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Advancing Excellence in Health Care: Getting to Effectiveness
  1. Carolyn M. Clancy,
  2. Jean R. Slutsky
  1. From the Agency for Healthcare Research and Quality (C.M.C.) and the Center for Outcomes and Evidence (J.R.S.), Agency for Healthcare Research and Quality, Rockville, MD
  1. Address correspondence to: Dr. Carolyn M. Clancy, John M. Eisenberg Building, 540 Gaither Road, Rockville, MD 20850; e mail: carolyn.clancy{at}ahrq.hhs.gov .

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In 2005, Americans are fortunate to live at a time when investments in biomedical science have resulted in a plethora of new diagnostic and therapeutic options. A broader array of choices for treating hypertension, heart failure, and other chronic illnesses; new techniques for managing cardiac and other diseases; and unprecedented innovations in diagnostic evaluation and prediction bring us closer to a vision of personalized health care than ever before.

These new opportunities represent only the beginning and also challenge clinicians, payers, and health care organizations to determine which innovations represent added value, which offer modest enhancements to current choices, and which fail to reach their potential. As health care expenditures continue to rise, individual consumers increasingly confront differential cost sharing for alternative options and sites of care, so they have a new stake in identifying which options offer the best value for their needs and preferences. The current clinical research enterprise does not produce the information needed to make informed decisions. The need for better evidence about the benefits, risks, and costs of alternative choices is imperative.

Thus, the article by Kupersmith and colleagues is timely and provocative.1He and a group of distinguished leaders in clinical research articulate the distinction between research …

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