Category: AHRQ

Industry conflicts arise at PCORI threatening any real comparative effectiveness research

February 7, 2014- By Steven E. Greer, MD

The Patient Centered Outcome Research Institute (PCORI) was created by the PPACA “ObamaCare” law in 2010. Well-funded with approximately $3 Billion over ten years,  the mission was, among other things, supposed to be to conduct comparative effectiveness research (CER) that would determine whether costly therapies are any better than cheaper alternatives.

The rise of CER has been one of the most feared developments by the drug and device industries. To avoid powerful lobbying efforts that could have resulted in de-funding and the death of PCORI before it got started, the institute steered away from even hinting at conducting CER. Now, almost four years later, PCORI is finally funding CER research. However, critics, such as former White House Director of Office of Management and Budget, Peter Orzag, say that the money spent by PCORI on CER is still not enough.

Meanwhile, a leading doctor in charge of PCORI research strategies, Harlan Krumholz, MD, Read more »

NY Times reports that CMMI “research” is junk science

February 3, 2014- By Steven E. Greer, MD

The Healthcare Channel was the first to report in 2012 that the new CMMI, created by the ACA “Obamacare” law, was nothing but a pork project designed to deliver funds to political cronies. Subsequent to our reporting, the senate convened oversight hearings, and the director of CMMI was fired.

Today, the New York Times reports that the quality of “research” coming out of CMMI is suspect. Gina Kolata writes, ” The idea seemed transformative. The Affordable Care Act would fund a new research outfit evocatively named the Innovation Center to discover how to most effectively deliver health care, with $10 billion to spend over a decade. But now that the center has gotten started, many researchers and economists are disturbed that it is not using randomized clinical trials, the rigorous method that is widely considered the gold standard in medical and social science research. Such trials have long been required to prove the efficacy of medicines, and similarly designed studies have guided efforts to reform welfare-to-work, education and criminal justice programs.” Read more »

Gordon Guyatt, MD: Update on the problem of clinical trials being stopped early to inflate efficacy of drugs

Gordon Guyatt, MD, epidemiologist, internist, and biostatistician at McMaster University updates us on the progress being made against the problem of clinical trials being stopped early to inflate efficacy of drugs. Since our first coverage of the topic two years ago, the FDA, the Cochrane group, and other agencies have implemented changes in policy.  Dr. Guyatt discusses the Crestor JUPITER trial as an example of a trial that was stopped early and inflated efficacy.


Early breast cancer screening leads to false positives and overdiagnosis

Archie Bleyer, MD, radiation oncologist at the Oregon Health and Science University, discusses his NEJM paper that concluded early breast cancer screening using mammography led to more findings of false positives.

Peter Pronovost, MD, PhD: The medical checklist concept to reduce adverse events

By Steven Greer, MD

(Viewable in full screen 1080iHD)

Dr. Peter Pronovost, Professor of anesthesiology and critical care at the Johns Hopkins Hospital, discusses his paradigm changing medical checklist concept that has greatly reduced adverse events in hospitals. Starting with reducing central line infections dramatically, the concept was expanded to reducing ventilator pneumonias and then to reducing mortality in the operating room.

Dr. Pronovost was named one of Time Magazine’s “Most Influential People in the World” and is a recipient of the MacArthur Foundation “Genius” award. Dr. Steven Greer took a tour of his ICU and discussed his advances.


Roger Chou, MD: How the AHRQ creates and grades a meta-analysis

Produced and interviewed by Steven Greer, MD

A meta-analysis is the most influential form of systematic review now, but are all meta-analysis worthy of the highest level of quality in the hierarchy of the AHRQ? Are some meta-analyses “garbage in, garbage out”? Are there standardized, widely accepted, methods for going about a meta-analysis, or are the drug and device industries manipulating this process to create marketing junk science? Are academic doctors doing more meta-analyses because they end up being referenced by more journals and boost their CV?

In Part 1, Dr. Roger Chou of Oregon, a researcher for the AHRQ via a contracted Evidence-based Practice Center, and also a contributor to the U.S. Preventive Services task Force, discusses the rulebooks used by the AHRQ to go about systematic reviews of medical literature.

In Part 2, Dr. Chou discusses how they spot a bad meta-analysis and exclude it from their systematic reviews. He lists as a specific example of a sloppy meta-analysis.

AHRQ report: Best evidence for rotator cuff tear repair

Produced and interviewed by Steven Greer, MD

August 1, 2010

CurrentMedicine.TV, in conjunction with the AHRQ, has created a video summary of the AHRQ report about the comparative effectiveness research on the various ways to surgically repair torn rotator cuffs and to rehabilitate the injuries. Is surgery more effective than physical therapy alone? Which forms of PT are best?

Karen Siegel, physical therapist within AHRQ, discusses the report.


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