comparative effectiveness research (CER) compares the clinical outcomes, effectiveness, and appropriateness of interventions to prevent, diagnose, or treat diseases, disorders, and other health conditions. Such studies can provide information on the relative strengths and weaknesses of various medical interventions and help doctors and their patients make informed decisions about health management.
CER is an emerging research area at NIA, and the Institute supports an evolving portfolio of research exploring CER issues relevant to aging. Of particular interest are studies comparing the effectiveness of health management strategies in people with multiple health conditions or complex syndromes; CER among individuals who take several medications or who are following complex treatment regimens; and studies exploring the effects of coexisting health conditions on safety and effectiveness of interventions.
In 2009, an influx of Recovery Act funding facilitated the expansion of NIA’s CER portfolio, and many projects initially funded by ARRA are continuing. For example:
- One study is taking advantage of a unique health insurance lottery currently underway in Oregon to evaluate the effects of access to enhanced insurance on health care usage and health outcomes among low income adults. This project will allow us to explore the effects of insurance expansions among underserved individuals.
- The Lifestyle Interventions and Independence for Elders (LIFE) Study compares the effects of a moderate-intensity physical activity program to a health education program on prevention of mobility loss disability in older Americans; cognitive function, falls, and cardiovascular health are also under study in this trial.
- Another ongoing study is comparing the effects of lowering systolic blood pressure to 120 vs. 140 on several health outcomes, including cognitive health in older adults. NIA supports this study in collaboration with the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the National Institute of Diabetes and Digestive and Kidney Diseases.
NIA also collaborates with other NIH Institutes and federal agencies to promote and support CER. For example, a major CER effort has been NIA’s administration, on behalf of the Agency for Health Care Research and Quality and the Office of the DHHS Secretary, of a major research initiative identifying ways that principles of behavioral economics could be used to encourage health care providers to incorporate findings from CER studies into their practices.