The document discusses improving comparative effectiveness research to make it more patient-centered. It focuses on matching research questions to the most appropriate research methods to provide patient-centered answers. It also emphasizes engaging patients, caregivers, clinicians, administrators, commissioners, and policymakers throughout the entire research process. By linking clinical decision making in a participatory way to the right research methodology, research can be generated that is fit for improving patient outcomes. However, it notes that more focus is needed on reducing health inequalities by conducting research in deprived areas and addressing the unmet health needs of vulnerable populations.

1. Improving Comparative Effectiveness Research
New methodological standards focus on quality and relevance of
research to patients.
Introduction
How can we make research more patient-centred? This is an exemplar of the
sort of research question that might help researchers’better address patient-
centred outcomes.
Reference– Tunis R., 2012.Improving Comparative Effectiveness Research.BMJ,
4th August, vol 345 pp. 10
Précis of Article
The driver for this joined-up thinking comes from the Supreme Court of the
United States after it affirmed ‘The Affordability Act’ as being constitutional.
Now the American and UK health services are seeking to design services to
meet the needs of specific populations of patients. The first aim is to match
the type of research question to a research method most likely to provide a
patient-centred answer. Then it is necessary to ensure that patients,
caregivers, practicing clinicians, healthcare administrators, commissioners, the
commissioning executive (financial accountability) and policy makers remain
engaged with all phases of the research process. It is only when we link clinical
decision making in a participative way to right research methodology that we will
generate research fit for the purpose of improving patient outcomes.
Discussion
This is very encouraging thus far: it is possible to link research methodologies
most likely to answer the patient generated research questions. But there is no
emphasis on the importance of working in deprivation zones to generate
research questions that are designed to reduce the health gap between the
mobile novo-health rich professional classes and the unmet healthneeds of our
aging communities. Here for example,neither patients with complex health
morbiditynor their carers’ arephysically able to access services. In these

2. emerging health ghettos,the high levels of morbidity does not link to the
availability of health professionals to meet unmet health need. Unless health
policymakers focus on the delivery of services to patients with long-term
conditions, then we can never create a health service truly free at the point of
need. Yet we are only two steps away from achievingthis utopian dream:
1. Patients must be able access to services in an equitable way
2. The leadership of our health services has to be provided from the
bottom-up.
Health policymakers’will have learned to listen to the people who are the most
vulnerable within our society and thereafter will work with them to create novo-
health policy fit for a new age.
Nigel Roper