Nurses and Patient-Centered Research

By Shawn Kennedy, editor-in-chief

I’m immersed in nursing research and nursing leaders this week, attending (in order and immediately following one another) meetings of the Council for the Advancement of Nursing Science (CANS), the 25th anniversary concluding scientific symposium of the National Institute of Nursing Research (NINR), and finally, the American Academy of Nursing.

Wednesday was CANS and its focus on comparative effectiveness research. After an opening keynote by Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHRQ), who discussed the need to accelerate progress in improving U.S. health outcomes, a panel of nurses discussed different methodological considerations, from databases to competencies.

Research to help people make informed decisions. Especially interesting was a discussion of the Patient-Centered Outcomes Research Institute (PCORI), the research entity which was mandated by the 2010 Patient Protection and Affordable Care Act. […]

Mammography Screening: Change Isn’t Easy

Exactly what is the evidence supporting annual mammography screening and breast self-examination for women over the age of 40? Napoli pointed out that the available evidence from large international studies didn’t support the belief that early detection of breast cancer actually resulted in lower mortality rates and that the high number of false positive tests resulted in unnecessary anxiety and treatment. At the time, there was even some evidence that premenopausal women who are diagnosed with breast cancer through mammography may actually die earlier than women who are not screened.

Comparative Effectiveness Research–Is Health Care Reform Possible Without It?

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Improve health, reduce costs: that’s the mantra health care reform advocates keep repeating. And it’s easy to see why: this year, total health care spending in the United States is expected to reach $2.5 trillion, accounting for almost 18% of the gross domestic product. By 2018 the total could be $4.4 trillion-and because economic growth is expected to be slower over this period, that total may account for one-fifth of the gross domestic product in 2018. And even with all of this spending, the United States lags behind other industrialized nations on many measures of health and well being.

While there are many paths to achieving the twin goals of better outcomes and lower costs, a consensus has been growing among health policy experts and economists that part of the solution is to improve the way medical research is conducted and then put it into practice in both providers’ and consumers’ decision making. Comparative effectiveness research (CER)-a model by which cost-benefit analyses of different treatments for a given condition are compared-provides the means for understanding which interventions yield the best health outcomes for the least amount of money.

Read the rest of the article in the October issue of AJN here. With something so complex, life altering, and expensive as health care, how could we not expect to do a little comparative shopping about cost and quality?

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