Developing a multidisciplinary model of comparative effectiveness research within a clinical and translational science award

Abstract

The Clinical and Translational Science Awards (CTSAs) were initiated to improve the conduct and impact of the National Institutes of Health's research portfolio, transforming training programs and research infrastructure at academic institutions and creating a nationwide consortium. They provide a model for translating research across disciplines and offer an efficient and powerful platform for comparative effectiveness research (CER), an effort that has long struggled but enjoys renewed hope under health care reform. CTSAs include study design and methods expertise, informatics, and regulatory support; programs in education, training, and career development in domains central to CER; and programs in community engagement.Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center have entered a formal partnership that places their CTSA at a critical intersection for clinical and translational research. Their CTSA leaders were asked to develop a strategy for enhancing CER activities, and in 2010 they developed a model that encompasses four broadly defined "compartments" of research strength that must be coordinated for this enterprise to succeed: evaluation and health services research, biobehavioral research and prevention, efficacy studies and clinical trials, and social science and implementation research.This article provides historical context for CER, elucidates Einstein-Montefiore's CER model and strategic planning efforts, and illustrates how a CTSA can provide vision, leadership, coordination, and services to support an academic health center's collaborative efforts to develop a robust CER portfolio and thus contribute to the national effort to improve health and health care.

Figure 1

The integrated model for comparative effectiveness research at the Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center.

Figure 2

Programs linked to comparative effectiveness research at the Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center. The dotted box indicates the Einstein-Montefiore Institute for Clinical and Translational Research (ICTR). All components that are completely within the ICTR appear within the dotted box (e.g., the Center for Public Health Sciences), and those that are separate but related entities are partially contained by the box (e.g., the Office of Community Health).

Figure 3

A timeline of institutional activities related to comparative effectiveness research development at the Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center