Comparative Effectiveness Research (CER): New Methods, Challenges and Health Implications

Francesco Chiappelli, PhD (Editor)
Division of Oral Biology and Medicine, University of California at Los Angeles School of Dentistry Department of the Health Sciences, California State University, Northridge, CA, US; American Association for the Advancement of Science (AAAS) Fellow (Overseas), Royal Society of Medicine (RSM) UCLA School of Dentistry, CHS 63-090
Center for the Health SciencesLos Angeles, CAUSA
Part-Time Faculty – Biostatistics, Department of the Health Sciences, California State University, Northridge, CA USA

Series: Health Care in Transition
BISAC: MED035000



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Briefly stated, comparative effectiveness research pertains to the direct, succinct and precise comparison of existing healthcare interventions to determine what works best for each individual patient, and which treatment course poses the greatest benefits, costs and harms. The core question of comparative effectiveness research goes beyond establishing what treatment works best, for whom, and under what circumstances: it is a hypothesis-driven endeavor designed to uncover and implement the consensus of the best evidence base for patient-centered, effectiveness-focused and evidence-based health care.

Members at the Institute of Medicine and the Patient-Centered Outcomes Research concur that comparative effectiveness research involves the generation and synthesis of the best available evidence for a treatment intervention by means of a process driven by the PICOTS question/hypothesis, and are directed at comparing and contrasting the benefits, costs and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical conditions with the specified intent of improving the delivery of health care. The purpose of comparative effectiveness research is to assist healthcare providers, patients, allied clinicians, caregivers and other stakeholders to engage together and make informed decisions that will improve healthcare at both the individual and population levels, and in so doing utilize the identified best evidence base in specific clinical settings, a process that the Agency for Healthcare Research and Quality defines as “Translational Effectiveness”.

In brief, comparative effectiveness research is the tool and the process necessary for translational effectiveness. In this light, it is critical and timely to facilitate comparative effectiveness research as one of the essential and primary components of patient-centered, effectiveness-focused and evidence-based clinical decision-making in healthcare, as the premier process that results in improved patient outcomes, enhanced research planning, better products, and novel evidence-based policy development. This book is a compilation of the writings of several experts in the field and their collaborators. Each chapter examines specific facets of the process of comparative effectiveness research-based clinical decision-making in the principal domains of healthcare, which are subsumed in this work as dentistry, Western and alternative medicine, nursing, and pharmacology. Taken together, the chapters in this book present a brief, yet comprehensive overview and discussion of the current state of comparative effectiveness in healthcare.

They establish the central role of systematic reviews in the process of clinical decision-making in evidence-based health care, and examine in depth the statistical significance and the clinical relevance of actualizing and evaluating clinical decision-making. Additionally, policies in optimizing evidence-based, patient-centered and effectiveness-focused clinical outcomes, stakeholders engagement for raising health literacy in the U.S. and worldwide in this decade of the twenty-first century and beyond are discussed.

(Imprint: Nova)



Chapter 1
Methods, Fallacies and Implications of Comparative Effectiveness Research (CER) for Healthcare in the 21st Century
(Francesco Chiappelli, UCLA School of Dentistry, Division of Oral Biology and Medicine, Los Angeles, CA, USA)

Dental Materials & Implantology

Chapter 2
Innovative Fillers for Dental Resin
(Roberto Eggenhöffner, Tercio Terencio, Rosanna Spera, Paola Ghisellini, Cristina Rando, Luca Giacomelli, Department of Surgical Sciences and Integrated Diagnostics, School of Medicine, Genova, Italy)

Chapter 3
Primary Stability Study in Implantology: Correlation of Micromovements to Bone Density and Peak Insertion Torque
(Eugenio Sorrenti, Luca Giacomelli, Roberto Eggenhoffner, Stefano Benedicenti, Department of Surgical Sciences and Integrated Diagnostics, School of Medicine, Genova University, Genova, Italy)

Chapter 4
The use of Mineral Trioxide Aggregate (MTA) in Endodontics
(Viviane Ferreira Guimarães Xavier, Marcelo T. T. Caliman Sato, Juliana Guimarães Xavier, Daniel Guimarães Xavier, Célio Soares de Oliveira Junior, Universidade Vale do Rio Doce, Department of Endodontics, Governador Valadares, MG, Brazil, and others)


Chapter 5
Endodontic Nickel-Titanium Instruments: A CER Approach
(Xenia Maria Caldeira Brant, Marcelo Mangelli Decnop Batista, Francesco Chiappelli, Caio Caldeira Brant Sandy, Michael J. Scianamblo, Avenida dos Andradas, MG, Brazil, and others)

Chapter 6
Single-Visit Endodontics
(Ruy Hizatugu, Gustavo Pazzeto Meneghine, Fernanda Bortolai Martins Vasconcelos, Caio Caldeira Brant Sandy, Department of Endodontics, Escola de Aperfeiçoamento Profissional, São Paulo, SP, Brazil, and others)

Chapter 7
Endodontics: A Conservative Approach Preserving the Functional Pulp in Vulnerable Age Groups
(Claudio Francisco Boiero, National University of Córdoba, Endodonctics Departament, Argentina)

Chapter 8
Comparative Effectiveness Research in Endodontics Pulp Revascularization/Revitalization: Treatment for Immature Teeth with Necrotic Pulps
(Adriana de Jesus Soares, Andrea Cardoso Pereira, Emmanuel João Nogueira Leal da Silva, Alexandre Augusto Zaia, Department of Restorative Dentistry, Endodontics Area, State University of Campinas, Campinas - SP, Brazil, and others)

Chapter 9
Determining Working Length in Endodontics
(Xênia Maria Caldeira Brant, Caio Caldeira Brant Sandy, Ana Carolina Trindade Valadares, Rosane Tavares Rubião da Cunha, Francesco Chiappelli, Avenida dos Andradas, Belo Horizonte, MG, Brazil, and others)


Chapter 10
Comparative Effectiveness of HER2 in Cancer: A Pathology Overview from Diagnosis to Treatment
(Beatriz De Melo Maia, Hermano Martins Bellato, Rafael Malagoli Rocha, Molecular Morphology Department, AC Camargo Cancer Center, São Paulo, Brazil)

Chapter 11
The Challenges of the Dental Treatment Plan Pre and Post Head and Neck Radiotherapy
(Eduardo Fregnani, Ana Cecilia Corrêa Aranha, Fábio Ynoe de Moraes, Sandra de Barros da Cunha, Ecinele Francisca Rosa, Cláudia Joffily Parahyba Moraes, Ana Cristina Aló Nesrallah, Simony Hidee Hamony Kataoka, Gustavo Maluf, Oral Medicine Department, Head, Hospital Sírio-Libanês, São Paulo, SP, Brazil, and others)

Chapter 12
Treatment and Management of Melanoma and Colon Cancer
(Corazon B. Cajulis and Paola De Gregorio, Mount Sinai Medical Center, New York, NY, USA)

Patient-Centered Care

Chapter 13
Impact of Education on Interdisciplinary Patient Teaching Tool by Nurses’ Adherence in an Acute Care Setting
(Angelina C. Begonia, Mount Sinai Medical Center, New York, NY, USA)

Chapter 14
Creating a Barcoding Compliance Database Reporting System
(Kathleen Ann C. Begonia, Mount Sinai Medical Center, New York, NY, USA)

Chapter 15
Clinical Research, Practice Based, Patient Centered and Cost Effective: A Time to Deliver
(António Duarte Sola Pereira da Mata and Duarte Nuno da Silva Marques, Center for Evidence Based Dentistry, Faculty of Dentistry, University of Lisbon, Portugal)

Chapter 16
Low-Level Laser Therapy and Temporomandibular Joint Disorders: A Comparative Effectiveness Approach to Analysis
(Ricardo Viana Bessa-Nogueira, Janaina Andrade Lima Salmos-Brito, Rafael Correia Cavalcante, Polyanna Ataíde Soares, Dental School - Federal University of Alagoas, Av. Lourival Melo Mota, s/n Campus A. C. Simões, Cidade Universitária, Maceió/Al - Brazil, and others)

Chapter 17
Evidence-Based Research and Practice in the Big Data Era
(Janet G. Bauer Susan S. Spackman, Francesco Chiappelli, Loma Linda University School of Dentistry, Loma Linda, CA, USA, and others)

Chapter 18
Your Procedural Outcome was Excellent, but you Lost the Patient
(Susan S. Spackman, Janet G. Bauer, Loma Linda University School of Dentistry, Loma Linda, CA, USA)

Chapter 19
Evidence Based Decision Making in Dentistry Using Artificial Intelligence and Axiomatic Design Principles: Fixed Denture Prosthesis (FDP) or Single Crown Supported on Implant (SCSI): Deciding the Best Treatment Option for Single Missing Tooth
(Mahesh Verma, Gurinder (Gary) Wadhwa, Aditi Nanda, Maulana Azad Institute of Dental Sciences, New Delhi, India; and others)

Chapter 20
Comparative Effectiveness Research in the Pharmacological Treatment of HIV/AIDS: The Immune Reconstitution Inflammatory Syndrome (IRIS)
(Marcela Nogueira, Robertha V. Da Silva Marinho, Isabela Harumi Narumiya, Qyuen Bach, Vandan Kasar, Daniel Khorshad, Francesco Chiappelli, Department of Endodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil, and others)

Chapter 21
Comparative Effectiveness Research: Appropriating the Benefits to Traditional Health Care Referring Ayurveda
(Sanjeev Rastogi, Rashtriya Ayurveda Vidyapeeth, New Delhi, India)

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