Resolution on patient-centered outcomes research adopted
January 16, 2012
By Jean Williams, ADA News staff
Las Vegas—The 2011 House of Delegates adopted a resolution that spells out the ADA's policy on comparative effectiveness research—also known as patient-centered outcomes research.
"CER and PCOR could have profound implications for the way dentists practice in the future," said Dr. Jonathan Knapp, vice chair of the Council on Dental Practice. Dr. Knapp was one of five members of a subcommittee that initially drafted the ADA's policy.
In 2010, through the Patient Protection and Affordable Care Act, Congress created the Patient Centered Outcomes Research Institute—an independent nonprofit organization to lead CER/PCOR (www.pcori.org).
In its report to the 2011 House, the council said that several concerns related to CER/PCOR have been raised. Some of these include the possibility that improvements in dental care through new or improved therapeutic devices, pharmaceuticals or procedures may be limited, and the misuse of CER/PCOR findings may limit insurance coverage policy or coverage decisions.
The Federal Coordinating Council for Comparative Effectiveness Research, established through the American Recovery and Reinvestment Act of 2009, defines CER as "the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in real world settings."
Currently, PCORI is obtaining public input prior to adopting priorities, agendas, methodological standards, peer review processes and dissemination strategies. "By establishing a policy framework, the ADA seeks to weigh in on PCORI's efforts," said Dr. Kevin Sessa, also a member of CDP's Subcommittee on CER.
In keeping with the concept that CER/PCOR should focus on the best possible outcomes for patients, the ADA supports such research "as methodologies that can lead to improved clinical outcomes, higher quality and increased patient satisfaction," according to 36H-2011.
As such, the ADA's new policy outlines principles for PCORI and other CER/PCOR entities to consider when evaluating any diagnostic or treatment modalities in oral health care delivery.
The six guidelines that make up the ADA's policy specify that the CER/PCOR process:
- must be well designed as well as open and transparent;
- should not limit innovative treatments and diagnostics;
- must maintain the doctor/patient relationship;
- should be widely disseminated;
- should not be payment driven.