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ICER's mission is to lead innovation in comparative effectiveness research through methods that integrate considerations of clinical benefit and economic value.  Through a unique collaboration with patients, clinicians, manufacturers, insurers and other healthcare stakeholders, ICER develops tools to support patient decisions and medical policy that share the goal of achieving maximum value for every healthcare dollar.

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ICER article published in Health Affairs, Nov 2008
Dr. Pearson and colleagues participating in the ICER appraisal of CT colonography (CTC) recently published an examination of the challenges that arise in assessments of the comparative effectiveness of diagnostic technologies, including:
  • Rapid technological evolution vs. the “point-in-time” nature of most comparative effectiveness efforts
  • Impact of interpreter training on diagnostic accuracy
  • Factors influencing variability in reported results
  • Lack of data on impact of diagnostic technologies on direct patient outcomes
  • Generalizability from highly-specialized settings to broader community practice
  • Impact of screening intervals on outcomes and comparative value

Using the ICER CTC appraisal process as a case study, the article describes elements of the process that addressed many of these issues, including a focus on the current state-of-the-art technology as well as information on the likely developmental trajectory of CTC, limiting studies for review to those incorporating minimum standards for interpreter training, input from the CTC Evidence Review Group on protocol, interpreter, and other issues that affected certain study results, attempts to balance evidence by focusing on studies conducted with generalizable protocols, and use of the decision-analytic model to examine the impact of various screening intervals on clinical outcomes and cost-effectiveness.  

The full text of the article can be found at:

http://content.healthaffairs.org/cgi/content/full/27/6/1503

[Health Affairs 27, no. 6 (2008): 1503–1514]