Perspective: The emerging context for advances in comparative effectiveness assessment

The call for an entity for independent assessment and guidance on alternative medical interventions is timely. The emergence of four developments underscores the importance and sets the stage for progress: an improving evidence base; growing recognition of the importance of variation in the effectiveness of treatments across patients; recent emphasis on transparency; and growing adoption of pay-for-performance initiatives. To advance progress on these issues, the Institute of Medicine (IOM) has convened a Roundtable on Evidence-based Medicine. The roundtable is exploring ways to improve the development of evidence, the thoroughness with which it is applied, and the mechanisms for increasing national capacity for the work.