Comparative effectiveness research using the electronic medical record: an emerging area of investigation in pediatric primary care
Previous research demonstrated that as many as one-half of all clinical decisions are reached without adequate medical evidence to inform choices. In contrast to other areas of investigation, comparative effectiveness research (CER) directly addresses this problem. Specifically, CER uses varied study designs to generate and synthesize evidence demonstrating the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor clinical conditions or improve the delivery of care. The need for CER is especially urgent in pediatrics, a field in which clinicians and families frequently depend on the generalization of medical knowledge from adult trials despite limited evidence to support the use of these treatments. To close these knowledge gaps, the American Recovery and Reinvestment Act of 2009 (ARRA) allocated $1.1 billion for CER.