Dissemination of Comparative Effectiveness Research

  • Michael A. FischerEmail author
Living reference work entry
Part of the Health Services Research book series (HEALTHSR)


Comparative effectiveness research (CER) findings provide the opportunity to improve health-care processes and patient outcomes through increased use of evidence-based medicine. Effective dissemination of comparative effectiveness research findings to practicing clinicians can allow the health system to take advantage of this opportunity. This chapter reviews challenges in the current system of medical practice, licensing, and education that limit the dissemination of comparative effectiveness research findings and their uptake into clinical practice. The chapter then discusses possible solutions to enhance the dissemination of comparative effectiveness research, including new methods of continuing medical education, health information technology intervention, and changes in clinician reimbursement. Attention to all of these domains will be required for comparative effectiveness research findings to be disseminated to clinicians in a way that will improve patient care and health outcomes.


Health Information Technology Comparative Effectiveness Research Puerperal Fever Dissemination Plan Decision Support Intervention 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. ALLHAT Officers, T. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA. 2002;288(23):2981–97.CrossRefGoogle Scholar
  2. Avorn J, Soumerai SB. Improving drug therapy decisions through educational outreach: a randomized controlled trial of academically based “detailing.”. N Engl J Med. 1983;308:1457–63.PubMedCrossRefGoogle Scholar
  3. Avorn J, Soumerai S, et al. A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes. N Engl J Med. 1992;327:168–73.PubMedCrossRefGoogle Scholar
  4. Bates DW, Teich JM, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999;6(4):313–21.PubMedCentralPubMedCrossRefGoogle Scholar
  5. Bodenheimer T. Primary care – will it survive? New Engl J Med. 2006;355(9):861–4.PubMedCrossRefGoogle Scholar
  6. Bozkurt B, Agoston I, et al. Complications of inappropriate use of spironolactone in heart failure: when an old medicine spirals out of new guidelines. J Am Coll Cardiol. 2003;41(2):211–4.PubMedCrossRefGoogle Scholar
  7. Carlat D. Dr. Drug Rep. New York Times Magazine. 2007.Google Scholar
  8. Chaudhry B, Wang J, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Int Med. 2006;144:742–52.PubMedCrossRefGoogle Scholar
  9. Davidoff F, Haynes B, et al. Evidence based medicine. BMJ. 1995;310(6987):1085–6.PubMedCentralPubMedCrossRefGoogle Scholar
  10. Evidence-based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992;268(17):2420–5.CrossRefGoogle Scholar
  11. Fletcher SW. Whither scientific deliberation in health policy recommendations? – Alice in the Wonderland of breast-cancer screening. New Engl J Med. 1997;336(16):1180–3.PubMedCrossRefGoogle Scholar
  12. Hager M, Russell S, Fletcher SW (eds). Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning, Proceedings of a Conference Sponsored by the Josiah Macy, Jr. Foundation; 2007 Nov 28 – Dec 1; Bermuda. New York: Josiah Macy, Jr. Foundation; 2008. Accessible at
  13. Isaac T, Weissman JS, et al. Overrides of medication alerts in ambulatory care. Arch Intern Med. 2009;169(3):305–11.PubMedCrossRefGoogle Scholar
  14. Kopans DB. Why the critics of screening mammography are wrong. Diagn Imaging. 2009;31(12):18–24.Google Scholar
  15. O’Brien MA, Rogers S, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007;4:CD000409.PubMedGoogle Scholar
  16. Pitt B, Zannad F, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med. 1999;341(10):709–17.PubMedCrossRefGoogle Scholar
  17. Solomon DH, Van Houten L, et al. Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Arch Intern Med. 2001;161(15):1897–902.PubMedCrossRefGoogle Scholar
  18. Soumerai SB, Avorn J. Economic and policy analysis of university-based drug “detailing”. Med Care. 1986;24(4):313–31.PubMedCrossRefGoogle Scholar
  19. Stafford RS, Bartholomew LK, et al. Impact of the ALLHAT/JNC7 Dissemination Project on thiazide-type diuretic use. Arch Intern Med. 2010;170(10):851–8.PubMedCentralPubMedCrossRefGoogle Scholar
  20. Turner J, Ersek M, et al. Patient outcomes after lumbar spinal fusions. JAMA J Am Med Assoc. 1992;268(7):907–11.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Pharmacoepidemiology and PharmacoeconomicsBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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