Comparative Effectiveness Research and Its Application Trend in Neurology_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGDe-ren ¹ ,  LIUMing ^1,2

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Center of Cerebrovascular Disease, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUMing, Email: wyplmh@hotmail.com

Keywords：

Comparative effectiveness research; Evidence-based medicine; Neurology

DOI：

10.7507/1672-2531.20150042

Video：

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The core idea of comparative effectiveness research (CER) refers to "study in the real-world" which can be considered as the extension of evidence-based medicine. So far CER has arouse wide concern. CER includes many intervention trials and observational studies, including systematic reviews/meta-analyses, effectiveness randomized controlled trials, and registry trials. Database is an important platform for CER. CER has better feasibility and can provide useful evidence for "real-world" decision-making. However, it also has limitations such as difficult control of confounding factors. It still needs to be further studied due to its immature methodological base. CER has been already applied in some neurological fields, with internationally-recommended research priorities for CER in neurology.

Citation： WANGDe-ren, LIUMing. Comparative Effectiveness Research and Its Application Trend in Neurology. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 244-244. doi: 10.7507/1672-2531.20150042 Copy

1.	中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010. 中华神经科杂志, 2010, 43(2):146-153.
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6.	刘鸣, 张苏明, 郝子龙. 中国急性缺血性卒中诊治指南2010版的制定及解读. 中华神经科杂志, 2011, 44(6):369-374.
7.	Vickrey BG, Hirtz D, Waddy S, et al. Comparative effectiveness and implementation research:directions for neurology. Ann Neurol, 2012, 71(6):732-742.
8.	Mattson RH, Cramer JA, Collins JF, et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med, 1985, 313(3):145-151.
9.	Tunis SR, Stryer DB, Clancy CM. Practical clinical trials:increasing the value of clinical research for decision making in clinical and health policy. JAMA, 2003, 290(12):1624-1632.
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11.	In H, Rosen JE. Primer on outcomes research. J Surg Oncol, 2014, 110(5):489-493.
12.	Clancy CM, Eisenberg JM. Outcomes research:measuring the end results of health care. Science, 1998, 282(5387):245-246.
13.	刘鸣. 系统评价、Meta分析及在神经疾病的临床应用. 中华神经科杂志, 2001, 34(6):369-371.
14.	Alemayehu D, Cappelleri JC. Evaluating methodological assumptions in comparative effectiveness research:overcoming pitfalls. J Comp Eff Res, 2014, 3(1):79-93.
15.	Meyer AM, Wheeler SB, Weinberger M, et al. An overview of methods for comparative effectiveness research. Semin Radiat Oncol, 2014, 24(1):5-13.
16.	Brott TG, Hobson RW, Howard G, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med, 2010, 363(1):11-23.
17.	Velentgas P, Dreyer NA, Nourjah P, et al. Developing a Protocol for Observational Comparative Effectiveness Research:A User's Guide. AHRQ Publication No. 12(13)-EHC099. Rockville, MD:Agency for Healthcare Research and Quality; January 2013. Available at:www. effectivehealthcare.ahrq.gov/Methods-OCER.cfm.
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21.	Oxfordshire Community Stroke Project. Incidence of stroke in Oxfordshire:first year experience of a community stroke register. BMJ, 1983, 287(6394):713-717.
22.	Bogousslavsky J, van Melle G, Regli F. The Lausanne Stroke Registry:analysis of 1000 consecutive patients with first stroke. Stroke, 1988, 19(9):1083-1092.
23.	郝子龙, 刘鸣, 李伟, 等. 成都卒中登记方法及3123例患者基本特征和功能结局. 中华神经科杂志, 2011, 44(12):826-831.
24.	Tao WD, Liu M, Fisher M, et al. Posterior versus anterior circulation infarction:how different are the neurological deficits? Stroke, 2012, 43(8):2060-2065.
25.	Wang D, Liu M, Hao Z, et al. Features of acute ischemic stroke with rheumatic heart disease in a hospitalized Chinese population. Stroke, 2012, 43(11):2853-2857.
26.	Lin S, Wu B, Hao ZL, et al. Characteristics, treatment and outcome of ischemic stroke with atrial fibrillation in a Chinese hospital-based stroke study. Cerebrovasc Dis, 2011, 31(5):419-426.
27.	McDonald RJ, McDonald JS, Therneau TM, et al. Comparative effectiveness of carotid revascularization therapies:evidence from a National Hospital Discharge Database. Stroke, 2014, 45(11):3311-3319.
28.	Moradiya Y, Murthy SB, Newman-Toker DE, et al. Intraventricular thrombolysis in intracerebral hemorrhage requiring ventriculostomy:a decade-long real-world experience. Stroke, 2014, 45(9):2629-2635.

1. 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010. 中华神经科杂志, 2010, 43(2):146-153.
2. Wright JD, Pawar N, Gonzalez JSR, et al. Scientific Evidence Underlying the American College of Obstetricians and Gynecologists' Practice Bulletins. Obstetrics & Gynecology, 2011, 118(3):505-512.
3. Tanenbaum SJ. Comparative effectiveness research:evidence-based medicine meets health care reform in the USA. Journal of Evaluation in Clinical Practice, 2009, 15(6):976-984.
4. Conway PH, Clancy C. Comparative-Effectiveness Research-Implications of the Federal Coordinating Council's Report. N Engl J Med, 2009, 361(4):328-330.
5. Iglehar JK. Prioritizing comparative-effectiveness research-IOM recommendations. N Engl J Med, 2009, 361(4):325-327.
6. 刘鸣, 张苏明, 郝子龙. 中国急性缺血性卒中诊治指南2010版的制定及解读. 中华神经科杂志, 2011, 44(6):369-374.
7. Vickrey BG, Hirtz D, Waddy S, et al. Comparative effectiveness and implementation research:directions for neurology. Ann Neurol, 2012, 71(6):732-742.
8. Mattson RH, Cramer JA, Collins JF, et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med, 1985, 313(3):145-151.
9. Tunis SR, Stryer DB, Clancy CM. Practical clinical trials:increasing the value of clinical research for decision making in clinical and health policy. JAMA, 2003, 290(12):1624-1632.
10. Zwarenstein M, Treweek S, Gagnier JJ, et al. Improving the reporting of pragmatic trials:an extension of the CONSORT statement. BMJ, 2008, 337:a2390.
11. In H, Rosen JE. Primer on outcomes research. J Surg Oncol, 2014, 110(5):489-493.
12. Clancy CM, Eisenberg JM. Outcomes research:measuring the end results of health care. Science, 1998, 282(5387):245-246.
13. 刘鸣. 系统评价、Meta分析及在神经疾病的临床应用. 中华神经科杂志, 2001, 34(6):369-371.
14. Alemayehu D, Cappelleri JC. Evaluating methodological assumptions in comparative effectiveness research:overcoming pitfalls. J Comp Eff Res, 2014, 3(1):79-93.
15. Meyer AM, Wheeler SB, Weinberger M, et al. An overview of methods for comparative effectiveness research. Semin Radiat Oncol, 2014, 24(1):5-13.
16. Brott TG, Hobson RW, Howard G, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med, 2010, 363(1):11-23.
17. Velentgas P, Dreyer NA, Nourjah P, et al. Developing a Protocol for Observational Comparative Effectiveness Research:A User's Guide. AHRQ Publication No. 12(13)-EHC099. Rockville, MD:Agency for Healthcare Research and Quality; January 2013. Available at:www. effectivehealthcare.ahrq.gov/Methods-OCER.cfm.
18. Saver JL, Warach S, Janis S, et al. Standardizing the Structure of Stroke Clinical and Epidemiologic Research Data:The National Institute of Neurological Disorders and Stroke (NINDS) Stroke Common Data Element (CDE) Project. Stroke, 2012, 43(4):967-973.
19. Gliklich RE, Dreyer NA, editors. Registries for Evaluating Patient Outcomes:A User's Guide. 2nd edition. Rockville (MD):Agency for Healthcare Research and Quality (US); 2010 Sep. Available at:http://www.ncbi.nlm.nih.gov/books/NBK49444/.
20. 卢伟, 曾繁典, 董卫, 主译; (美)理查德(Gliklich RE), (美)南希(Dreyer NA), 主编. 评估患者结局注册登记指南. 第2版. 上海:上海科学技术出版社, 2012.
21. Oxfordshire Community Stroke Project. Incidence of stroke in Oxfordshire:first year experience of a community stroke register. BMJ, 1983, 287(6394):713-717.
22. Bogousslavsky J, van Melle G, Regli F. The Lausanne Stroke Registry:analysis of 1000 consecutive patients with first stroke. Stroke, 1988, 19(9):1083-1092.
23. 郝子龙, 刘鸣, 李伟, 等. 成都卒中登记方法及3123例患者基本特征和功能结局. 中华神经科杂志, 2011, 44(12):826-831.
24. Tao WD, Liu M, Fisher M, et al. Posterior versus anterior circulation infarction:how different are the neurological deficits? Stroke, 2012, 43(8):2060-2065.
25. Wang D, Liu M, Hao Z, et al. Features of acute ischemic stroke with rheumatic heart disease in a hospitalized Chinese population. Stroke, 2012, 43(11):2853-2857.
26. Lin S, Wu B, Hao ZL, et al. Characteristics, treatment and outcome of ischemic stroke with atrial fibrillation in a Chinese hospital-based stroke study. Cerebrovasc Dis, 2011, 31(5):419-426.
27. McDonald RJ, McDonald JS, Therneau TM, et al. Comparative effectiveness of carotid revascularization therapies:evidence from a National Hospital Discharge Database. Stroke, 2014, 45(11):3311-3319.
28. Moradiya Y, Murthy SB, Newman-Toker DE, et al. Intraventricular thrombolysis in intracerebral hemorrhage requiring ventriculostomy:a decade-long real-world experience. Stroke, 2014, 45(9):2629-2635.

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