Improving the Evidence Base for Invasive Therapeutic Procedures

Award Year:
Carol Ashton, Nelda Wray
Evidence-Based Medicine
Despite the American fascination with high-tech medicine, new treatments don't always deliver desired cures or improvements. While pharmaceutical products must be rigorously tested and approved by the U.S. Food and Drug Administration before going to market, any surgeon or interventionist can provide a new therapeutic procedure without valid scientific proof of its effectiveness. This can pose real problems for people seeking to make health care decisions - whether it's a physician considering how to treat a medical problem, a health plan deciding whether to cover a procedure, or a patient considering surgery. Oftentimes, the evidence needed to make those decisions simply doesn't exist. Carol M. Ashton, M.D., M.P.H., and Nelda P. Wray, M.D., M.P.H. explore how studies that generate evidence of what works bestby comparing alternatives can be applied to surgical and other therapeutic procedures. They examine how payment incentives might be used to encourage physicians and patients to help generate the data needed to quantify the risks and benefits of procedures and to create the evidence upon which more informed treatment decisions can be made. Their project, Improving the Evidence Base for Invasive Therapeutic Procedures, should help inform the design of payment policies to promote the use of procedures with scientifically proven benefits and reduce the use of those for which safer, more effective, and less expensive alternatives exist.