As part of the American Recovery and Reinvestment Act (ARRA) of 2009, Congress appropriated $1.1 billion to accelerate the nation's
comparative effectiveness research (CER) efforts and then asked the Institute of Medicine (IOM) to recommend national priorities for research to be supported by ARRA funds.
First, the IOM developed the following definition for comparative effectiveness research:
CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual
and population levels.
On June 20, the IOM published a list of the 100 highest-priority CER questions. Heads up: Here is a list of nutrition-focused or nutrition-related topics:
∑ Compare the effectiveness of treatment strategies for obesity (e.g., bariatric surgery, behavioral interventions and pharmacologic treatment) on the resolution of obesity-related outcomes such as diabetes, hypertension, and musculoskeletal disorders.
∑ Compare the effectiveness of dietary supplements (nutraceuticals) and usual care in the treatment of selected high-prevalence conditions.
∑ Compare the effectiveness and cost-effectiveness of conventional medical management of type 2 diabetes in adolescents and adults, versus conventional therapy plus intensive educational programs or programs incorporating support groups and educational resources.
∑ Compare the effectiveness of different treatment strategies (e.g., modifying target levels for glucose, lipid, or blood pressure) in reducing cardiovascular complications in newly diagnosed adolescents and adults with type 2 diabetes.
∑ Compare the effectiveness of clinical interventions (e.g., prenatal care, nutritional counseling, smoking cessation, substance abuse treatment and combinations of these interventions) to reduce incidences of infant mortality, pre-term births, and low birth rates, especially among African American women.
∑ Compare the effectiveness of school-based interventions involving meal programs, vending machines and physical education, at different levels of intensity, in preventing and treating overweight and obesity in children and adolescents.
∑ Compare the effectiveness of various strategies (e.g., clinical interventions and selected social interventions such as improving the built environment in communities and making healthy foods more available) to prevent obesity, hypertension, diabetes, and heart disease in at-risk populations such as the urban poor and American Indians.