National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland 20892, USA.
Otolaryngol Head Neck Surg. 2011 Oct;145(4):526-9. doi: 10.1177/0194599811419458. Epub 2011 Aug 22.
The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care.
2010 年的《患者保护与平价医疗法案》要求制定国家比较结果研究项目议程。比较效果研究包括临床试验和观察性研究，并由电子健康记录提供便利。一个全国性的电子健康记录网络将创建一个庞大的电子数据“仓库”，其中包含呈指数增长的观察性数据。高质量的关联将确定实用临床试验的研究课题，而临床试验的系统评价将提供最佳的循证医学证据。循证医学是在为个体患者的护理做出决策时，自觉、明确和明智地使用当前最佳证据。因此，医疗改革将为比较效果研究、系统评价和循证医学提供一个强大的环境，而循证医学的实施应该会提高护理质量。
