National Academy of Medicine

Assessing the Population Impact of Published Intervention Studies

By Catherine Chanfreau-Coffinier, Steven M. Teutsch, Jonathan E. Fielding
June 23, 2015 | Discussion Paper

Not only does the United States spend more per capita on medical care than any other nation, and more than twice as much as the average for all other countries in the Organisation for Economic Co-operation and Development, it spends more on medical research as well. Yet despite the high level of spending, our health outcomes are mediocre at best; the United States ranks 26th in life expectancy and 31st in infant mortality among developed nations. This discrepancy raises the question about the value derived from the governmental and nongovernmental investments in medical research. In contradistinction to basic science research, for which the goal is arguably to advance science for the development of knowledge, translational science seeks to improve health through the development of bench-to-bedside interventions and to assure their use in patients and populations that would benefit from them. To improve health measurably, translational research needs to focus on identifying interventions that are likely to provide the greatest population health benefit as well as interventions that are widely used but are ineffective or harmful. In a prior paper we proposed a set of criteria for researchers, funders, journal editors, and consumers of research to assess the importance and value of studies on health interventions—to answer the “so what” question. Those criteria include the burden of disease (quality-adjusted life years [QALYs] lost due to the condition), the preventable burden (how much health burden could be alleviated if the intervention were successful), the economic value (cost and cost-effectiveness), and the additional information gained from the study (e.g., sufficient information to change an evidence-based recommendation).

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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.