Comparative effectiveness research in Ontario, Canada: producing relevant and timely information for health care decision makers

Milbank Q. 2009 Sep;87(3):585-606. doi: 10.1111/j.1468-0009.2009.00572.x.


Context: Comparative effectiveness research is increasingly being recognized as a method to link research with the information needs of decision makers. As the United States begins to invest in comparative effectiveness, it would be wise to look at other functioning research networks to understand the infrastructure and funding required to support them.

Methods: This case study looks at the comparative effectiveness research network in Ontario, Canada, for which a neutral coordinating committee is responsible for prioritizing topics, assessing evidence, providing recommendations on coverage decisions, and determining pertinent research questions for further evaluation. This committee is supported by the Medical Advisory Secretariat and several large research institutions. This article analyzes the infrastructure and cost needed to support this network and offers recommendations for developing policies and methodologies to support comparative effectiveness research in the United States.

Findings: The research network in place in Ontario explicitly links decision making with evidence generation, in a transparent, timely, and efficient way. Funding is provided by the Ontario government through a reliable and stable funding mechanism that helps ensure that the studies it supports are relevant to decision makers.

Conclusions: With the recent allocation of funds to support comparative effectiveness research from the American Recovery and Reinvestment Act, the United States should begin to construct an infrastructure that applies these features to make sure that evidence generated from this effort positively affects the quality of health care delivered to patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decision Making*
  • Evidence-Based Medicine*
  • Health Care Reform
  • Health Policy
  • Health Services Research* / economics
  • Humans
  • Ontario
  • Therapies, Investigational
  • United States
  • Workforce