Research rarely shows which drugs, devices and medical procedures work best, despite increasing investments in such efforts, a new government report says.
Determining the effectiveness of medical technologies will improve the quality of healthcare but might not lower costs, and supporters have been too optimistic in predicting its impact, the report said.
The study was prepared by the Office of Technology Assessment, a congression-al research agency. It examines efforts to decide which technologies are most effective and to develop guidelines for their use. The report, Identifying Health Technologies That Work: Searching for Evidence, was released this month.
Analyzing administrative databases-a popular technique-reveals how physicians use technologies but doesn't establish which uses are best, the OTA said. Meanwhile, methods of developing clinical practice guidelines vary so widely that guidelines on the same topic often conflict (See related story, p. 36), the agency said.
Cost-effectiveness analyses, which compare the costs and outcomes of alternative technologies (Feb. 28, p. 36), also differ significantly in their underlying assumptions. Interpreting such studies is frustrating, and their results are difficult to apply, the OTA said.
It recommends that the federal government coordinate-and perhaps finance-efforts to develop standards for cost-effectiveness analysis.
Other recommendations include:
That lawmakers encourage collaboration between the Agency for Health Care Policy and Research and the National Institutes of Health, which both carry out effectiveness research.
That the government maintain a database of government-sponsored clinical trials and, when possible, industry trials to make information on the effectiveness of technology more available.
That the government build a national infrastructure for conducting large, community-based clinical trials.