Improving the use of information in medical effectiveness research.

There is increased emphasis on improving the quality of health care by obtaining and disseminating information about the effectiveness and outcomes of care and by facilitating more consumer input participation in decision-making. We examine barriers to information use and the challenges that these barriers pose for effectiveness research. We divide our discussion into four goals of effectiveness research. These are: (1) to provide more information so that consumers, providers and policymakers can make "rational" decisions; (2) to incorporate patient preferences into health care decisions; (3) to develop guidelines that incorporate both individual perspectives and societal perspectives; (4) to use information to improve the practice of health care. We discuss four recommendations for improving the use of information: (1) the evidence on how people actually make decisions should be used to inform the design and implementation of effectiveness research; (2) decision-making should be structured through guidelines and policies; (3) criteria should be developed for determining which guidelines should fully incorporate patient preferences; (4) safeguards should be established to guard against misuse of information.