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What can epidemiology contribute to comparative effectiveness research?
  1. Jessica Chubak1,2
  1. 1Group Health, Group Health Research Institute, Seattle, Washington, USA
  2. 2Department of Epidemiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Jessica Chubak, Group Health, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA; Chubak.j{at}ghc.org

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Haven't epidemiologists been doing comparative effectiveness and safety research all along?

For many of us, the answer is yes. Comparative effectiveness may have been formally defined only recently as ‘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’1 but it is not entirely new. Authors publishing in the Journal of Epidemiology and Community Health used the term at least as far back as 1985.2 Studies that could be classified as comparative effectiveness research (CER) appeared considerably earlier in the journal.3–5 Much of our field seeks to evaluate and compare the benefits and harms of two or more preventive, diagnostic, or therapeutic services, behaviours, programmes, or policies designed to improve health. Although not all CER research is epidemiology and not all epidemiology is CER, the two are intimately connected. CER is a research agenda and epidemiology is a discipline that provides methodology for answering the primary questions in CER: what health interventions, behaviours and policies work best for different groups in the real world?6–8 Embedded in the goals of CER is a focus on real-world interventions, causality, effect modification and generalisability. Epidemiology has a long history of tackling each of these issues and, as a result, provides established tools to address the CER agenda through observational studies and randomised controlled trials (RCTs). The importance of CER methods …

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